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Disability Information - Early Childhood Disorders

 Please note that this is not an all-encompassing list of early childhood disorders, diseases and/or developmental delays.  New disorders will be added periodically.

Reactive Attachment Disorder

Childhood Disintegrative Disorder

Separation Anxiety Disorder

Feeding Disorder of Infancy & Early Childhood

Dysthymia or Dysthymic Disorder (Chronic Depression)

Enuresis and Encopresis: Uncontrolled Wetting or Soiling

Early Childhood Autism

Hypotonia

Tomorrow's Child

Tomorrow's Child is your resource for grief support, risk reduction, and community education, leading the effort to provide information and assistance to families and the medical community. The leading causes of infant death in Michigan are: problems related to prematurity and low birth weight, congenital anomalies, accidents, heart disease, and pneumonia. For babies who survive the first month of life, SIDS continues to be the leading cause of death.

 

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 Reactive Attachment Disorder
Reactive Attachment Disorder is characterized by the breakdown of social ability of a child. It is associated with the failure of the child to bond with a caretaker in infancy or early childhood. This can be caused by many factors, ranging from child neglect to the child being hospitalized for severe medical problems. The children may display either indiscriminate social extroversion as they grow older (treating all people as if they were their best friend) or showing mistrust of nearly everyone.  For more information on this topic visit http://www.nlm.nih.gov/medlineplus/ency/article/001547.htm.

 

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 Childhood Disintegrative Disorder
Childhood Disintegrative Disorder strikes children who have developed normally through at least their first two years of life. They then become impaired in at least two of the following major functional areas: social, communication, restricted receptive language, or stereotyped movements. Though the age of onset is later, in the most severe cases, these children can resemble autistic children, although the severity is generally less.  For more information on this topic visit http://www.nlm.nih.gov/medlineplus/ency/article/001535.htm.

 

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 Separation Anxiety Disorder
Separation Anxiety Disorder is a disorder that affects children who are afraid to be separated from the main caretakers in their lives, even to go to a friends house or school. When separated, they are constantly afraid that something horrible will happen to either themselves or to their primary caretaker (they or the caretaker will die, for instance). When the subject of separating is brought up, the child begins to present with somatic symptoms ranging from headaches to nausea and vomiting, with anxiety.  For more information on this topic visit http://www.healthsquare.com/mc/fgmc2420.htm

 

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 Feeding Disorder of Infancy & Early Childhood

Feeding Disorder of Infancy and Early Childhood

 
Definition: A feeding disorder of infancy or early childhood is the failure of a young child to obtain adequate nutrition, which is reflected by weight loss or a failure to gain weight appropriately for development.
Overview, Causes, & Risk Factors

Feeding disorders are diagnosed when the infant or young child appears malnourished and the problem is not caused by a medical condition (such as cleft palate, congenital heart disease, or chronic lung disease), or a mental condition (such as any disorder that causes mental retardation).

The cause of these disorders is often unknown, but they often result from a variety of factors such as poverty, dysfunctional child-caregiver interactions, or parental misinformation about appropriate diet to meet the child's needs.
 

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 Dysthymic Disorder (Chronic Depression)

Dysthymic Disorder is a term for a chronically depressed mood, sadness, or feelings of being "down in the dumps" that occurs for most of the day for at least two years. It is very much like major depression, but symptoms of weight changes and psychomotor symptoms tend to be less severe than with Major Depression.

 
The individual with Dysthymic Disorder may experience any of the following symptoms:

 
Fatigue
Low self-esteem
Eating or sleeping problems
Difficulty concentrating or making decisions
Have feelings of hopelessness
Lathargy
Feelings of inadequacy
Irritability

 
Approximately 75% of individuals with Dysthymic Disorder will go on to develop Major Depression.

 
In children, Dysthymic Disorder tends to occur equally between boys and girls. Children tend to be cranky and irritable and have difficulty socializing and in school. They tend to have a pessimistic view of life.
Dysthymic Disorder is common among first level biological relatives with Major Depression, with approximately 6% of the population developing Dysthymic Disorder at sometime during their life.
 

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 Enuresis and Encopresis: Uncontrolled Wetting or Soiling

Early childhood is a time when a primary developmental task is establishing control over one's own body. Because of the implications for autonomy and for caregivers, there is real pressure to regulate the body's elimination processes. Prolonged difficulties in these areas typically create lowered self-esteem, family strife, and social complications.

 
Enuresis (wetting)
Enuresis refers to uncontrolled wetting beyond the age when most children have stopped (at least age 5). It is much more common among boys than girls, for reasons not well understood. The most common form is bed-wetting while asleep. Most children eventually outgrow this, but some may have problems throughout childhood. There is a clear psychological component, at least for some cases, in that the problems is exacerbated during periods of stress or disruption, and children with other disorders are more vulnerable.

 
When a causal medical condition is absent, the apparent cause appears to be deep sleep in which bladder pressure is not sufficient to wake the child. Medications have been used with some success, usually because the medication has a side-effect of restricting urine flow, but many feel this is inappropriate. In contrast, the most common intervention is the bell pad. The bell pad is a conditioning technique to teach the child to wake up when there is a need to urinate. The child sleeps on a pad consisting of two perforated metal plates, with a cloth insulator between the plates. Each plate is connected to a bell and a battery. When the child begins urination the circuit between the two plates is completed, setting off the bell. This awakens the child abruptly and also stops the urination. The child can then go to the bathroom.

