Childhood disorders: what they are, types, examples, and intervention methodologies

In this article, psychology expert Rosa Hidalgo Torres explains what childhood disorders are, their types, examples, and intervention methods.

What are childhood disorders?

Childhood neurodevelopmental disorders are a group of conditions that appear at an early age and are characterized by cognitive, behavioral, psychosocial, and neurological deficits.

These childhood disorders are linked to how the nervous system works and appear while the brain is maturing. It is during childhood that difficulties in reaching developmental milestones appear and that impairments in personal, social, and academic functioning occur.

Among childhood disorders, it’s important to distinguish between learning disorders and developmental disorders.

Learning disorders

A functional, specific developmental delay in acquiring certain skills (reading, writing, math, drawing, etc.).

These children have a normal or high cognitive level, and their sociocultural environment is adequate.

Developmental disorders

Impairments in psychomotor, cognitive, language, and emotional development.

They are related to an organic impairment and affect neurological function and the performance of different skills.

Common childhood disorders

Learning disorders

• Dyslexia: problems with reading and writing (reading and writing disorder);
• dyscalculia: problems acquiring number concepts (mathematics disorder) and arithmetic;
• dysgraphia: impaired writing skills due to difficulty remembering and automating the motor movements needed to form letters or numbers;
• dysorthography: an impairment of written language involving difficulties with spelling and writing, with problems recognizing, understanding, and associating sounds with written symbols.

Developmental disorders

• Dysphasia: difficulties acquiring and developing language;
• aphasia: difficulty reading, speaking, understanding, or repeating language due to damage to areas of the brain;
• dyslalia: impaired articulation of phonemes;
• dysglossia: an articulation disorder or malformation of the peripheral speech organs;
• dysarthria: impaired articulation involving an underlying lesion in the CNS;
• stuttering (dysphemia): affects speech fluency;
• dysphonia: voice problems;
• aphonia: voice problems.

Autism spectrum disorders (ASD)

Among childhood disorders, autism is a condition that interferes with communication and social interaction.

It shows up as a restricted and repetitive pattern of interests and activities. The associated symptoms are usually recognizable during the second year of life. The first symptoms are delayed language development, along with a lack of social interaction and unusual play or communication patterns.

Classification of autism symptoms

The DSM-5 (APA, 2014) classifies symptom severity
into three levels according to functioning in the areas of communication and social interaction: 

• Level 1: (requiring support). Deficits in social communication cause significant problems: there are difficulties initiating social interactions. Inflexible behavior makes it hard to switch between activities, and organization and planning problems limit independence.
• Level 2: (requiring substantial support). There are deficits in verbal and nonverbal social communication skills. Initiation of social interactions is limited. Inflexible behavior, difficulty coping with change, and other restricted, repetitive behaviors are common. There is anxiety or difficulty shifting focus.
• Level 3: (requiring very substantial support). There are severe deficits in verbal and nonverbal social communication skills. Initiation of social interactions is very limited, and response to social overtures is minimal. Behavior is inflexible.

How to work with children with autism spectrum disorders (ASD)

For children with autism spectrum disorders (ASD), it’s important to promote personal autonomy and independence, and to develop self-control and social interaction. Spontaneous communication strategies and emotional reciprocity should be encouraged.

It’s important to develop cognitive processes such as attention and memory. 

Teaching in natural settings is more conducive to learning. It’s important to establish daily routines and design situations that encourage communication. Use long pauses and try to create situations in which the child needs help and is able to ask for it. Don’t forget to use simple language and pay attention to the child’s emotional states and how they express them.

One of the therapies that has produced very good results is hippotherapy. In the following article, we explain what hippotherapy is, its principles, and its methodology.

Hippotherapy: what it is, foundations, benefits, and methodology

Other childhood disorders

Attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome share similarities in the brain areas and neurotransmitters involved. Many of the symptoms of ADHD and frontal lobe dysfunction are also found in Tourette syndrome.

But what are these two childhood disorders?

Attention-deficit/hyperactivity disorder (ADHD)

Among childhood disorders, ADHD is caused by an impairment of the prefrontal cortex, affecting executive functions such as working memory, impulse inhibition, organization, and planning.

