1.

​Child: Meaning & Definitions

a)​Biological Definition

●​ A child is defined biologically as a human being in the developmental stage between

infancy and adolescence.
●​ Characterized by rapid growth, dependency on caregivers, and ongoing development of
cognition, emotions, and social skills (De Clercq et al., 2012).

b)​Legal Definition

●​ UN Convention on the Rights of the Child (1989): “A child means every human
being below the age of 18 years, unless under the law applicable to the child,
majority is attained earlier.” (Gran, 2020).
●​ In India:
○​ Child Labour Act (1986): A child is below 14 years.
○​ Juvenile Justice Act (2015): Child means anyone below 18 years.

c)​Sociological View

●​ Childhood is not just a biological stage but a social construct (Lenzer, 2017).
●​ Children actively shape their environments and are not passive recipients of adult control
(Boocock & Scott, 2005).

Life-Span Development

●​ Each of us develop partly like all other individuals, partly like some other individuals,
and partly like no other individuals.
●​ Attention is directed to an individual’s Uniqueness.
●​ As humans, we have all traveled some common paths like —
●​ walked at about 1 year.
●​ Engaged in fantasy play as a young child.
●​ Became more independent as youth.
●​ Through the course, what you will learn or gain — some insight about your own history
— as an infant, a child, an adolescent, or a young adult.
●​ You will discover that the study of life-span development is intriguing and filled with
information about — Who we are, how we came this way, and where our future will
take us.
 Development

●​ A progressive series of changes that occur as a result of maturation and experiences.

●​ Development does not consist merely of adding inches to one’s height or of
improving one’s ability.
●​ Development is a complex process of integrating many structures and functions.
●​ Two essential antagonistic processes in development—

1​- Growth or Evolution

2​- Atrophy or Involution

●​ Both begin at conception and end at death.

●​ In early years growth is predominates, even though atrophic changes can occur as early
as embryonic life.
●​ In latter part of life, atrophy predominates, though growth does not stop — hair
continues to grow, and cell continue to be replaced.

Characteristics of development

●​ Lifelong
●​ Multidimensional
●​ Multidirectional
●​ Plastic
●​ Contextual
●​ Multidisciplinary
●​ It involves growth, maintenance and regulation
●​ Co-construction of biology, culture and individual

Aspects of Development

●​ Biological processes - Changes in an individual’s physical nature.

Examples - Genes inherited from parents.

The development of the brain, heightened weight gains.

Changes in motor skills.

The hormonal changes of puberty.

Cardiovascular decline.

●​ Cognitive processes - Changes in an individual’s thought, intelligence, and language.

Examples - Watching a colourful mobile swinging above the crib.

Putting together two word sentence.

Memorising a poem.

Imagining what it would be like to be a movie star.

Solving a crossword puzzle.

●​ Socio-emotional processes - Changes in an individual’s relationships with other people,

emotions, and personality.

Examples - An infant’s smile in response to parent’s touch.

Toddler’s aggressive attack on a playmate.

A school-age child’s development of assertiveness.

An adolescent’s joy at the senior prom.

Affection of an elderly couple.

 Periods of development

●​ Prenatal Period - Conception to birth

●​ Infancy - Birth to 18-24 months
●​ Early Childhood - 2 to 5 years
●​ Middle and late childhood - 6 to 11 years
●​ Adolescence - 10-12 to 18-21 years
●​ Early adulthood - 20s to 30s
●​ Middle adulthood - 40s to 50s
●​ Late adulthood - 60s-70s to death

Developmental issues

●​ Nature versus Nurture - The issue that involves the extent to which development
is influenced by nature and by nurture. The “nature” proponents claims biological
inheritance is the most important influence on development; the “nurture” proponents
claims that environmental experiences are the most important.
●​ Stability versus change - Involves the degree to which early traits and
characteristics persist through life or change.
●​ Continuity versus discontinuity - The issue regarding whether development involves
gradual, cumulative change (continuity) or distinct stages (discontinuity).

Evaluating developmental issues

Most life-span developmentalists acknowledge that development is not all nature or all nurture,

not all stability or all change, not all continuity or all discontinuity. Nature and nurture, stability

and change, continuity and discontinuity characterise development throughout the human life

span.

Theories of Development

●​ Psychoanalytic Theories - Theories that describe development as primarily

unconscious and heavily colored by emotion. Behavior is merely a surface

characteristic, and the

symbolic workings of the mind have to be analyzed to understand behavior. Early

experiences with parents extensively shape development.

●​ As Freud listened to, probed, and analyzed his patients, he became convinced that their

problems were the result of experiences early in life. He thought that as children grow

up, their focus of pleasure and sexual impulses shifts from the mouth to the anus and

eventually to the genitals. As a result, we go through five stages of psychosexual

development: oral, anal, phallic, latency, and genital. Our adult personality, Freud (1917)

claimed, is determined by the way we resolve conflicts between sources of pleasure at

each stage and the demands of reality.

 Psychosocial Theory - Erik Erikson (1902-1994)

●​ Erikson said we develop in psychosocial stages, rather than in psychosexual stages as

Freud maintained.

●​ According to Freud, the primary motivation for human behavior is sexual in nature;

according to Erikson, it is social and reflects a desire to affiliate with other people.

