COMMON BEHAVIOURAL AND
SOCIAL DISORDERS IN
CHILDREN
BY
Mrs. AKHILA.C.
([Link]. CHILD
HEALTH NURSING)
ASSISTANT
PROFESSOR
JUBILEE MISSION
COLLEGE OF
NURSING
THRISSUR
CENTRAL
OBJECTIVE
O At the end of the class students
will acquire knowledge regarding
“Common Behavioral and
Social Disorders in Children”
and develop desirable attitude
and skills towards the topic and
in future practice.
SPECIFIC
At the end OBJECTIVES
of the class Students will be able to,
O define behavioral disorders
O enlist the causes of behavioral disorders
O enumerate the classifications of behavioral
disorders
O describe the behavioral problems of infancy
O discuss the behavioral problems of childhood
O explain the behavioral problems of
adolescence
O describe the nursing responsibilities in
behavioral disorders
OVERVIEW
INTRODUCTION
DEFINITION
CAUSES
CLASSIFICATION
BEHAVIOURAL PROBLEMS OF INFANCY
BEHAVIOURAL PROBLEMS OF CHILDHOOD
BEHAVIOURAL PROBLEMS OF
ADOLESCENCE
NURSING RESPONSIBILITIES
INTRODUCTION
BEHAVIORAL PROBLEMS ARE MAINLY
DUE TO FAILURE IN ADJUSTMENT TO
EXTERNAL ENVIRONMENT AND
PRESENCE OF INTERNAL CONFLICT.
IT IS ALWAYS REQUIRE
SPECIAL ATTENTION.
DEFINITION
A CHILD IS SAID TO HAVE A
BEHAVIORAL DISORDER WHEN HE OR
SHE DEMONSTRATES BEHAVIOUR THAT
IS NOTICEABLY DIFFERENT FROM THAT
EXPECTED IN THE SCHOOL OR
COMMUNITY.
CAUSES OF BEHAVIOURAL
DISORDERS
O FAULTY PARENTAL ATTITUDE
O INADEQUTE FAMILY ENVIRONMENT
O HANDICAPPED CONDITIONS
O INFLUENCE OF SOCIAL RELATIONSHIP
O INFLUENCE OF MASS MEDIA
O INFLUENCE OF SOCIAL CHANGE
CLASSIFICATION
SOME BEHAVIORAL PROBLEMS ARE
SPECIFIC TO PARTICULAR AGE GROUP. SO
ACCORDING TO AGE IT IS DIVIDED IN TO 3
GROUPS.
A. BEHAVIOURAL PROBLEMS OF INFANCY
B. BEHAVIOURAL PROBLEMS OF
CHILDHOOD
C. BEHAVIOURAL PROBLEMS OF
ADOLESCENCE
A. BEHAVIOURAL
PROBLEMS OF INFANCY
1. RESISTANCE TO FEEDING
OR IMPAIRED APPETITE
INFANT MAY REFUSE
NEW FOODS DUE TO
DISLIKE OF TASTE OR
DUE TO SEPARATION
ANXIETY FROM
MOTHER.
AVOID SEPARATION OF
PARENTS, CHANGE OF
FOOD ITEMS, PROVIDE
TENDER LOVING CARE
2. ABDOMINAL COLIC
IT IS A CONDITION
CHARACTERIZED BY INTENSE
CRAMPING OR COLICKY PAIN,
WHICH MAY BE ACCOMPANIED
BY NAUSEA AND VOMITING
PLACE BABY ON UPRIGHT
POSITION, BURPING,
FREQUENT
FEEDING,ANTISPASMODIC
DRUGS
3. SEPARATION ANXIETY
(STRANGER ANXIETY)
IT IS THE NORMAL FEAR
EXPRESSED BY INFANTS
WHEN REMOVED FROM
THEIR MOTHERS OR
APPROACHED BY
STRANGERS.
IT MAY CONTINUE UP TO 13-
15 MONTHS OF AGE.
GRADUAL APPROACH AND
LOVING CONCERN OF THE
STRANGER.
B. BEHAVIOURAL
PROBLEMS OF
CHILDHOOD
1. TEMPER TANTRUMS
IT IS A SUDDEN
OUTBURST OR
VIOLENT DISPLAY OF
ANGER.
USUALLY PRESENT IN
BOYS AND SINGLE
CHILD
PROFESSIONAL HELP
FROM CGC, CALM &
LOVING APPROACH
OF PARENTS,
PHYSICAL ACTIVITIES
2. BREATH-HOLDING SPELL
IT IS OBSERVED IN RESPONSE
TO ANGER AND
FRUSTRATION.
FOUND WITH VIOLENT
CRYING,HYPERVENTILATION
AND SUDDEN CESSATION OF
BREATHING, CYANOSIS
RIGIDITY, AND SLOW HR.
OCCURS BETWEEN 6 MONTHS
TO 5 YEARS OF AGE.
PUNISHMENT IS NOT
APPROPRIATE,
IDENTIFICATION
&CORRECTION OF REASONS
ARE ESSENTIAL APPROACH.
