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IDEA DEFINITION

“Specific learning disability” means a disorder in 1 or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.  Such term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

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                                              CAUSES 

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                                              CAUSES 

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Genetic/Hereditary, teratogenic factors (alcohol, cocaine during pregnancy)

Medical factors (premature birth, diabetes, meningitis of mother or offspring)

Environmental factors: malnutrition, poor prenatal healthcare.

Perinatal causes: anoxia, prematurity/low birth weight, prolonged and difficult delivery, trauma caused by medical instruments such as forceps.

Postnatal causes: concussions, head injury resulting from falls or accidents, high fever, seizures.

Biochemical abnormalities

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In 2020–21, the number of students ages 3–21 who received special education services under the Individuals with Disabilities Education Act (IDEA) was 7.2 million, this is the 15 percent of all public school students.
Among students receiving special education services, the most common category of disability was specific learning disabilities (33 percent).

1. At least 1 in every 59 children has one or several learning disabilities.

2. 1 in 5 children in the U.S. have learning and thinking differences such as ADHD or Dyslexia.

3. As of 2021, 2.8 million kids are actively getting services involving special education.

4. 4 million children younger than 18 have learning disabilities in the United States.

5. Children with learning disabilities account for 47% of the total amount of them receiving special education.

6. Kids with learning conditions have a 31% greater chance of being bullied than kids with no disabilities.

7. Boys account for about 66% of children with a learning disability diagnosis.

8. Over 18% of learning-disabled kids drop out of school.

9. The three most common learning disabilities found in American children are ADHD, dyslexia, and dysgraphia.

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Vaccinations

Developing resilience

Education

Testing expectant mothers: analyzing risk factors and screening infants.

Prenatal Care

PKU screening

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Memory difficulties

Written language problems

Oral language difficulties

Poor gross and fine motor skills

Disorders of attention

Hyperactivity

Information-processing problems

Lack of cognitive strategies needed for efficient learning.

Psychological processing deficits

Quantitative disabilities

Reading disorders

Social/emotional challenges

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Shortened assignments

Explicit instruction and guided practice

Extra time

Use visual aids and multi-sensory learning techniques

Using manipulatives and hands-on activities

Testa in a small group setting

·Proactive behavior plan (reminders, warnings)

Instructional and curricular accommodations: reduction or alteration of assignments

Preferential seating (away from distractions)

Visual stimulus (schedules, directions)

Have a daily routine that changes as little as possible.

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Email system allowing students with learning disabilities to connect with each other across the nation.

E-Buddies

Explicit instruction in how to use computers and other communication systems are an important part of curriculum for students with learning disabilities

alternative keyboards, word processing

Internet-based

Audio player and recorders

Speech recognition software

Electronic Math worksheets

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Parent resources for learning disabilities

LD OnLine

Learning Disabilities of America

IDEA Annual Reviews and Learning Disabilities

Learning Disabilities Association of America

NCLD

International Dyslexia Association

Strategies For Teaching Children With Learning Disabilities

Facts About Intellectual Disability

Learning-disabilities-types-causes-symptoms

Childrens books about disabilities

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Parents or caregivers may notice academic problems or other signs of a learning disability in their child and not know where to start. Often this "invisible disability" does not become obvious until a child reaches school age. Even then, difficulties may be subtle and hard to recognize.

Here you will find a wealth of information on understanding learning disabilities, negotiating the special education process, and helping your child and yourself.

Featured Articles & Resources

Specific Learning Disabilities

Related Disorders

Support for Parents

ADD/ADHD

ADHD often begins in childhood and can persist into adulthood. It may contribute to low self-esteem, troubled relationships, and difficulty at school or work.
Symptoms include limited attention and hyperactivity.

Homework Handouts for Parents

Mental Health

Post Secondary Options

Pre-K thru High School

Professional Resources

Special Education Services

Teaching Reading

The LDA Podcast

Your Voice in Washington

Guides & Booklets

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Parents or caregivers may notice academic problems or other signs of a learning disability in their child and not know where to start. Often this "invisible disability" does not become obvious until a child reaches school age. Even then, difficulties may be subtle and hard to recognize.

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                                             IDEA DEFINITION

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                                             IDEA DEFINITION

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Other health impairments can also fall under the umbrella of IDEA’s disability category besides the ones specifically mentioned in the law. The U.S. Department of Education mentions specific other  disorders or conditions that may, in combination with other factors, qualify a child for services under IDEA.

Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child’s educational performance.

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Neurological Dysfunction: anatomical differences and imbalances in brain chemistry.

Envirnmental Factors:

Consumption of drugs and alcohol during pregnancy

Premature birth

Low birthweight

Exposure to toxic environmental metals (e.g., lead, mercury)

Nutrient deficiency in diet

Hostile early childhood experiences like familial conflict or poverty.

Heredity: ADD and ADHD tend to run in families.

ADHD has a high heritability, which means if a parent has been diagnosed with ADHD, it is highly likely that their child would have ADHD as well. Thus, genetics have long been linked to being a risk factor for ADHD. Genetic studies have found that the interaction of more than one gene could be contributing towards the development of ADHD.

Chemical Imbalances

Neo-Natal Activities: Maternal smoking, drug use, and pre-maturity all increase the risk.

Altered Brain Function: Brain scans reveal differences in the structure and brain activity.

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Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and into adulthood.

According to the CDC

The estimated number of children aged 3–17 years ever diagnosed with ADHD, according to a national survey of parents, is 6 million (9.8%) using data from 2016-2019. This number includes

3–5 years: 265,000 (2%)

6–11 years 2.4 million (10%)

12–17 years: 3.3 million (13%).

Boys (13%) are more likely to be diagnosed with ADHD than girls (6%).

Black, non-Hispanic children and White, non-Hispanic children are more often diagnosed with ADHD (12% and 10%, respectively), than Hispanic children (8%) or Asian, non-Hispanic children (3%).