●​ According to Freud, our basic personality is shaped during the first five years of life;

according to Erikson, developmental change occurs throughout the life span.

●​ Erikson’s theory, eight stages of development unfold as we go through life. At each

stage, a unique developmental task confronts individuals with a crisis that must be

resolved. These crisis is not a catastrophe but a turning point marked by both increased

vulnerability and enhanced potential. The more successfully an individual resolves each

crisis, the healthier development will be.

8 Stages Of Erikson’s Theory -

 Cognitive Theories

●​ Jean Piaget’s Cognitive Developmental Theory-

●​ Psychoanalytic theories stress the importance of the unconscious, cognitive theories

emphasize conscious thoughts. Three important cognitive theories are Jean Piaget’s

cognitive developmental theory, Lev Vygotsky’s sociocultural cognitive theory, and

the information-processing theory.

●​ Piaget’s theory states that children go through four stages of cognitive development as

they actively construct their understanding of the world.

●​ Piaget based his theory on two biological tendencies: organisation and adaptation.

●​ Humans are designed to organise their experiences in to logical sets of meanings.

Organisation defines how experiences are related to each other. The organisation of

information and experiences makes the human thinking process more efficient.

Adaptation is the tendency to adjust to the environment. It is the process by which

humans match the original experience and the new experience and this may not fit

together.

●​ According to Piaget there are two processes at work in cognitive development:

assimilation and accommodation. Cognitive growth is the result of the constant

interweaving of assimilation and accommodation. Assimilation occurs when we modify

or change new information to fit into our schemas (what we already know). It keeps the

new information or experience and adds to what already exists in our minds.

Accommodation is when we restructure of modify what we already know so that new

 information can fit in better. This results from problems posed by the environment and

when our perceptions do not fit in with what we know or think.

Four Stages -

●​ Sensorimotor Stage (Birth to Age 2 years) - The infant constructs an understanding of

the world by coordinating sensory experiences with physical actions. An infant

progresses from reflexive, instinctual action at birth to the beginning of symbolic thought

toward the end of the stage.

●​ Preoperational Stage (2 to 7 years of age) - The child begins to represent the world

with words and images. These words and images reflect increased symbolic thinking

and go beyond the connection of sensory information and physical action.

●​ Concrete Operational Stage (7 to 11 Years of Age) - The child can now reason

logically about concrete events and classify objects into different sets.

●​ Formal Operational Stage (11 Years of Age Through Adulthood) - The adolescent

reasons in more abstract, idealistic, and logical ways.

Sociocultural Cognitive Theory

●​ Lev Vygotsky (1896–1934)

●​ Vygotsky’s theory - A sociocultural cognitive theory that emphasizes how culture and

social interaction guide cognitive development.

●​ In Vygotsky’s theory, children are more often described as social creatures than in

Piaget’s theory. They develop their ways of thinking and understanding primarily through

social interaction. Their cognitive development depends on the tools provided by society,

and their minds are shaped by the cultural context in which they live.
 ●​ The Zone of Proximal Development (ZPD) - Vygotsky’s belief in the role of social

influences, especially instruction, in children’s cognitive development is reflected in his

concept of the zone of proximal development.

●​ Zone of proximal development (ZPD) - Vygotsky’s term for tasks that are too difficult

for children to master alone but can be mastered with the assistance of adults or

more-skilled children. Thus, the lower limit of the ZPD is the level of skill reached by

the child working independently. The upper limit is the level of additional responsibility

the child can accept with the assistance of an able instructor.

●​ Scaffolding - Closely linked to the idea of the ZPD is the concept of scaffolding.

Scaffolding means changing the level of support. Over the course of a teaching session, a

more-skilled person (a teacher or advanced peer) adjusts the amount of guidance to fit the

child’s current performance. When the student is learning a new task, the skilled person

may use direct instruction. As the student’s competence increases, less guidance is given.

Dialogue is an important tool of scaffolding in the zone of proximal development. Vygotsky

viewed children as having rich but unsystematic, disorganised and spontaneous concepts. In a

dialogue, these concepts meet with the skilled helper’s more systematic, logical and rational

concepts. As a result, the child’s concepts become more systematic, logical, and rational.

●​ Language and Thought - According to Lev Vygotsky, children use speech not only to

communicate socially but also to help them solve tasks. Vygotsky (1962) further believed

that young children use language to plan, guide, and monitor their behavior. This use of

language for self-regulation is called private speech.

●​ Vygotsky said that language and thought initially develop independently of each other

and then merge. He emphasized that all mental functions have external, or social, origins.
 Children must use language to communicate with others before they can focus inward on

their own thoughts.

●​ Self-talk becomes second nature to children, and they can act without verbalizing. When

they gain this skill, children have internalized their egocentric speech in the form of inner

speech, which becomes their thoughts.

●​ When young children talk to themselves they are using language to govern their behavior

and guide themselves.

●​ For example, a child working on a puzzle might say to herself, “Which pieces should I

put together first? I’ll try those green ones first. Now I need some blue ones. No, that blue

one doesn’t fit there. I’ll try it over here.”

The information-processing theory

●​ George Armitage Miller was one of the founders of the field of psychology known as

cognition. He played a large role when it came to the Information Processing theory. He

researched the capacity of the working memory discovering that people can only hold

up to 7 plus or minus 2 items.