 

Studies reveal that most children are quickly conditioned to wake before bed-wetting, although the relapse rate is somewhat high, requiring a periodic need for additional treatment with some children.

Encopresis (soiling)
Encopresis refers to repetitive failure recognize the need for bowel elimination in a bathroom before soiling or leaking occurs. It is less common than enuresis, but is also more common in males. The factor often cited as casual is that these children seem to have weaker cues regarding the need to eliminate. The cues themselves may actually be less, or the children may simply be less willing to attend to cues. Procedures also exist to push these children toward regular bowel movements (e.g., using schedules and laxatives) which minimize the need to focus on the cues.

 

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 Early Childhood Autism

Specific Behaviors Seen in Infants Can Predict Autism, New Research Shows - Canadian researchers have become the first to pinpoint specific behavioral signs in infants as young as 12 months that can predict, with remarkable accuracy, whether a child will develop autism.
 

Brochure for Health Care Professionals: "Your Next Patient Has Autism..." (PDF; size=247k) - The Education Subcommittee of the North Shore-Long Island Jewish Health System (NSLIJHS) Autism Steering Committee has recently completed work on its first educational initiative. “Your Next Patient Has Autism...” is a trifold brochure developed for the many health professionals – nurses, physicians, technicians and others – who provide services for children on the autism spectrum. It is especially designed for those who only occasionally treat this population. Physical assessment, diagnostic imaging, and a variety of other interventions – both invasive and non-invasive – may induce fear and anxiety in people with autism. Their behavioral responses to such experiences often interfere with needed care and increase the risk of physical and/or psychological trauma. “Your Next Patient Has Autism...” provides caregivers with a brief synopsis of autism together with specific recommendations for managing the special needs of these patients in the context of in-patient or out-patient healthcare. Thanks to Beth Kimmel of ASA-Oakland for suggesting this resource.

 

In Autism, New Goal is Finding it Soon Enough to Fight it - For years, autism was rarely noticed before the age of 2, its symptoms overlooked by busy parents or so subtle that pediatricians missed them. But in the last two years much has changed. Propelled by an explosion of public awareness and growing evidence that early treatment with behavioral therapy can improve a child's chances, scientists have set out to diagnose the disorder as early as possible, and slowly, more children with autism are being identified before they turn 2.

 

New Tool Helps Primary Care Physicians Diagnose Autism Early - A primary care physician caring for approximately 1,000 children in a general practice should expect that approximately three to seven of his/her patients will demonstrate signs of autism spectrum disorder (ASD). ASD appears to be more common than once thought. The reason for this is not yet clear but probably relates to a number of factors, including broader criteria, increasing professional and public awareness of the symptom spectrum, better ascertainment and perhaps a true rise in prevalence.

 

Early childhood autism is a pervasive disorder affecting children from birth (although it usually takes a few months for symptoms to be sufficiently evident for diagnosis). The disorder is well named, in that autism refers to behavior that is unresponsive to the world around the child. The impairment can vary but is usually regarded as severe.

 
Major symptoms include:

Communication deficiencies - these children are especially slow to develop language skills, and often seem to have an aversion to using language; sound may be attractive (e.g., echolalia, breaking glass), but not for the purpose of communicating with others.

 
Preference for sameness - novelty is often reacted to as distasteful, perhaps with temper tantrums; the children makes it clear that a particular environment and regimen is required.

 
Self-stimulation, repetition - highly repetitive, self-stimulatory behaviors, such as watching one's fingers or plate spinning, are common.


Preference for things over people - there seems to be an aversion to other people, especially in the form of physical contact and prolonged social interaction; in contrast, they often enjoy objects, at times in a way that denies the original purpose.

 
Various causes have been proposed. One that was popular for some years was the hypothesis that parents were "emotional refrigerators," thereby creating emotionally unresponsive infants. In fact, studies do confirm that parents are less involved with these children, but it is clear now that this is a reaction to unresponsive infants rather than something the parents brought to their child-raising. Rather, most evidence now points to severe brain pathology as a result of defective genes. Although the disorder is rare, studies of the few cases with twins, as well as instances of multiple cases in a single family, reveal that this may be among the most genetically determined of psychiatric conditions.

 
Various treatments have been tried, often with substantial success. The most successful programs are extremely intensive, relying heavily on completely controlling the child's reinforcement, so that prosocial and communication behaviors can be taught. Long-term studies suggest problems, sometimes severe, can continue into adulthood, although many cases can develop into functioning adults.
 

To learn more about Autism in detail, visit our section on Autism.

 

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 Hypotonia

Hypotonia is an abnormally severe loss of muscle tone. The muscles feel soft and doughy.

 

Click here for a fact sheet on Hypotonia.

 

Learn more about Hypotonia at The Benign Congenital Hypotonia Website.
 

Early Recognition and Intervention is the Key to Recovery for Hypotonia - Benign congenital hypotonia (BCH) is a nonprogressive neuromuscular disorder that is present at birth. Children with BCH exhibit decreased muscle tone with varying degrees of severity. Hypotonia affects many areas of a child’s life leading to developmental delays that include cognitive development.  Through the development of Individualized Family Service Plans, educators improve the chance for success. Early intervention programs are the key to optimal outcomes for children with hypotonia.

 

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