3. THUMB SUCKING
HABIT DISORDER DUE TO FEELING
OF INSECURITY AND POOR
BREASTFEEDING
BEYOND 4 YEARS LEADS TO GI
INFECTIONS, THUMB DEFORMITY,
MALALIGNMENT OF TEETH AND
SPEECH DIFFICULTIES (D&T)
AFTER 7-8 YEARS INDICATES SIGNS
OF STRESS
KEEP HANDS BUSY BY
DISTRACTION, SHOULD NOT SCOLD
THE CHILD, FOLLOW HYGIENIC
MEASURES, CONSULTATION WITH
DENTIST & SPEECH THERAPIST
4. NAIL BITING
IT IS A SIGN OF TENSION,
INSECURITY AND SELF
PUNISHMENT OR MAY
OCCUR AS IMITATING THE
PARENT
FOUND IN SCHOOL AGE
BEYOND 4 YEARS
IDENTIFY THE CAUSE
WITH THE HELP OF A
CLINICAL PSYCHOLOGIST,
AVOID PUNISHMENT,
KEEP CHILD’S HAND
5. ENURESIS OR BED
WETTING
REPITITIVE INVOLUNTARY
PASSGE OF URINE AT
INAPPROPRIATE PLACE
BEYOND THE AGE OF 4-5
YEARS
CAUSES ARE SMALL BLADDE
CAPACITY, INAPPROPRIATE
TOILET TRAINING AND DEEP
SLEEP
MANAGEMENT DEPENDS ON
CAUSE.
ORGANIC CAUSES ARE
MANAGED WITH SPECIFIC
TREATMENT
6. ENCOPRESIS
IT IS THE PASSAGE OF FECES
INTO INAPPROPRIATE PLACES
AFTER THE AGE OF 5 YEARS
CAUSED BY EMOTIONAL
DISTURBANCES DUE TO
STRESS, ANXIETY AND ANGER
MANAGEMENT IS BY PARENTAL
SUPPORT, REASSUARANCE,
COUNSELLING, TOILET
TRAINING,etc
7. GEOPHAGIA OR PICA
IT IS A HABIT DISORDER OF
EATING NON-EDIBLE
SUBSTANCES LIKE CLAY,
PAINT, CHALK, PENCIL, etc
IT IS NORMAL UP TO THE
AGE OF 2 YEARS
CAUSED BY PARENTAL
NEGLECT, POOR
SOCIOECONOMIC STATUS,
POOR ATTENTION OF
CAREGIVERS
MANAGEMENT IS DONE WITH
PSYCHOTHERAPY OF
8. TICS OR HABIT SPASM
TICS ARE SUDDEN, ABNORMAL,
REPITITIVE, RAPID,
PURPOSELESS AND
INVOLUNTARY MOVEMENTS
MUSCLES LIKE EYE BLINKING,
TONGUE PROTRUSION, etc.
IT IS DUE TO GENETIC DISORDER
WITH ONSET AT 11 YEARS
MANAGEMENT IS BY BEHAVIOR
THERAPY, DRUG THERAPY AND
COUNSELLING
9. SPEECH PROBLEMS
IT INCLUDES,
STUTTERING OR STAMMERING
(INTERRUPTION IN THE FLOW OF
SPEECH)
CLUTTERING (UNCLEAR AND
HURRIED SPEECH)
DELAYED SPEECH BEYOND 3 YEARS
CAN BE CONSIDERED AS ORGANIC
CAUSES LIKE MR AND AUTISM
DYSLALIA MEANS DIFFICULTY IN
ARTICULATION DUE TO
ABNORMLITIES OF TEETH, JAW OR
PALATE
MANAGEMENT IS BY CORRECTION
OF DEPRIVATION, MODIFICATION OF
FAMILY ENVIRONMENT AND
COUNSELLING
10. SLEEP DISORDERS
IT INCLUDES
DIFFICULTY TO FALL ASLEEP
NIGHT MARES (BAD DREAMS)
NIGHT TERRORS (SCREAMING DURING
SLEEP)
SOMNAMBULISM (SLEEP WALKING)
SOMILILOQUY (SLEEP TALKING)
BRUXISM ( TEETH GRINDING DURING
SLEEP)
COMMON IN CHILDREN WITH ANXIETY,
TENSION AND OVERACTIVITY
MANAGEMENT IS BY LIGHT DIET IN
DINNER,PLEASANT STORIES AT BED
TIME, DOORS AND WINDOWS TO BE
KEPT CLOSED,SPECIFIC DRUG
THERAPY AND PSYCHOTHERAPY
11. ATTENTION DEFICIT
DISORDERS
THESE ARE LEARNING
DISBILITIES RELATED TO
CNS DYSFUNCTION OR
HYPERACTIVITY
CHILD WILL MANIFEST
WITH READING
DISABILITY, IMPAIRED
MEMORY, POOR SPEECH
DEVELOPMENT,
OVERACTIVE AND
INATTENTIVE
MANAGEMENT INCLUDES
12. SCHOOL PHOBIA
IT IS THE ABNORMAL FEAR OF
GOING TO SCHOOL
CAUSES INCLUDES ANXIETY OF
MATERNAL SEPARATION, OVER