●​ Two other theorists associated with the Cognitive Information Processing Theory are

John William Atkinson and Richard Shiffrin. In 1968 these two proposed a multi-stage

theory of memory. They explained that from the time information is received by the

processing system, it goes through different stages to be fully stored. They broke this

down to sensory memory, short-term memory, and long-term memory.

●​ Information-processing theory Emphasizes that individuals manipulate information,

monitor it, and strategize about it. Central to this theory are the processes of memory

and thinking.
●​ According to this theory, individuals develop a gradually increasing capacity for

processing information, which allows them to acquire increasingly complex knowledge

and skills.

●​ Robert Siegler ,a leading expert on children’s information processing, states that

thinking is information processing. In other words, when individuals perceive, encode,

represent, store, and retrieve information, they are thinking. Siegler emphasizes that an

important aspect of development is learning good strategies for processing

information.

●​ The information-processing approach often uses the computer as an analogy to

help explain the connection between cognition and the brain.

●​ They describe the physical brain as the computer’s hardware, and cognition as its

software. In this analogy, the sensory and perceptual systems provide an “input channel,”

similar to the way data are entered into the computer.

●​ As input (information) comes into the mind, mental processes, or operations, act on it,

just as the computer’s software acts on the data. The transformed input generates

information that remains in memory much in the way a computer stores what it has

worked on.

●​ The information is retrieved from memory and “printed out” or “displayed” (so to

speak) as an observable response.

Behavioural and Social cognitive theories

●​ Behavioural tradition grew the belief that development is observable behaviour that

can be learned through experience with the environment.

●​ The behavioural and social cognitive theories emphasize continuity in development and

argue that development does not occur in stage-like fashion.

Skinner’s Operant Conditioning

●​ According to B.F Skinner - the key aspect of development is behaviour, not thoughts and

feelings. He emphasized that development consists of the pattern of behavioral changes

that are brought about by rewards and punishments.

●​ Through operant conditioning the consequences of a behavior produce changes in the

probability of the behavior’s occurrence.

 ●​ A behavior followed by a rewarding stimulus is more likely to recur, whereas a behavior

followed by a punishing stimulus is less likely to recur.

●​ Examples : when an adult smiles at a child after the child has done something, the child is

more likely to engage in that behavior again than if the adult gives the child a

disapproving look.

●​ Class presentations are daily parts of student life. If a student is praised or

complimented, he/she will be encouraged to do well, but if the student is laughed on or

criticized in front of everyone, the presentation will be nothing more than just a formality

in future.

●​ A child throws a tantrum because he/she didn’t get the candy bar. So, his/her father gets

him one. He/She then stops the tantrum i.e. something unpleasant is avoided, and his/her

father’s behavior of getting candy will increase.

Bandura’s Social Cognitive Theory

●​ Social cognitive theory holds that behavior, environment, and cognition are the key

factors in development.

●​ Bandura emphasizes that cognitive processes have important links with the environment

and behavior. His early research program focused heavily on observational learning (also

called imitation or modeling),which is learning that occurs through observing what

others do.

●​ For example, a young boy might observe his father yelling in anger and treating other

people with hostility; with his peers, the young boy later acts very aggressively, showing

the same characteristics as his father’s behavior.

 ●​ Social cognitive theorists stress that people acquire a wide range of behaviors, thoughts,

and feelings through observing others’ behavior and that these observations play a

central role in life-span development.

●​ Bandura’s most recent model of learning and development includes three elements:

behavior, the person/ cognition, and the environment. An individual’s confidence in

being able to control his or her success is an example of a person factor; strategies are an

example of a cognitive factor.

Ethological Theory

●​ Ethology Stresses that behavior is strongly influenced by biology, is tied to

evolution, and is characterized by critical or sensitive periods.

●​ According to ethologists, the presence or absence of certain experiences has a

long-lasting influence on individuals.

●​ European zoologist Konrad Lorenz (1903–1989) helped bring ethology to prominence.

In his best-known research, Lorenz (1965) studied the behavior of greylag geese, which

will follow their mothers as soon as they hatch.

●​ Lorenz called this process imprinting—the rapid, innate learning that involves

attachment to the first moving object seen.

●​ John Bowlby (1969, 1989) illustrated an important application of ethological theory to

human development. Bowlby stressed that attachment to a caregiver over the first year of

life has important consequences throughout the life span.

●​ In his view, if this attachment is positive and secure, the individual will likely develop

positively in childhood and adulthood. If the attachment is negative and insecure,

life-span development will likely not be optimal.

Ecological Theory

●​ Ecological theory developed by Urie Bronfenbrenner.

●​ Ecological theory emphasizes environmental factors. This theory also known as

theory of Individual and Social Development.

●​ Ecological theory has important implications for understanding life-span development.

●​ Bronfenbrenner’s environmental systems theory that focuses on five environmental

systems: microsystem, mesosystem, exosystem, macrosystem, and chronosystems

Research methods

●​ Longitudinal method: For the study of developmental changes in the same group or

individual, over a period of time, this method is useful. The same individual is tested

at different age group. Example, case study of children behaviour in classroom.