Estimates for ADHD vary by state:

ADHD diagnosis among children aged 3–17 years: State estimates vary from 6% to 16%.

Any ADHD treatment among children with current ADHD: State estimates vary from 58% to 92%

ADHD medication: State estimates vary from 38% to 81%

ADHD behavior treatment: State estimates vary from 39% to 62%

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Complications during pregnancy are associated with ADHD. A healthy diet and avoiding drugs and alcohol during pregnancy may help prevent ADHD child.

Read food labels carefully to avoid colorants and

Protect child from exposure to pollutants and toxins, including cigarette smoke and lead paint.

Limit screen time. Although still unproved, it may be prudent for children to avoid excessive exposure to TV and video games in the first five years of life.

Processed sugars and carbohydrates may affect a child's activity level by rapidly raising blood sugar levels.

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DSM-5 Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development:

Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

2. Often has trouble holding attention on tasks or play activities.

3. Often does not seem to listen when spoken to directly.

4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

5. Often has trouble organizing tasks and activities.

6. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

7. Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

8. Is often easily distracted

9. Is often forgetful in daily activities.

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:

1. Often fidgets with or taps hands or feet, or squirms in seat.

2. Often leaves seat in situations when remaining seated is expected.

3. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

4. Often unable to play or take part in leisure activities quietly.

5. Is often “on the go” acting as if “driven by a motor”.

6. Often talks excessively.

7. Often blurts out an answer before a question has been completed.

8. Often has trouble waiting their turn.

9. Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.

Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).

There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months

Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months.

Because symptoms can change over time, the presentation may change over time as well.

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Children with ADD/ADHD are capable of appropriate classroom behavior, but they need structure and clear expectations in order to keep their symptoms in check.

Implemenet a behavior plan if necessary

Extra time on tests

Flexible seating

Instruction and assignments tailored to the child

Divide big assignments into smaller ones, and allow children frequent breaks.

Write important information down where the child can easily read and reference it.

Remind the student where the information is located.

Positive reinforcement and feedback

Give consequences immediately following misbehavior. Be specific in your explanation, making sure the child knows how they misbehaved.

Allowing breaks or time to move around.

Extra help with staying organized

Limit distractions

Give praise and rewards when rules are. followed.

Give  clear, effective directions or commands.

Create and reinforce routines for homework and chores

Help your child  build relationships, strong social skills and maintain friendship.

Provide a quiet work space

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Word-prediction software

Portable word processors

Audiobooks

Learning Ally Audio-books

Text to speech

Word prediction software

Printed/ electronic calendar

Optical character recognition

Speech recognition software

Talking calculator

Electronic math worksheet

These asistive technology Apps help with  organization, academics: DropTask,  MindX, Ghotit Real Writer and Reader, Notability, Isolator, Time Timer, WordQ

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National Resource Center for ADHD

Assistive-technology-adhd

Parents Overview Learning Disabilities

NIMH » Publications About ADHD

Know Your Rights: Students with ADHD

IDEA vs 504 infographic

Youth/ResourceCenters/ADHD_Resource_Center

Video -Help For ADHD

Understanding-adhd/adhd-fact-sheets

Overview - CHADD

About NRC - CHADD

Teaching-children-with-add-adhd

Families and

Books about ADHD

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Centers for Disease Control and Prevention

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Deciding if a child has ADHD is a process with several steps. This page gives you an overview of how ADHD is diagnosed. There is no single test to diagnose ADHD, and many other problems, like sleep disorders, anxiety, depression, and certain types of learning disabilities, can have similar symptoms.

If you are concerned about whether a child might have ADHD, the first step is to talk with a healthcare provider to find out if the symptoms fit the diagnosis. The diagnosis can be made by a mental health professional, like a psychologist or psychiatrist, or by a primary care provider, like a pediatrician.

The American Academy of Pediatrics (AAP) recommends that healthcare providers ask parents, teachers, and other adults who care for the child about the child's behavior in different settings, like at home, school, or with peers. Read more about the recommendations.

The healthcare provider should also determine whether the child has another condition that can either explain the symptoms better, or that occurs at the same time as ADHD. Read more about other concerns and conditions.

How is ADHD diagnosed?

Healthcare providers use the guidelines in the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth edition (DSM-5), to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities can also help determine how many children have ADHD, and how public health is impacted by this condition.

DSM-5 Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity- impulsivity that interferes with functioning or development:

1. Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

Often has trouble holding attention on tasks or play activities.

Often does not seem to listen when spoken to directly.

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

Often has trouble organizing tasks and activities.

Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted

Is often forgetful in daily activities.

2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person's developmental level:

Often fidgets with or taps hands or feet, or squirms in seat.

Often leaves seat in situations when remaining seated is expected.

Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

Often unable to play or take part in leisure activities quietly.

Is often "on the go" acting as if "driven by a motor".

Often talks excessively.

Often blurts out an answer before a question has been completed.

Often has trouble waiting their turn.

Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.

Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).

There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months

Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months.

Because symptoms can change over time, the presentation may change over time as well.

Diagnosing ADHD in Adults

ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 years or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity.

For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.

Reference

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA., American Psychiatric Association, 2013.

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ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active.

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IDEA DEFINITION

The Individuals with Disabilities Education Act, or IDEA, defines the term “speech or language impairment” as follows:

“(11) Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.” [34 CFR §300.8(c)(11]

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Family history of speech and language delays.

Intellectual disability

Dyslexia

Hearing loss

Stroke

Traumatic brain injury

Syndromes

Cerebral palsy

Failure to thrive

Hereditary versus environmental factors (nature V. nurture)

Neurological disorders

Premature birth

Low birth weight

Hearing loss (frequent ear infections)

Autism

Vocal misuse

Fetal alcohol syndrome

Tumors

Lack of good nutrition

Physical impairments

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By 2019, Speech and language disorders are common in children, with an estimated 4-12% of school-aged children affected.1,2

806,319 children ages 3 through 5 served under IDEA part B. Total served in the category of speech or language impairment  39.9% in the 50 states.