PROTECTIVE MOTHER,TEASING
BY OTHER STUDENTS, FEAR OF
EXAMS AND TEACHERS, etc
IT CAN BE MANAGED BY HABIT
FORMATION, PLAT SESSION,
RECREATIONAL ACTIVITIES AT
SCHOOL, AND FAMILY
COUNSELLING TO RESOLVE
ANXIETY OF MATERNAL
SEPARATION
C. BEHAVIOURAL
PROBLEMS OF
ADOLESCENCE
1. MASTURBATION
IT IS THE GENITAL
STIMULATION BY HANDLING
THE GENITALS GIVES
PLEASURE TO THE CHILDREN
BOYS ARE MOSTLY ENGAGE
WITH THIS PRACTICE
IT IS DUE TO ANXIETY AND
SEXUAL EXCITEMENT
IN PUBESCENT PERIOD IT
HAS A ROLE IN PHYSICAL
AND EMOTIONAL
DEVELOPMENT AND ALSO
HELPS IN TENSION RELIEF
2. JUVENILE DELIQUENCY
IT MEANS INDULGENCE IN AN
OFFENCE BY A CHILD IN THE FORM
OF PURPOSEFUL AND UNLAWFUL
CTIVITIES DONE HABITUALLY AND
REPEATEDLY
THE MAIN CAUSES ARE POOR
ECONOMY, LACK DISCIPLINE,
INFLUENCE OF MASS MEDIA, LACK
EDUCATION AND LIFE STYLES, etc.
DELIQUENT CHILDREN NEEDS
SYMPATHETIC ATTITUDE WITH
NECESSARY GUIDANCE, COUNSELING
FOR MODIFICATION OF BEHAVIOR,
HEALTHY RELATIONSHIP, PROVIDING
EDUCATIONAL OPPORTUNITIES AND
FULLFILLMENT OF BASIC NEED, etc.
3. SUBSTANCE ABUSE OR
DRUG ABUSE
IT IS THE REPEATED INTAKE OF HABIT
FORMING SUBSTANCES OR DRUGS LIKE
TOBACOO, ALCOHOL, SLEEPING PILLS,
COCAINE, CHARAS, GANJA, etc.
IT IS A THREATENING SOCIAL PROBLEMS
OF SCHOOL GOING AND ADOLESCENCE
AGE GROUP
REASONS INCLUDES POOR PARENTAL
GUIDANCE, LACK OF EDUCATION, GANG
ACTIVITIES, DISTURBED FAMILY, AND
LACK OF RECRETION, etc.
MANAGEMENT IS BY PSYCHOTHERAPY,
DEADDICTION SERVICES,
REHABILITATION, PUBLIC AWARENESS,
HEALTH EDUCATIONBAND PROPER
GIDANCE, etc.
4. ANOREXIA NERVOSA
IT IS AN EATING
DISORDER FOUND AS
REFUSAL OF FOOD TO
MAINTAIN NORMAL BODY
WEIGHT BY REDUCING
FOOD INTAKE ESPECIALLY
FATS ANS
CARBOHYDRTES
MOST OFTEN IN
ADOLESCENT GIRLS
THERE IS NO SPECIFIC
ORGANIC CAUSE
MANAGEMENT INCLUDES
NURSING
RESPONSIBILITIES
ASSESSMENT OF PROBLEMS OF THE CHILD.
INFORMING THE PARENTS AND MAKING
THEM AWARE.
ASSISTING PARENTS, TEACHERS AND
FAMILY MEMBERS.
PROVIDE COUNSRLING SERVICES.
ENCOURAGING CHILD FOR BEHAVIOUR
MODIFICATION.
PARTICIPATING IN MANAGEMENT AS A
MEMBER OF HEALTH TEAM AND
ORGANIZING CGC.
REFERRING THE CHILDREN TO BETTER
HEALTH CARE FACILITIES, SOCIAL WELFARE
AND SUPPORT AGENCIES.
REFERENCES
OBOOK REFERENCES
“Dorothy R. Marlow, Barbara A Redding “ ” Textbook of paediatrics
nursing,” 6th edition; Sounder’s publication; 2009; [Link]- 947-56
“ A Parthasarathy” “IAP textbook of pediatrics” 3rd edition; 2006;
Jaypee publication pg no – 128
“Marliyn J Hockenberry, Wilson Winkelstein” “ Wong’s
‘Essentials of Pediatric nursing’”, 7th edition, elseveir
publications pg no- 159,.231
Parul data, “Pediatric Nursing”, 2nd edition, elseveir
publications pg. No-264.
Dutta p. Pediatric nursing 2nd ed. New Delhi: Japypee
brothers, 2009. P-282 – 86.
Ghai P.O., Paul K.V, Bagg. A essential ;paediatrics. 7th ed.
New Delhi: CBS publishers; 2010. [Link] – 1302-08
ONET REFERENCES
[Link] , [Link]