●​ Cross-section Method: A research strategy in which individuals of different ages are

compared at one time. This method helps to get the norms or standards of typical pattern

of development for different age. This is faster and cheaper method than longitudinal

method. It does not loose subject who dropout of the study since the subject are tested

only once. Example for this method is eating behaviour of 5 years old.

●​ Time lag method: This method is studying the development of different age group in

different years to determine the effects of historical events on behaviour. This method

rarely used in developmental psychology, because it takes long time and large numbers of

subjects are required and have to be the same age at the time of testing.

Significant facts about development

●​ Early foundations are critical

●​ Roles of maturation& learning in devt.

●​ It follows a definite and predictable pattern

●​ All individuals are different

●​ Each phase has characteristic behavior

●​ Each phase has hazards

●​ It is aided by stimulation

●​ It is affected by cultural changes

 ●​ Social expectations different for every stage

●​ Traditional beliefs about people in all ages

Prenatal period

Importance of conception

●​ Heredity endowment

●​ Sex

●​ Number of offspring

●​ Ordinal position

Attitudes of prenatal development

●​ Origin of attitudes

●​ Conditions influencing attitudes

●​ Persistence of attitudes

●​ Effects of attitudes on children

●​ Effects of attitudes on family relationship

Hazards during prenatal period

Physical hazards

●​ Conditions influencing physical hazards

●​ Long term effects

●​ Attempt to cope with development irregularities

 Psychological Hazards

●​ Traditional beliefs

●​ Maternal stress

●​ Unfavorable attitudes on part of Significant Others

Overview of Behavioural Problems in Children

●​ Childhood is a critical period where personality, cognition, and emotions develop

(De Clercq et al., 2012).
●​ Behavioral problems reflect the interaction of biological vulnerabilities and
environmental influences (Lenzer, 2017).
●​ Early recognition is crucial to prevent long-term maladaptation.

Childhood is a formative stage of human life marked by rapid physical, cognitive, emotional,
and social development. It is during these early years that children acquire the foundations of
personality, behavior, and coping strategies that influence their later adjustment in school,
family, and society (De Clercq et al., 2012). However, this period is also marked by vulnerability
to developmental and behavioral problems when biological predispositions and adverse
environmental conditions interact.

From a sociological perspective, children are not merely passive recipients of adult socialization
but are active participants in shaping their own worlds (Lenzer, 2017; Boocock & Scott, 2005).
Behavioral problems must therefore be understood not only in terms of individual pathology but
also in relation to social structures, family systems, peer groups, schools, and broader societal
contexts.

Research in developmental psychology highlights that behavioral problems in children can

manifest in different forms:

●​ Neurodevelopmental disorders such as ADHD, Autism Spectrum Disorder, and Specific

Learning Disorders often reflect disruptions in brain development and executive
functioning.
●​ Conduct disorders and antisocial behaviors are frequently linked to family
conflict, inconsistent parenting, and community influences.
●​ Emotional problems like anxiety, depression, and trauma-related disorders (e.g., PTSD)
reflect a child’s struggles to cope with stress, neglect, or adverse life events (Gran,
2020).

The impact of childhood behavioral problems extends beyond the child to families, schools, and
communities. For example, difficulties in concentration or aggression can hinder academic
achievement, peer relationships, and self-esteem, leading to long-term consequences such as
school dropout, unemployment, or adult psychopathology. Thus, early identification and
timely intervention are crucial.

In India, the challenge is magnified by factors such as poverty, malnutrition, lack of awareness,
stigma surrounding mental health, and limited access to child mental health services (Arati
Mann, 2015). Recognizing this, programs such as the Integrated Child Development Services
(ICDS) play a pivotal role in promoting early childhood care, health, nutrition, and psychosocial
development. These services create opportunities for screening, intervention, and family
guidance that can significantly reduce the long-term burden of behavioral problems.

In summary, childhood behavioral problems are not isolated medical issues but multidimensional
concerns shaped by the interplay of biology, psychology, and society. Addressing them requires a
comprehensive and early response, integrating clinical, educational, and community-based
supports, with ICDS serving as a crucial platform in the Indian context.

Etiology of Mood Disorders

The causes of mood disorders can be broadly divided into biological and psychosocial theories.

Biological Theories

The genetic hypothesis suggests that heredity plays an important role in mood disorders. The
lifetime risk for first-degree relatives of bipolar patients is around 25%, while for recurrent
depressive disorder patients it is about 20%. Children of one parent with bipolar disorder have a
27% risk, while the risk increases to 74% if both parents are affected. Concordance rates in twins
further support this, being 65% in monozygotic twins and 20% in dizygotic twins.

The biochemical theory highlights abnormalities in monoamine neurotransmitters, especially

serotonin, norepinephrine, and dopamine. These changes in the central nervous system
contribute to mood disorder symptoms. Decreased norepinephrine is linked with depression,
while increased norepinephrine is associated with mania. The action of antidepressants and
mood
stabilizers provides further evidence for biochemical involvement.

The neuroendocrine theory emphasizes the role of endocrine disorders such as hypothyroidism,
Cushing’s disease (with increased cortisol), and Addison’s disease (with decreased cortisol).
These conditions show a strong association with mood symptoms.