A speech sound disorder affects 10% to 15% of preschoolers and 6% of students.

6,472,061 students ages 6 through 21 served under IDEA part B. Total 16.3% in the category of speech or language impairment, in the 49 states for which data were available.

Less than 20% of students receiving special education services are receiving services for speech and language impairments.

Acoding to the U.S. Department of Education in 2018 Approximately  1,016,000 individual ages 6-21 were identified as having  speech and language impairments.

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Talk, read, and play with your child every day

Children learn sounds and words by hearing and seeing them

Take care of your child’s teeth and mouth

Have the child’s hearing checked

Have the child’s speech screened at a local clinic or school

Prenatal and postnatal effects development

Give the child time to talk

Try not to interrupt the child while he or she is speaking

At risk infants should be referred to an audiologist for hearing test

Have your child tested by a speech-language pathologist (SLP) if you are worried

Language disorders in adults are often caused by brain injury or stroke.

Reduce risk factors for stroke by – stopping smoking – keeping your blood pressure down • Use helmets and seat belts to prevent brain injury.

Limit the exposure to heavy metals

Some disfluency is common, and most of the time, it goes away without treatment.

Do not pay too much attention to avoid a stuttering pattern.

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Speech sound disorders Signs include:

Substituting one sound for another (wabbit for rabbit)

Leaving sounds out of words (winnow for window)

Changing how sounds are made

Stuttering
Many children may stutter sometimes. Signs of stuttering include:

Repeating sounds at the beginning of words (“b-b-bball”)

Pausing while talking – stretching sounds out (“sssssssnake” for “snake”)

Saying “um” or “uh” a lot while talking

Voice disorders Signs include

Voice disorder

Tension in the voice or sounds

Hoarse, breathy, or nasal-sounding voice

Speaking with a pitch that is too high or too low

Talking too loudly or too softly

Easily losing your voice

Language disorders Signs include

Difficulty understanding what others are saying

Difficulty saying words and sentences

having a small vocabulary

Having trouble thinking of words

Inability to express ideas

Inappropriate grammatical patterns

Reduced vocabulary

Inability to follow directions

Difficulty getting others to understand what they are trying to communicate.

Repetition of sounds, words, or parts of words of phrases after age 4.

Making words longer

Eye blinking while talking

Frustration with attempts to communicate

Embarrassment with speech

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Preferential seating

Positive behavior management

Organizational training

Extra time on tests

Give instructions in sequential order

Chunk information into small sentences

Instruction and assignments tailored to the child;

Positive reinforcement and frequent feedback;

Using technology to assist with tasks;

Allowing breaks or time to move around;

Changes to the environment to limit distraction;

Shorten and/or reduce assignments

Use amplification system if appropriate

Use of an interpreter if appropriate

Pre tutor and review vocabulary

Reduce the amount of background noise in the classroom

Provide preferential seating near the teacher

Modify assignments requiring student to make oral classroom presentations.

Discuss Speech concerns with speech language pathologist.

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Audiobooks

Computer text-to- speech

Assistive listening devices

Augmentative and alternative communication devices (AAC)

Alerting devices

More natural synthesized speech

Reminder device

Seat cushion

Fidget toy

Student response systems

Brain-computer interface research

Text to speech software

Optical character recognition

Word prediction software

Portable word processors

Speech to text software

Talking calculator

Electronic math worksheet

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https://www.chop.edu/health-resources/age-appropriate-speech-and-language-milestones

https://www.asha.org/

https://gemiini.org/?msclkid=e661e879fd9018834cf78c68e6f4a23d#

https://www.asha.org/

Speech Or Language Impairments - Project IDEAL

www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/

Speech and Language Impairments | Center for Parent Information and Resources

https://www.parentcenterhub.org/ei-overview/

https://www.parentcenterhub.org/idea-copies/

http://www.entnet.org/content/about-your-voice

http://www.med.umich.edu/yourchild/topics/speech.htm

www.stutteringhelp.org

https://www.ncbi.nlm.nih.gov/books/NBK356270/

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While not every child develops speech and language on the same timetable, the National Institute on Deafness and Other Communication Disorders does provide a list of age-appropriate speech and language milestones for babies and young children.

If you suspect your child is failing behind his peers, consult your child's doctor or schedule a speech and language evaluation for your child.

Milestones related to speech and language

Birth to 3 months

Seems to know your voice and quiets down if crying

​Reacts to loud sounds with a startle reflex

Is awakened by loud voices and sounds

Vocalizes pleasure and displeasure sounds differently (laughs, giggles, coos, cries, or fusses

Makes noise and smiles when spoken to

Responds to sound of rattle

4 to 6 months

Looks or turns toward a new sound

Responds to "no" and changes in tone of voice

Enjoys rattles and other toys that make sounds

Vocalizes back when talked to

Begins to repeat sounds (such as, "ooh," "aah," and "ba-ba")

7 to 11 months

Responds to his or her own name, telephone ringing, or someone's voice even when not loud

Knows words for common things (such as, "cup" or "shoe") and sayings (such as, "bye-bye")

Babbles (says "ba-ba-ba," "ma-ma" or "da-da")

Tries to communicate by actions or gestures

Looks at things or pictures when someone talks about them

Starts to respond to requests (such as, "come here")

Enjoys games like peek-a-boo and pat-a-cake

Makes babbling sounds, even when alone

Imitates simple words and sounds; may use a few single words or baby signs meaningfully

12 to 17 months

Understands simple phrases (such as, "put the ball in the box" or "put the car on the table")

Enjoys being read to

Follows one-step commands when shown by a gesture

Answers simple questions by shaking his/her head or going to get an item when asked

Says two to three words to label a person or object (pronunciation may not be clear)

Tries to imitate simple words

Vocabulary includes four to six words or more

Says more words as each month passes

18 to 23 months

Understands the meaning of action words (such as clap, sit or jump)

Points to some body parts when asked

Understands and answers simple "yes-no" questions (such as, "Are you hungry?")