It shows up through behavioral signs:

• Hyperactivity/impulsivity,
• inattention,
• impulsivity.

According to the DSM-5 (APA, 2014), the disorder is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity. Inattention shows up as wandering off task, lack of persistence, poor organization, and difficulty sustaining attention, which is not due to a lack of understanding. Hyperactivity is excessive motor activity, and impulsivity refers to hasty actions taken without thinking that may put the person at risk of harm.

It can present in three subtypes:

• Predominantly inattentive,
• predominantly hyperactive/impulsive,
• combined presentation.

Symptoms appear before age 12.

How does ADHD develop over time?

• Infancy: babies are restless, insatiable, irritable, and inconsolable, with a higher prevalence of colic (Barkley, 2002; 2006; Miranda et al., 2001);
• up to age two: delays in motor development and speech. Excessive activity for no reason. Attention to objects for very short periods of time. Inappropriate emotional reactions, irritability, and sleep and/or feeding problems (Barkley, 2002; 2006; Miranda et al., 2001);
• ages two to five: excessive motor activity. Difficulty relating to others. Inattention. Problems with emotional regulation and difficulty adapting to school. Problems with sleep/wake cycles, meals, and toilet training;
• school age: disobedience. Between 30% and 60% are defiant or oppositional, especially boys (Barkley, 2002). Problems learning to read and write;
• adolescence: hyperactivity decreases in adolescence, giving way to a subjective feeling of restlessness (Barkley, 1996). Risk behaviors such as addictions, accidents, and dropping out of school appear (Barkley, 2002; Miranda et al., 2001);
• adulthood: significant problems with inattention and poor inhibition. Difficulty resisting distractions, poor regulation, and little self-discipline. Hyperactivity decreases over the years, but these people are often restless and need to stay busy all the time (Barkley, 2000; Wilens and Dodson, 2004).

Among childhood disorders, ADHD has a prevalence of 5% of the population and is more common in boys, since there aren’t many studies on girls, who show less disruptive behavior at school and at home.

A differential diagnosis is needed to rule out other associated comorbid childhood disorders. This requires a multidisciplinary perspective that includes information about the child’s different cognitive, social, family, and school areas.

What does treatment for ADHD involve?

Intervention should take a multidisciplinary approach:

• Medication: the aim is to regulate neurotransmission to reduce symptoms of hyperactivity, impulsivity, and inattention. It should not be used as the first treatment option in children under six. Treatment helps improve school performance, control impulsivity, and reduce motor restlessness.
• Psychotherapy: working with the child on techniques aimed at increasing compliance, developing social and cognitive skills, and improving family and school relationships. The family’s role after therapy has been proven effective. Parent programs in natural settings are the most effective (Delgado, Rubiales, Bakker, and Zuluaga, 2012).
• Psychoeducational: at school, it’s important for these children to work with self-instructions that guide their tasks and with visual reinforcers, as well as to break schoolwork into smaller parts. It’s very helpful for them to sit at the front of the class, near the teacher, who can help and guide them with their work. A smooth relationship with the family should be established in order to adapt and reinforce the desired behaviors and avoid overloading the child with reinforcement activities.

Gilles de la Tourette syndrome

Among childhood disorders, Tourette syndrome affects the basal ganglia and their connections with the cerebral cortex and the limbic system.

It is characterized by multiple motor tics and at least one vocal tic, whether simple or complex, which occur frequently throughout the day.

Tics can include blinking, grimacing, grunting, or throat clearing. The best known is coprolalia (swearing and socially unacceptable language).

The disorder is more common in boys than in girls and has a strong genetic component.

Other associated factors are stress, maternal smoking during pregnancy, and low birth weight.

 There are medication and behavioral treatments, but once diagnosed, the disorder tends to persist throughout life.

In the case of persistent motor or vocal tic disorder, if tics last less than a year, they usually decrease and disappear after a few years.