Sleep studies reveal that sleep abnormalities are common in mood disorders. For example,
decreased sleep is seen in mania, while oversleeping often accompanies depression.
Brain imaging studies have shown ventricular dilatation, which is the enlargement of the brain’s
fluid-filled ventricles. Other findings include changes in brain volume, alterations in the white
matter of the brain, and differences in blood flow patterns.

Psychosocial Theories

From a psychoanalytic perspective, depression can arise from the loss of a libidinal object,
fixation in the oral stage of development, or an intense craving for narcissism or self-love.
Stressful life events also play a significant role, as an increased number of stressors can trigger
the onset or relapse of mood disorders, especially when these stressors occur in early
developmental periods.

The cognitive-behavioral theory explains depression through negative cognition and learned
helplessness. Depressed individuals often harbor thoughts such as “I am stupid,” “I am
insignificant,” or “I deserve to die,” which reinforce their depressive state. Learned helplessness
further worsens the condition as individuals begin to feel powerless in changing their situation.
Additionally, anger that is directed inward, or toward oneself, contributes to depressive
symptoms.

Neurodevelopmental disorders

Neurodevelopmental Disorders (NDDs)

Definition:​
Behavioral and cognitive disorders that begin in the developmental period (before 18 years) and cause
significant difficulties in intellectual, motor, language, or social functioning.

Key Points:

●​ Onset is typically before 18 years, even if diagnosis occurs later.

●​ Only disorders with core neurodevelopmental features are included (not secondary deficits
from schizophrenia, bipolar, etc.).
●​ Causes are complex, often genetic or present from birth.
●​ Environmental factors, like lack of stimulation or learning opportunities, may contribute.
●​ Can also result from injury or disease to the CNS during development.

Disorders of Intellectual Development (DID)

Definition:​
 Significant limitations in intellectual functioning and adaptive behavior that begin during the
developmental period.

Essential Features

1.​ Intellectual Functioning Deficits​

○​ Significant limitations in areas such as:

■​ Perceptual reasoning
■​ Working memory
■​ Processing speed
■​ Verbal comprehension
○​ Usually ≥ 2 SD below the mean (~<2.3rd percentile).
○​ Assessed via standardized tests or, if unavailable, clinical judgment.
2.​ Adaptive Behavior Deficits​

○​ Problems in everyday life skills, including:

■​ Conceptual skills: reading, writing, problem-solving, decision-making
■​ Social skills: relationships, social responsibility, following rules
■​ Practical skills: self-care, health, work, recreation, technology use
○​ Also measured with standardized tests or clinical judgment.
3.​ Onset​

○​ During the developmental period (childhood).

○​ Adults diagnosed later can be assessed retrospectively.

Severity Specifiers

Severity is based on intellectual ability + adaptive behavior.

Severity Intellectual & Functioning &

Adaptive Support Needed
Behavior
Mild 2–3 SD below mean Difficulty with
(0.1–2.3 complex
percentile) concepts; mostly
independent in
self-care,
domestic tasks,
work; needs
minimal support.

Moderate 3–4 SD below mean Limited academic

(0.003–0.1 skills; may
percentile) master basic
self-care;
requires
consistent
support for
independence
and employment.

Severe ≥ 4 SD below mean Very limited

(<0.003 language and
percentile) academic skills;
may have motor
impairments;
needs daily
supervised
support; can
learn basic
self-care.

Profound ≥ 4 SD below mean Very limited

(<0.003 communication
percentile) and academic
 skills;
motor/sensory
impairments
common;
requires
constant
supervised care.

Provisional / Global Infants/children <4 Diagnosis given until

Developmental years or cases valid testing can
Delay where be performed.
assessment is
difficult due to
impairments

Notes:

●​ Severity is mainly determined by adaptive behavior across conceptual, social, and practical
domains.
●​ Mild, moderate, severe, and profound distinctions help guide support and care needs.
●​ Provisional DID allows for early identification when assessment is limited.

Autism spectrum disorder

Autism Spectrum Disorder (ASD):

Essential Features

1. Persistent Deficits in Social Communication and Interaction

The person shows ongoing difficulties in initiating and maintaining social communication and
reciprocal interactions, which are beyond what is typical for their age.​
Symptoms vary depending on age, verbal ability, intellectual ability, and severity. Common
manifestations include:

●​ Difficulty understanding or responding appropriately to others’ verbal or nonverbal

communication.
 ●​ Poor integration of spoken language with nonverbal cues (eye contact, gestures, facial
expressions, body language).
●​ Trouble using language in social contexts, including starting or maintaining conversations.
●​ Limited social awareness and inappropriate behavior for the social context.
●​ Difficulty understanding or responding to others’ feelings, sharing interests, and forming peer
relationships.

2. Restricted, Repetitive, and Inflexible Patterns of Behavior

These patterns are clearly unusual or excessive for the person’s age and culture. Common
manifestations include:

●​ Difficulty adapting to new experiences; distress from minor changes or unexpected events.
●​ Rigid routines, such as specific routes, mealtimes, or transport schedules.
●​ Excessive rule-following, especially in games.
●​ Ritualized behaviors, e.g., lining up or sorting objects in a specific way.
●​ Repetitive motor movements, such as rocking, tiptoe walking, unusual hand or finger
movements, or posturing.
●​ Intense preoccupation with specific interests, parts of objects, or particular stimuli; strong
attachment to objects.
●​ Unusual sensory responses, e.g., hypersensitivity or hyposensitivity to sounds, light, textures,
smells, tastes, temperature, or pain.