Understands "not now" and "no more"

Chooses things by size (such as, "big" or "little")

Uses a vocabulary of 50 words, pronunciation is often unclear

Asks for common foods by name

Makes animal sounds (such as, "moo")

Starts to combine words into 2- to 3-word phrases to talk about and ask for things (such as, "more milk")

Begins to use pronouns (such as, "mine")

2 to 3 years

Knows some spatial concepts (such as "in" or "on")

Understands and uses more pronouns (such as, "you," "me" or "her")

Knows descriptive words (such as, "big" or "happy")

Answers many simple questions

Follows two-step commands (such as, "Get your shoes and come here.")

Uses three- to four-word sentences

Uses at least 100 words by 2 years of age

Uses question inflection to ask for something (such as, "My ball?")

Begins to use plurals, such as "shoes" or "socks" and regular past tense verbs (such as, "jumped")

Speech pronunciation is improving, but may still leave off ending sounds; strangers may not be able to understand much of what is said

3 to 4 years

Answers simple questions (such as, "What do you do when you are hungry?")

Groups objects into categories (such as, foods or clothes)

Recognizes colors

Uses 300 to 500 words by 3 years of age

Describes the use of objects (such as, "You eat with a fork")

Has fun with language; enjoys poems and recognizes language absurdities such as, "Is that an elephant on your head?")

Expresses ideas and feelings rather than just talking about the world around him

Uses verbs that end in "ing" (such as, "walking" or "talking")

Uses most speech sounds, but may distort some of the more difficult or later developing sounds, (such as l, r, s, sh, ch, v, z, th)

Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but tries to say them

Strangers are able to understand much of what is said

4 to 5 years

Answers "why" questions

Lists items that belong in a category (such as, animals or vehicles)

Understands more abstract spatial concepts (such as, "behind" or "next to")

Understands complex questions

Uses some irregular past tense verbs (such as, "ran" or "fell")

Describes how to do things (such as, painting a picture)

Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words (such as, "hippopotamus")

5 years

Understands time sequences (such as, what happened first, second, or third)

Carries out a series of three directions

Understands rhyming

Engages in conversation

Produces sentences that can be eight or more words in length

Uses compound and complex sentences

Describes objects

Uses imagination to create stories

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Age-Appropriate Speech and Language Milestones

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While not every child develops speech and language on the same timetable, the National Institute on Deafness and Other Communication Disorders does provide a list of age-appropriate speech and language milestones for babies and young children. If you suspect your child is failing behind his peers, consult your child's doctor or schedule a speech and language evaluation for your child.

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(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.

(ii) Autism does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in paragraph (c)(4) of this section.

(iii) A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria in paragraph (c)(1)(i) of this section are satisfied.

The American Psychiatric Association (APA) characterizes autism spectrum disorder as persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills for developing, maintaining, and understanding

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More research is needed there is a lot of debate about it. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD. Some causes may be:

Genetic predispositions or chromosomal conditions

Medical condition like Fragile X Syndrome and tuberous sclerosis

Genetics

Brain Development

Environmental variables such as perticides

Pharmaceuticals

Parental Age

Family history

Severe infections such as meningitis or encephalitis that result in brain damages

Complications or infections during pregnancy

Complications at birth

Being exposed to toxins in the environment before and after birth.

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An estimated 3.5 million individuals in the U.S. have autism spectrum disorders.

The rate of autism in the U.S. went from 1 in 150 in 2000 to 1 in 100 in 2022.

About 1 in 44 children has been identified with autism spectrum disorder (ASD) according to estimates from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network.

ASD is reported to occur in all racial, ethnic, and socioeconomic groups.

ASD is more than 4 times more common among boys than among girls.

According to U.S. Department of Education in 2018 there were  almost 76,750 preschoolers identified with ASD, representing 10.1 percent of all youngsters with a disability.

In 2019  806,319 children ages 3 through 5 Total served in the category of autism 11.8% in the 50 states.

There were 6,472,061 students ages 6 through 21 served Total 11.0% in the category of autism, in the 49 states.

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Autism cannot be entirely prevented or cured, but there are ways that a woman can reduce the chances of their child being diagnosed.

Get vaccinated before pregnancy

Live healthy

Get existing conditions treated

Seek treatment for existing health conditions

Airborne toxins: reduce exposure to pollution from cars and trucks

Autism rates are 15 percent higher in children born to mothers in their 40s and 66 percent higher for fathers over 50

Early diagnosis helps to find treatment and/or intervention

Avoid drinking alcohol, smoking or doing drugs

Access to clean water

Switching to green personal care products

Maintain a relaxed environment

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Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. People with ASD often have problems with:

Social communication and interaction

Restricted or repetitive behaviors or interests

Concentration and attention: hyperactivity, short attention span, impulsivity, stimulus overselectivity

Anxiety Disorders: self-injurious behaviors,

Excessive scratching or rubbing

Gastrointestinal issues (for example, constipation)

Rigid, repetitive behaviors

Delayed language skills

Delayed movement skills

Sleeping disorder

Limiting diet to a few foods, eating inedible items

Obsessive-compulsive disorder.

Affective Disorders:abnormalities of mood or affect (giggling or crying for no apparent reason)

Bed-wetting

Depression, suicidal ideation.

Learning Difficulties: uneven achievement, impaired executive functioning, poor reading comprehension, inadequate receptive/expressive language skills.