What to keep in mind with Tourette syndrome in children

Keep in mind that these childhood disorders severely affect these children at school, since the disruption caused by tics, together with attention difficulties, low flexibility, and impulsivity in many activities, contributes to school failure.

In the classroom, these children need to work with techniques and tools that stimulate concentration, and the content of their stage of education should be adapted.

At home, the family should help the child accept the condition. The more naturally those around the child handle the condition, the more naturally the child will face their own reality. We need to give the child the skills that will help them get along better with their peers. We need to work on their ability to sustain attention, build a motivation that guides them and reinforces that attention, and put new resources into practice for managing frustration when things go wrong. 

Conclusions

• Of all the childhood disorders described, the most important thing is always to consider how the child is doing emotionally.
• For a child, the most important settings are their family and their school.
• Keep in mind that each person has a specific level of tolerance, a communication style (passive, aggressive, passive-aggressive, or assertive), and expectations and skills that will determine how strongly the child shows symptoms of distress.
• As the child develops, each family’s parenting style is another factor to consider. Relationships between parents and children should be based on communication, secure attachment, and affection.
• It’s important to work in parallel with the school to establish the child’s educational guidelines.
• It’s the parents who need to ensure their child’s emotional well-being, aware of the situation and firmly motivated to overcome resistance and take on board all the recommendations professionals can give about the childhood disorders they are dealing with at home.
• It’s vital to make parents aware of the need for psychological support for their child, since a low locus of control makes depressive states in the child more likely.

References:

• Brian Sulkes,S (2022) Generalidades sobre los trastornos del aprendizaje. Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry.(Recuperado de: https://www.msdmanuals.com/es-es/professional/pediatr%C3%ADa/trastornos-del-aprendizaje-y-del-desarrollo/generalidades-sobre-los-trastornos-del-aprendizaje?query=trastornos%20de%20aprendizaje)
• Davis A (2021) Padres de Niños con TDAH: Las claves para crecer hijos con atención dispersa, explosivos o con problemas de concentración. Editorial: Freedom Bound Publishing. ISBN : 1646943767
• Ferré Veciana, J.(2008)Desarrollo neurofuncional del niño y sus trastornos. Editorial:Lebon.ISBN:978-84-89963-80-1
• Fisher J (2021) Cómo Crecer y Educar a Niños con Déficit de Atención e Hiperactividad: Estrategias Efectivas para Desarrollar una Mejor Concentración, Control Emocional y Auto Regulación. Editorial: Publish Drive.
• Guillermina Yañez Téllez, M (2016). Neuropsicología de los trastornos del desarrollo. Editorial: El Manual Moderno.ISBN:9786074485660
• Navas Martínez,L;Castejón Costa J.L(2017)Dificultades y trastornos del aprendizaje y del desarrollo en infantil y primaria. Editorial: Club universitario. ISBN: 8416966052
• Parellada, M(2009)TDAH. Trastorno por déficit de atención e hiperactividad. De la infancia a la edad adulta. Editorial: Alianza. ISBN: 9788420682785.
• Robertson, M; Cavanna A(2010)El síndrome de Tourette. Editorial Alianza.ISBN:978-84-206-8318-8
• Semrud-Chikeman,M;Teeter Elison, PA(2011)Neuropsicología infantil.Evaluación e intervención en los trastornos neuroevolutivos. Editorial: Pearson. ISBN:  9788483227152 
• Soler Sarrió, A; Roger Sánchez C.(2020) Niños sin etiquetas: Cómo fomentar que tus hijos tengan una infancia feliz sin limitaciones ni prejuicios. Editorial: Planeta.
• Victorio, C; (2021) Trastornos de tics y síndrome de Tourette en niños y adolescentes.MD, Akron Children’s Hospital. (Recuperado de: https://www.msdmanuals.com/es-es/professional/pediatr%C3%ADa/trastornos-neurol%C3%B3gicos-infantiles/trastornos-de-tics-y-s%C3%ADndrome-de-tourette-en-ni%C3%B1os-y-adolescentes)

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“This article has been translated. Link to the original article in Spanish:”
Trastornos infantiles: qué son, tipos, ejemplos y metodologías de intervención