3. Onset and Impact

●​ Symptoms typically begin in early childhood, but may become fully evident later when social
demands increase.
●​ Symptoms cause significant impairment in personal, family, social, educational, or
occupational functioning.
●​ Some individuals can function in many areas through exceptional effort, but a diagnosis is still
valid even if deficits are not obvious to others.

Developmental Learning Disorder/Specific Learning Disorder

1. Significant Difficulty in Learning Academic Skills

The individual shows major problems in reading, writing, or arithmetic.​

Their skill level is much lower than expected for their age.

2. Difficulties Occur Despite Proper Teaching

The learning problems appear even when the child has received appropriate and adequate
instruction.​
The difficulty may affect:

●​ only one area (e.g., basic numeracy, word decoding), or

●​ multiple areas (reading, writing, and arithmetic together).​
These limitations are ideally measured through standardized, age-normed tests.

3. Early Onset, But May Be Identified Later

Problems usually begin in the early school years.​
However, some individuals are diagnosed later in adolescence or adulthood, when academic demands
become too difficult.

4. Not Due to External Factors

The learning difficulty is not caused by:

●​ poverty
●​ poor teaching
●​ lack of schooling
●​ environmental deprivation

5. Not Better Explained by Another Disorder

The symptoms are not caused by:

●​ intellectual disability
●​ another neurodevelopmental disorder
●​ motor disorders
●​ vision or hearing impairments
●​ medical or neurological conditions

6. Causes Significant Functional Impairment

The learning difficulties interfere with:

●​ academics
●​ work tasks
●​ daily functioning​
If the individual manages to perform adequately, it is only through excessive effort and extra
support.

Specifiers for area of learning impairment

●​ Specifiers should be applied to indicate which academic skills are significantly
impaired at the time of assessment. Multiple specifiers may be used to reflect
limitations in multiple skills.
Impairment in reading (Dyslexia)
●​ Learning difficulties are manifested in impairments in reading skills such as word
reading accuracy, reading fluency or reading comprehension.
Impairment in written expression (Dysgraphia)
●​ Learning difficulties are manifested in impairments in writing skills such as
spelling accuracy, grammar and punctuation accuracy, or organization and
cohesion of ideas in writing.
Impairment in mathematics (Dyscalculia)
●​ Learning difficulties are manifested in impairments in mathematical skills such as
number sense, memorization of number facts, accurate calculation, fluent
calculation or accurate mathematic reasoning.
Other specified impairment of learning
●​ Learning difficulties are manifested in impairments in learning and performance
of specific academic skills that are not adequately characterized by one of the
other available specifiers.
Developmental learning disorder, unspecified

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is diagnosed when a child or adult shows a persistent pattern (at least 6 months) of
inattention and/or hyperactivity–impulsivity that is more severe than what is normal for their age.

Symptoms can look different depending on the person’s age and the severity of the disorder.

1. Inattention (Key Symptoms)

These symptoms must be persistent and severe enough to negatively affect school, work, or social
life. They commonly include:

●​ Difficulty staying focused on tasks that are not interesting or do not give quick rewards.
●​ Poor attention to detail, making careless mistakes.
●​ Not finishing tasks or assignments.
●​ Easily distracted by outside stimuli or unrelated thoughts.
●​ Appears not to listen when spoken to.
●​ Often daydreaming or “mentally absent.”
●​ Frequently loses things; forgetful in daily activities.
●​ Trouble planning, organizing and managing tasks.

Note: Inattention may not appear when the person is doing highly stimulating or rewarding activities.

2. Hyperactivity–Impulsivity (Key Symptoms)

These symptoms must be persistent and severe enough to disrupt daily functioning. They are usually
more noticeable in structured environments that require self-control.

Common symptoms include:

Hyperactivity

●​ Excessive movement; leaving seat when expected to stay seated.

●​ Running around or fidgeting a lot (common in younger children).
●​ Feeling physically restless and uncomfortable sitting still (more common in teens and adults).
●​ Difficulty doing activities quietly.
●​ Talking excessively.

Impulsivity

●​ Blurting out answers or comments.

●​ Difficulty waiting for one’s turn in conversations, games, or activities.
●​ Interrupting or intruding on others.
●​ Acting without thinking about risks (e.g., dangerous behavior, impulsive decisions, reckless
driving).

3. Additional Requirements for Diagnosis

●​ Symptoms must have been present before age 12.​

(Some may be noticed only in adolescence/adulthood when demands increase.)​

●​ Symptoms must appear in more than one setting, such as home, school, work, or social
situations.​

●​ Symptoms must not be better explained by another mental disorder, such as anxiety or a
neurocognitive condition.​

●​ Symptoms must not be caused by substances or medications, such as stimulants,

bronchodilators, or thyroid medications, or by a neurological disease.

Disruptive Behaviour and Dissocial Disorders

Definition:
 ●​ These disorders involve persistent behaviour problems across multiple settings, usually
starting in childhood.
●​ Behaviours range from disruptive (defiant, disobedient, provocative) to dissocial (violating
others’ rights or societal rules).
●​ Key points:
○​ Must depart from normal behaviour for age, gender, and sociocultural context.
○​ Not diagnosed if behaviours are due to another disorder, substance, medical condition, or
adaptive response to environment.
○​ Often associated with family dysfunction, peer problems, school failure, and
psychosocial stressors.