Attention difficulties

Avoiding direct eye contact

Delayed speech and language skills

Affective or mood disorders

Sensiblity to noise, light and textures

Challenges with nonverbal cues such as gestures or body language

Experiencing stress when routines change

Difficulties with social interactions

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Predictable daily routines

Verbal instructions accompanied with visual instructions or physical demonstrations

Allow sensory breaks as needed

Implementation of sensory materials

Implementation of Social stories

Limit distractions

Special seating/flexible seating as needed

Check for understanding

Peer menntors

Make sure fidgets and other small sensory items meet the student’s needs.

Incorporate sensory tools,avoid overload.

Support social skills practice

Have a behavior plan in place

Visual schedules and routines

ABA teaching style

Treat students as individuals

Each student requires different forms of assistance.

Simple adjustments and modifications can allow students access.

Preferential seating

Wait time

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Fidget toys

Sensory toys

Sensory balls

Picture boards

Social skills cards and games

Social skills videos

Earplugs

Aut2Speak

Proloquo2Go

Autism iHelp

Communication folder/board

Augmentative and alternative communication (AAC),

Computer-assisted instruction(CAI)

App story maker

Speech to text apps

Text to speech apps

Visual Schedule

Cushion/ wiggle  seats

Time management apps

Digital reminders

Text to speech tools

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Best sports with Autism

National Professional Development Center on Autism

Very well Health

Autism Speaks

DIR / Floortime

Best-sports-for-kids-with-autism

Apps for Autism

Autism National Committee

Association for Science in Autism Treatment

Autism Science Foundation

Books for Children with Autism

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Mild autism is an unofficial term commonly used to refer to a diagnosis of autism spectrum disorder level 1. Mildly autistic people have less noticeable traits (that they often mask) and have low support needs. However, challenges can include social interaction, reading social cues, understanding body language, and deciphering facial expressions.

Because these traits can be subtle, mild autism is often missed during early intervention screenings in childhood. As a result, people with the condition tend to be diagnosed at an older age, possibly adulthood.

This article discusses mild autism in adults and children. It describes traits of autism with low support needs, how they are often overlooked, and how they may eventually be diagnosed.

What Are Traits of Mild Autism?

The term "mild autism" can be confusing unless you know that autism is a spectrum disorder with traits that range from the least to most intense.

Autistic people with mild traits, those with intense challenges, and autistic people in between are all diagnosed with ASD. However, their diagnoses are further classified by level. There are three, each of which is defined by the amount of support a person may need.

Level 1 autism describes people who need the least support for the activities of daily life. This is what some call mild autism.

In general, people with ASD have challenges with social communication, usually resist changes in their routine, and can be hypersensitive to noise, smell, touch, and other sensory experiences.

Autistic people with low support needs may have advanced academic abilities, but struggle with social skills, sensory challenges, or organization. Children and adults can exhibit different signs.

Support needed for a person with level 1 autism might include:

Building self-control

Controlling emotions

Being flexible

Developing back-and-forth communications skills

Understanding non-verbal communication

Reducing anxiety

How much support autistic people with mild traits need depends on many factors and varies from person to person, even though they have the same level-1 diagnosis.

Also Known As

Mild Autism Traits in Children

Autistic children with low support needs can have many neurotypical behaviors. When traits do appear, they can be slight and easy to overlook, or considered simple differences in personality or temperament.

Doesn't make eye contact: Autistic kids may seem very shy and look away from people when speaking or being spoken to, either often or consistently.

Seems distant: They can sometimes seem to be "in their own world" and may not seem to hear people who are speaking to them.

Attached to routine: A specific way of doing things often brings feelings of security. Any change to this routine can cause them to react in an emotional way.

Limits in adapting to change: Age-appropriate schoolwork or tasks may not be problematic, but a child may have a hard time changing activities or trying new ways of doing something.

Difficulty seeing another's perspective: It may be hard for an autistic child to understand what other people are thinking or feeling.

Challenges adjusting to different social situations: Autistic children might become upset in new social situations and not understand social "rules" and expectations.

Trouble developing and maintaining relationships: Autistic children often struggle with imaginative play, making friends, or sharing interests.

Repeating the same actions, activities, movements, or words: Autistic children may line up objects or do other activities over and over again, even if there is no obvious reason for doing so.

Limited range of interests, but in-depth knowledge: An autistic child might only care about a few things, but they'll know everything there is to know about them.

Extremely sensitive or indifferent to sensations: An autistic person can be extremely sensitive (hyperreactive) to the feel of material on their skin, be unable to stand loud noises, or have strong reactions to other sensory experiences. Others may not notice changes in sensation (hyporeactive), such as extreme heat or cold.

Some of these traits may be more obvious than others. It's also important to consider that autism traits and their expression can be affected by the child's location (e.g., at home or school), as well as who is with them (e.g., friends and family or strangers).

Autism traits may become more obvious as a child gets older. For example, an autistic preteen might be unable to keep up socially with their peers. This isn't always the case, however.

Mild Autism Traits in Adults

Autistic people with low support needs may not receive a diagnosis until they become adults-or at all. Signs of autism in adults may be difficult to see because autistic people with mild traits often adopt coping skills to suppress these traits, making them less obvious.

Some autism traits in adults include:

Difficulty relating to others: You may have a hard time putting yourself in "other people's shoes."

Difficulty making and maintaining friendships: Autistic adults have trouble understanding and following social rules, and can sometimes be seen as "rude" or inconsiderate. This can make it difficult to establish and maintain friendships.

Challenges with back-and-forth communication: An autistic person can find it hard to hold a conversation and use or understand body language, eye contact, and facial expressions.

Trouble expressing yourself verbally: You may say things that seem blunt, or have trouble describing what you are thinking or feeling.

Strong need for planning and routine: Autistic adults like structure and may have a rigid routine. They may have a need to plan out the details of everything they do.

Disliking change: Change can make an autistic adult feel very uncomfortable or emotional.

Experiencing anxiety in social situations: You might have difficulty adjusting to a new social situation or to situations where there is a lot of sensory input, such as a crowded store.

Having intense interests in very specific subjects: Autistic adults can become "hyperfixated" on certain subjects or activities.

Can an Autistic Person Have a "Normal" Life?

Why Mild Autism Traits May Go Undiagnosed

Autistic people with low support needs are more likely to fly under the radar and not be diagnosed until they are older. There are several reasons for this, some of which include their sex, how they adopt masking strategies, the difficulty with diagnosis, and more.

Assigned females are more likely to have mild autism traits that go undiagnosed until they are older. Autistic girls are less likely to engage in repetitive behaviors and don't act out as much as autistic boys.

They're also more likely to be seen as shy and withdrawn. If caregivers and teachers consider these behaviors "expected" for girls, it can contribute to the delay in autism diagnosis.

Masking and Coping Skills

Masking is when someone suppresses or covers up autism traits in order to "fit in" better with those around them. Examples of this include imitating the way others speak or carry themselves, and practicing statements before saying them.

Autistic people with low support needs are often better able to mask their autism traits than those with intense traits and high support needs. They can be successful in their efforts, though this usually ends up causing distress.

Autistic people with low support needs also tend to adopt coping skills to help them in settings like school and work. For example, a child may fidget with something under their desk throughout the day to feed their need for stimulation. This may go unnoticed or not be paid much mind if it is.

Difficulty With Diagnosis

Autism with low support needs can be hard to diagnose in anyone. But since children typically have several grown-ups monitoring them (caregivers, teachers, coaches, healthcare practitioners, and so on), getting to the point where an evaluation is actually done may be harder for autistic adults.

Usually, a person will need to see a psychologist or psychiatrist who specializes in adult autism. This might not happen if someone is unaware they are exhibiting signs or they do not want to acknowledge them.

Misdiagnosis

Sometimes an autistic person with mild traits may get a diagnosis-just not an autism diagnosis.

Autistic adults with low support needs may have been previously misdiagnosed with:

Anxiety

Depression

Obsessive-compulsive disorder

Psychosis

Personality disorders

Other neurodevelopmental disorders

These mental health diagnoses in adults with undiagnosed autism may actually be a sign of autistic burnout.

What Is Autistic Burnout?

How Mild Autism Is Diagnosed

Pediatricians, school staff, and parents may notice mild autism traits in a child that prompt an evaluation. This is done by an ASD specialist such as a child psychologist, child psychiatrist, pediatric neurologist, or developmental pediatrician.

Adults who may have autism must be evaluated by a psychologist or psychiatrist, but this requires them to take the initiative to make that appointment.

Diagnosing Mild Autism Traits in Children

The specialist will go over your child's medical and developmental history. Your child's intelligence, behavior patterns, and social and communication skills can be tested.

Tests used to help diagnose autism can include:

If your child is in school, you can also inquire about having your child evaluated through the school district.

Diagnosing Mild Autism Traits in Adults

The process of getting an autism diagnosis as an adult can be difficult and may vary from provider to provider.

Your healthcare provider will likely assess you based on:

Their observations about your autism traits

Your own observations about your autism traits

Screening questionnaires such as the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R)

Support services for autistic adults can be lacking, and many people have strong emotions after being diagnosed.

Mild Autism and Treatment

The recommended treatment for autistic people with low support needs usually depends on age. Autistic children and teens need support that differs from what autistic adults need.

As with any level of ASD, the most helpful treatments for autistic people with low support needs often involve a variety of therapies. The type of support that's needed, as well as how much is needed, may change over time.

Treatments for Children

Autistic children often need a very structured routine. Their caregivers can work with a team of professionals to ensure their child has the support they need at school and at home.

An education plan that's tailored to an autistic child's needs is also necessary. They may also benefit from:

Possible treatments for autism with low support needs include:

Behavioral therapy: This type of therapy uses rewards to teach autistic children expected or preferred behaviors.

Play or developmental therapy: This therapy uses play-based activities to build an autistic child's emotional and communication skills.

Speech therapy: Speech therapy for autistic children with low support needs is usually focused on conversation skills and learning to understand body language.

Occupational therapy: Occupational therapy is often helpful for sensory challenges that many autistic children face.

Physical therapy: Many autistic children have low muscle tone and struggle with physical activities.

Specific condition treatment: Autistic kids also need to be treated for any other physical or mental health conditions they have. For example, seizures, gastrointestinal disorders, sleep disorders, anxiety, and obsessive-compulsive disorder commonly co-occur with autism.

Treatments for Adults

Structure and predictability are also important for autistic adults. Examples of what this might include are:

Accommodations at work, such as scheduled breaks, written (rather than verbal) instructions, and earplugs or headphones to reduce sensory overload.

Cognitive behavioral therapy (CBT) to develop coping skills, which in turn helps them manage relationships and deal with frustrations at work and in life.

Occupational therapy that focuses on problem-solving skills, building self-esteem, managing sensory challenges, and taking charge of home and finances.

Speech therapyto help build communication skills and the ability to interpret body language.

As with autistic children, autistic adults also need treatment and support for any other conditions they have-for example, going to therapy or taking medication to help them cope with anxiety.

Mild autism is diagnosed as level 1 autism spectrum disorder. It means a person does not have intense autism traits and needs a lower level of support than other autistic people often do.

Autistic people with low support needs still have a hard time communicating and interacting with others. They can also find it difficult to change their routine and can be sensitive to sounds, pain, tastes, or other sensations. But generally, they are able to carry out the tasks of daily living well.

There's no separate diagnosis for mild autism, but providers may develop a treatment plan to align with level 1 autism traits and support needs.

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Could You or Your Child Have Mild Autism?

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Autistic people with lower support needs are often overlooked. Learn these mild autism traits and how to get diagnosed.

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(i) Emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems.

(ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this section.