1. Oppositional Defiant Disorder (ODD)

Essential Features:

●​ Persistent pattern of defiant, disobedient, and noncompliant behaviour, atypical for age or
context.
●​ Behaviour may include:
○​ Arguing with authority figures, refusing requests or rules
○​ Deliberately annoying others, blaming peers
○​ Provocative, spiteful, or vindictive actions
○​ Extreme irritability, anger, frequent temper loss
●​ Duration: ≥6 months
●​ Not explained by specific relational conflicts (e.g., only with a harsh parent or teacher).
●​ Causes significant impairment in personal, social, educational, or other areas.

2. Conduct-Dissocial Disorder (CDD)

Essential Features:

●​ Repetitive and persistent pattern of violating basic rights of others or age-appropriate

societal rules.
●​ Common behaviours:
1.​ Aggression to people/animals: bullying, fights, cruelty, sexual coercion
2.​ Destruction of property: fire setting, vandalism
3.​ Deceitfulness/theft: stealing, lying, breaking into places
 4.​ Serious rule violations: staying out late, running away, truancy
●​ Duration: Persistent over at least 1 year; single acts not enough.
●​ Causes significant impairment in multiple life areas.

Specifiers by Age of Onset:

●​ Childhood-onset: Features present before age 10

●​ Adolescent-onset: Features appear after age 10
●​ Unspecified: Age of onset unclear

Key Difference Between ODD and CDD:

Feature ODD CDD

Core behaviour Defiance, irritability, Violation of others’ rights or

noncompliance societal rules

Aggression Less severe, usually verbal or Severe, may include physical

minor harm

Rule-breaking Limited, mostly authority Serious, persistent, often illegal

defiance

Duration ≥6 months ≥1 year, recurrent

Age of onset Often early childhood Childhood (<10) or adolescence

(>10)

​
Anxiety and Fear-Related Disorders
Definition:​
These disorders involve excessive fear and anxiety, often causing behavioral disturbances and
significant impairment in daily functioning.

●​ Fear: Reaction to an immediate or present threat.

●​ Anxiety: Future-oriented, anticipating possible threats.
●​ Disorders are distinguished by the focus of apprehension – specific triggers (specific phobia)
vs. broad situations (generalized anxiety disorder).

Common Symptoms Across Disorders:

●​ Persistent worry or apprehension

●​ Muscle tension, restlessness, irritability
●​ Autonomic arousal: palpitations, sweating, tremors, GI symptoms
●​ Sleep disturbances
●​ Impaired concentration

1. Generalized Anxiety Disorder (GAD)

●​ Persistent, “free-floating” anxiety or excessive worry about multiple aspects of life (work,
health, family).
●​ Symptoms include: muscle tension, restlessness, irritability, difficulty concentrating, sleep
problems.
●​ Duration: Several months; not better explained by other disorders or medical conditions.
●​ Causes significant distress or impairment in daily functioning.

2. Panic Disorder

●​ Recurrent panic attacks: sudden episodes of intense fear with symptoms like palpitations,
sweating, shortness of breath, dizziness, fear of losing control or dying.
●​ At least some attacks occur unexpectedly, “out of the blue.”
●​ Followed by persistent worry about recurrence or behaviors to avoid future attacks.
●​ Causes significant impairment in functioning.

3. Agoraphobia

●​ Excessive fear of situations where escape might be difficult or help unavailable (e.g., public
transport, crowds, being outside alone).
 ●​ Fear may relate to panic attacks or embarrassing/incapacitating symptoms.
●​ Situations are avoided or endured with intense fear.
●​ Duration: Several months; causes distress or functional impairment.

4. Specific Phobia

●​ Excessive fear of specific objects or situations (e.g., animals, heights, blood)

●​ Fear is out of proportion to actual danger.
●​ Situations are avoided or endured with intense anxiety.
●​ Persistent for several months; significantly impacts life.

5. Social Anxiety Disorder

●​ Excessive fear or anxiety in social situations (e.g., conversations, eating in public, performing).
●​ Fear of negative evaluation or humiliation.
●​ Social situations are avoided or endured with distress.
●​ Persistent and impairs daily functioning.

6. Separation Anxiety Disorder

●​ Excessive fear about separation from attachment figures (parents, spouse, children).
●​ Symptoms: persistent worry about harm, refusal to go to school/work, nightmares, physical
symptoms (nausea, headache).
●​ Duration: Several months; causes significant distress or impairment.

7. Selective Mutism

●​ Consistent failure to speak in specific social situations despite adequate language ability in
others.
●​ Duration: At least 1 month (not just first month of school).
●​ Not due to language knowledge or other disorders.
●​ Significantly interferes with education, social communication, or other functioning.

Disorders Specifically Associated with Stress

Definition:

●​ These disorders are directly related to exposure to stressful or traumatic events.

 ●​ An identifiable stressor is necessary for diagnosis, though not everyone exposed develops a
disorder.
●​ Stressors can be:
○​ Normal life stressors: e.g., divorce, bereavement, financial problems
○​ Traumatic events: e.g., natural disasters, combat, serious accidents, assault, torture
●​ Diagnosis depends on nature, duration, and impact of symptoms, not merely exposure.