There are different types of emotional disturbance: anxiety disorders, bipolar disorders, conduct disorder, eating disorders, obsessive-compulsive disorders and psychotic disorders

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Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.

Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression and other emotional disorders.

A history of mental illness in a blood relative, such as a parent or sibling

Heredity (bipolar disorder, schizophrenia, obsessive-compulsive disorder,  and Tourette Syndrome)

Stressful life situations, such as financial problems, a loved one's death or a divorce

An ongoing (chronic) medical condition, such as diabetes or infections

Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head

Traumatic experiences, such as military combat or assault

Use of alcohol or recreational drugs

A childhood history of abuse or neglect

Few friends or few healthy relationships

A previous mental illness

Diet/ Poor nutrition

Biological and environmental issues

Lead poisoning

Poor nutrition

Exposure to toxins

Intrauterine exposure to alcohol, illicit drugs, or cigarette smoke

Family functioning: violence and dysfunction in the home

Abuse

A failure to develop trust during infancy and early toddlerhood, resulting in fear and mistrust.

Failure to experience a sense of competence, which leads to feeling of inferiority during  the elementary years.

Significant chronic stress

High levels of negativity and pessimism in the home.

Associating punishment for  behavior problems with receiving more attention.

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In 2019 there were 806,319 children ages 3 through 5 served under IDEA part B. served in the category of emotional disturbance 0.4% in the 50 states.

There were 6,472,061 students ages 6 through 21 served under IDEA part B. Total  5.5% in the category of emotional disturbance.

According to the CDC (centers for disease control and prevention), approximately 8.3 million children (14.5%) aged 4-17 years have parents  who have talked  about the child’s emotional or behavioral difficulties.

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There's no sure way to prevent mental illness. However, if you have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control.

Pay attention to warning signs, get routine medical care, get help when you need it, take good care of yourself. Follow these steps:

Work with the doctor or therapist

Don't neglect checkups or skip visits to primary care

Mental health conditions can be harder to treat if waiting until symptoms get worse

Get sufficient sleep

Maintain a healthy diet

Regular physical activity

Reducing overrepresentation

Healthy pregnancy care

Teach strong social skills

Establish and maintain positive relationships

School based interventions:

Primary Prevention:
school wide social skills training programs, and specific setting systems, reduce the incidence.

Secondary Prevention:
targeting  selected at-risk groups aiming to reduce the prevalence. Minimize the possibility that students at high risk will engage in misbehavior.

Tertiary Prevention:
the most intensive level of prevention, designed for individual students: individual counseling, individually tailored self monitoring program spreserve functional adaptations and the wellbeing of the person,as well as to avoid relapses.

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Feeling sad or down

Confused thinking or reduced ability to concentrate

Excessive fears or worries, or extreme feelings of guilt

Problems with alcohol or drug use

Major changes in eating habits

Hyperactivity (short attention span, impulsiveness)

Aggression or self-injurious behavior (acting out, fighting)

Withdrawal from friends and activities (not interacting socially with others, excessive fear or anxiety)

Immaturity (inappropriate crying, temper tantrums, poor coping skills)

Learning difficulties (academically performing below grade level)

Extreme mood changes of highs and lows

Significant tiredness, low energy or problems sleeping

Detachment from reality (delusions), paranoia or hallucinations

Inability to cope with daily problems or stress

Trouble understanding and relating to situations and to people

Sex drive changes

Excessive anger, hostility or violence

Suicidal thinking

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Psychological and counseling services

Movement breaks as needed

Small group

Establish clear rules

Provide a warmth classroom environment

Schedule routine opening and closing activities each day

Use graphic organizers, semantic maps, guided notes, and study guides.

Reduced/shortened assignments

Text to speechSelf-monitoring strategies checklis

Positive behavior strategies

Consistent praise

Provide extra time

Provide clear instructions

Break down tasks into smaller steps

Provide social and emotional lessons

Seek help from your primary care provider

Reach out to the counselor, teacher, close friend or loved one

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Video game

Weighted device

Reward chart

Funmaths.com

Word processing software

Text to speech software

Speech to text

Predictive text software

Self-monitoring

Voice Recognition Software

Vision boards to keep  track of goals

A reminder devices

Voice recognition software

Multi sensory technology programs

Behavior contract/charts

Feeling expression charts

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Parent Resource Center for ED

Music Therapy

Prntexas emotional disturbance support

Mental Health America

National Alliance Mental Illness

Books to learn more about ED

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Links updated, November 2021
This information in Spanish

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. ( 1)

We refer to mental disorders using different "umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness. Beneath these umbrella terms, there is actually a wide range of specific conditions that differ from one another in their characteristics and treatment. These include (but are not limited to):

anxiety disorders;

bipolar disorder (sometimes called manic-depression);

conduct disorders;

eating disorders;

obsessive-compulsive disorder (OCD); and

psychotic disorders.

You may be reading this fact sheet with one of these specific disorders in mind, or you may be looking for information about emotional disturbances in general. In either case, keep reading to find out what different emotional distubances have in common, how they are defined in federal law, and where to find more detailed information on specific disorders.
Quick-Jump Menu
Definition
IDEA defines emotional disturbance as follows:
We've chosen to use the term "emotional disturbance" in this fact sheet because that is the term used in the nation's special education law, the Individuals with Disabilities Education Act (IDEA).