Post-Traumatic Stress Disorder (PTSD)

Essential Features:

1.​ Exposure to a traumatic event​

○​ Extremely threatening or horrific: natural disasters, accidents, combat, assault, torture,

sexual violence, life-threatening illness.
○​ Witnessing injury/death or learning about sudden violent death of loved ones also counts.
2.​ Core Syndrome (lasting several weeks):​
a. Re-experiencing the trauma:​

○​ Vivid intrusive memories or images

○​ Flashbacks (from mild to severe, may lose awareness of present)
○​ Trauma-related nightmares
○​ Intense emotions (fear, horror) and physical sensations during re-experiencing
3.​ b. Avoidance:​

○​ Avoiding thoughts, memories, conversations, activities, or situations that remind of

trauma
○​ Sometimes changing environment to avoid triggers
4.​ c. Heightened current threat perception:​

○​ Hypervigilance, exaggerated startle response

○​ Safety behaviours: checking, guarding, over-cautiousness
5.​ Functional Impairment:​

○​ Significant distress or impairment in personal, social, educational, occupational, or other

 areas
○​ If functioning is maintained, it requires extra effort.

Additional Clinical Features:

●​ Dysphoria, dissociation, somatic complaints

●​ Social withdrawal, substance use (alcohol/drugs)
●​ Anxiety symptoms including panic
●​ Anger, guilt, shame, sadness, survivor guilt
●​ Obsessions or compulsions related to trauma.

Boundary with Normality:

●​ Not everyone exposed to trauma develops PTSD.

●​ Diagnosis requires full syndrome criteria, not just traumatic exposure.

Course Features:

●​ Onset: any time after trauma; typically within 3 months

●​ Delayed expression possible (years after trauma)
●​ Symptoms may wax and wane over time; can recur with reminders or additional stressors
●​ Duration: some persist months to years; nearly half recover within 3 months

Mood Disorders

Depressive Episode - an espidoe characterized by certain number of symptoms during a period of

time that leads to depressive disorders.

Essential Features:

●​ Duration: ≥2 weeks, most of the day, nearly every day

●​ Symptoms: At least 5 characteristic symptoms, including at least 1 affective symptom
●​ Affective cluster:
○​ Depressed mood (or irritability in children/adolescents)
○​ Markedly diminished interest or pleasure in activities (anhedonia)
●​ Cognitive-behavioural cluster:
○​ Poor concentration or indecisiveness
 ○​ Low self-worth or inappropriate guilt
○​ Hopelessness about the future
○​ Recurrent thoughts of death or suicidal ideation/attempts
●​ Impact: Significant distress or functional impairment

2. Depressive Disorders

General:

●​ Characterized by persistent depressed mood or loss of pleasure, with cognitive, behavioural,

or neurovegetative symptoms
●​ Cannot be diagnosed if there’s a history of manic, hypomanic, or mixed episodes (would
indicate bipolar disorder)

A. Single Episode Depressive Disorder

●​ Definition: One depressive episode, no prior manic/mixed/hypomanic episodes

●​ Severity/Specifiers:
○​ Mild
○​ Moderate (with/without psychotic symptoms)
○​ Severe (with/without psychotic symptoms)
○​ Partial or full remission

B. Recurrent Depressive Disorder

●​ Definition: Two or more depressive episodes separated by several months without significant
mood disturbance
●​ Severity/Specifiers:
○​ Mild, moderate (with/without psychotic), severe (with/without psychotic), partial/full
remission
●​ Note: If episodes overlay dysthymic disorder, remission is defined as return to baseline
dysthymic symptoms

C. Dysthymic Disorder (Persistent Depressive Disorder)

●​ Essential Features:
○​ Depressed mood for ≥2 years (children/adolescents: irritability)
 ○​ Additional depressive symptoms (mild form):
■​ Low interest, poor concentration, low energy, sleep/appetite changes,
hopelessness
○​ No 2-week period meets full depressive episode criteria in first 2 years
○​ No history of manic/mixed/hypomanic episodes
●​ Impact: Significant distress or functional impairment
●​ Additional Features:
○​ Suicide risk higher than general population
○​ Common co-occurrence: anxiety, OCD, substance use, personality disorders
●​ Course:
○​ Gradual onset in childhood, adolescence, or early adulthood
○​ Fluctuates with episodes of single/recurrent depression
○​ Early onset increases risk of co-occurring mental disorders
○​ Poorer outcomes linked with severity, anxiety/fear-related disorders, or conduct-dissocial
disorder

Quick Comparison Table for Depressive Disorders

Disorder Episodes Duration Key Features Severity

Specifiers

Single Episode 1 ≥2 weeks Depressed mood Mild, Moderate

Depressive or anhedonia + ≥4 (±psychotic),
other symptoms Severe
(±psychotic),
Remission

Recurrent ≥2, separated by ≥2 weeks per Same as single Mild, Moderate

Depressive months episode episode, (±psychotic),
recurrence pattern Severe
(±psychotic),
 Remission

Dysthymic Persistent ≥2 years Chronic low mood Partial/full

Disorder (children: ≥1 year) + mild depressive remission
symptoms