"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems." ( 2)

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. ( 3)

Characteristics

As is evident in IDEA's definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person's physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness of Southern Arizona puts this very well:

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. ( 4)

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:

Hyperactivity (short attention span, impulsiveness);

Aggression or self-injurious behavior (acting out, fighting);

Withdrawal (not interacting socially with others, excessive fear or anxiety);

Immaturity (inappropriate crying, temper tantrums, poor coping skills); and

Learning difficulties (academically performing below grade level).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes

No one knows the actual cause or causes of emotional disturbance, although several factors-heredity, brain disorder, diet, stress, and family functioning-have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. ( 5)

Frequency

Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder. ( 6) Half of all psychiatric illness occurs before the age of 14, and 75% by the age of 24. The most common psychiatric disorders in childhood are anxiety disorders, AD/HD and disruptive behavior, depression and bipolar disorders, and eating disorders. ( 7)

Help for School-Aged Children

IDEA requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child's individual needs associated with the disability-in this case, emotional disturbance, as defined by IDEA (and further specified by states). In the 2016 school year, more than 349,000 children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance. ( 8)

Determining a child's eligibility for special education and related services begins with a full and individual evaluation of the child. Under IDEA, this evaluation is provided free of charge in public schools.
10 Basic Steps in Special Education Questions Often Asked by Parents about Special Education Services Evaluating Children for Disability Developing Your Child's IEP
There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:

A Look at Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let's take a brief look at some of the most common of these.

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

The term "anxiety disorder" is a broad term covering several different disabilities that share the core symptom of irrational fear. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. ( 9)

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. ( 10) They are also highly treatable. Unfortunately, only about 36.9% of those affected receive treatment. ( 11)

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. ( 12)

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. ( 13)

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. ( 14) This may include some of the following behaviors:

aggression to people and animals;

destruction of property;

deceitfulness, lying, or stealing; or

truancy or other serious violations of rules. (15)

Treatment will depend on the child's symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

helping the child learn how to better solve problems, communicate, and handle stress, as well as how to control impulses and anger (what's known as cognitive-behavioral therapy);

family therapy;

peer group therapy (to help better social and interpersonal skills); and

medications (although these are not typically used to treat conduct disorder). (16)

Eating disorders are characterized by extremes in eating behavior-either too much or too little-or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder. ( 17)

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening. ( 18)

Binge eating is also considered an eating disorder. It's characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives. ( 19)

According to the National Eating Disorders Association:

Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder... Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder. ( 20)

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. ( 21)

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. ( 22) Treatment for most people with OCD should include one or more of the following:

therapist trained in behavior therapy;

Cognitive Behavior Therapy (CBT);

medication (usually an antidepressant). (23)

"Psychotic disorders" is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. ( 24) There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling). ( 25)

More about School

As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school. These services can be of tremendous help to students who have an emotional disturbance.

Typically, educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource section at the end of this fact sheet for more information on PBS.) It is also important to know that, within the school setting:

For a child whose behavior impedes learning (including the learning of others), the team developing the child's Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.

Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services available under IDEA and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

Recognizing and Addressing the Impact of COVID-19 | As young people return to in-person schooling in the 2021-2022 school year, they may bring with them the impact of the pandemic's trauma. This makes it essential that schools consider the possibility that many students will need to be re-evaluated to determine if they need additional services, especially behavioral support and mental health services, than they needed prior to COVID-19. Two resources of great relevance to reopening schools and returning students are the following:

Other Considerations

Children and adolescents with an emotional disturbance should receive services based on their individual needs, and everyone involved in their education or care needs to be well-informed about the care that they are receiving. It's important to coordinate services between home, school, and community, keeping the communication channels open between all parties involved.

The Importance of Support

Families often need help in understanding their child's disability and how to address the needs that arise from the disability. Help is available from psychiatrists, psychologists, and other mental health professionals that work in the public or private sector. There is also a network of mental health support operating in every state as well as locally.

To locate systems of support in your community or state, visit the organizations we've listed below. They can connect you with local resources, including support groups that provide connection and understanding, information, referral, and advocacy for those living with emotional disturbance.

There are also support groups available from organizations that address specific mental disorders under the umbrella term of emotional disturbance. See the resources at the end of this fact sheet to identify some of these groups.

Resources of More Information

AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.

AACAP also operates different Resource Centers, which offer consumer-friendly definitions, answers to frequently asked questions, clinical resources, expert videos, Facts for Families, and much more. Visit the Resource Center home page if you are concerned with one of the following:

Anxiety Disorders

Autism

Bipolar Disorder

Conduct Disorder

Depression

Oppositional Defiant Disorder

NIMH | National Institute of Mental Health | NIMH is clearly a source of authoritative information on specific mental disorders. Phone: 1.866.615.6464. TTY: 1.866.415.8051

NAMI | National Alliance on Mental Illness | NAMI is an excellent source of information and connection on mental illness, including the individual disorders mentioned in this fact sheet. NAMI's website and toll-free helpline are available in English and Spanish.

SAMHSA is the Substance Abuse & Mental Health Services Administration. It offers many resources to consumers, including:.

Detailed information on specific emotional disturbances, or related issues such as positive behavior supports, is also available from these sources:

Anxiety Disorders Association of America | https://adaa.org/

Center on Positive Behavioral Interventions and Supports | The PBIS Center provides research-based information on how to provide behavioral supports to children who need them. | https://www.pbis.org

Conduct Disorders | A soft place to land for battle-weary parents
https://www.conductdisorders.com/community/

Encyclopedia of Mental Disorders | http://www.minddisorders.com/index.html

National Eating Disorders Association
1.800.931.2237 | www.nationaleatingdisorders.org

Something Fishy | (eating disorders)
https://www.something-fishy.org

**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
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References

2 | Code of Federal Regulations, Title 34, §300.8(c)(4)(i)

3 | Code of Federal Regulations, Title 34, §300.8(c)(4)(ii)

5 | Ibid.

7 | Ibid.

11 | Ibid.

13 | Ibid.

14 | American Academy of Adolescent and Child Psychiatry. (2013, August). Conduct disorder: Facts for families. Washington, DC: Author. Available online at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Conduct_Disorder_33.aspx

15 | Ibid.

16 | Johns Hopkins Medicine Health Library. (n.d.). Conduct disorder in children. Baltimore, MD: Author. Online at:
https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/conduct_disorder_90,P02560

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Links updated, November 2021 This information in Spanish The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.