The most commonly diagnosed childhood mental health illnesses are depression and Attention Deficit Hyperactivity Disorder (ADHD). According to numerous population-based studies, depression affects 3 percent of children in the United States, and 20 percent display depressive symptoms. It is considered to be a serious mental problem as well. This disorder hurts the energy, mood, sleep, appetite, interest, and overall functioning, as the symptoms, unlike some passing mood conditions, such as grief, sadness, joylessness, tend to be firm and continuous. This means that the adverse effect on the ability to survive at home or school can not be underestimated. For infants, depression is narrowed down to nourishment and sleep disorders. Due to this they do not gain any weight, have a slowed-down development, and demonstrate meticulous behavior. When the child reaches school age, it usually starts to become argumentative and irritable, lacking motivation and the ability to get things done, it may experience mood swings, accompanied by unhappiness and disinterest.
The child rarely smiles, has a frozen facial expression, may do a lot of crying, and experiences anxiousness. It looks bored at all times, makes up excuses in order not to participate in general activities, experiences low self-esteem, shame, over-sensitivity, guilt. Boys usually demonstrate physical unrest, aggressiveness, hyperactivity, whereas social withdrawal is more common among girls. There is no such universal template that would fit all children. Through affecting the child’s mood, this mental disorder will also impair behavior, physical condition, the ability to think, do well in school. If depression’s onset occurred early in life, it will surely manifest itself later in adulthood and may lead to more severe mental and somatic disorders. To allow children to exercise their full life potential, and not have any depression-caused impairment in the social, academic, behavioral, and emotional field, it is vital to reveal this disorder as early in life, as possible and treat it accordingly.
Depression in children is usually diagnosed if the child had been experiencing the depressive state for at least two weeks, every day. There are a few ways that could be used to help the patient. The most widely used one is group or individual cognitive-behavioral therapy. However, it is only effective during a mild form of depression relapse. If the child is suffering from a more severe type, such therapy should be combined with medications. Although no drugs have proven to be effective towards children, serotonin re-uptake inhibitors are officially permitted to use in pediatrician practice. Another two approaches to treatment are individual therapy that helps the child make terms with depression causing stressful events, as well as family therapy, the aim of which is to ease up the interaction schemes within the family, which might also be causing the disorder (Atkinson & Hornby, 2002).
Another disorder mentioned above is ADHD – a commonly diagnosed, but the most difficult to understand one. There are quite numerous cases of school-age children receiving treatment for this illness in the United States. Parents and peers find a child with ADHD to be restless, getting easily wind up, awfully disorganized, have difficulty waiting for their turns (Wender, 2000). This always affects the child’s ability to do schoolwork, demonstrating very poor results, even with potentially high academic abilities. Untreated ADHD leads to not just school failure, but also social isolation. Still, some believe there is not enough proof to call this a separate disorder, while others are convinced that the inability to concentrate, hyperactivity, and impulsiveness, arrange into one syndrome. ADHD can be diagnosed if the child is experiencing its symptoms, but preferably before the age of 7 (Sagvolden & Archer, 1989). Every child with ADHD should have an individually adjusted treatment plan. Some of the most basic approaches include a few psychological interventions, like social skills training, parent training, school-based management of contingency. Ritalin is the most widely used drug for ADHD treatment. It does have a few side effects, such as loss of sleep, irritability, and rebound hyperactivity. But it does seem to help the child concentrate, usually lowers hyperactivity, improves its social skills, learning abilities, self-esteem. Because these results are only seen in 3-6 months, a lengthy treatment course is required. Another used psychological methodology is “reward and punishment” which seems to improve the child’s behavior over time. Some sort of social skills training is vital, as subjects with ADHD get rejected by their peers quite frequently, and the training helps them understand and cope with their difficulties (Wender, 1987).
There is doubtless evidence that childhood mental disorders impair children’s ability to communicate incredible and effective manner. For example, the above ADHD greatly affects the social life of a child. From this point, when the child starts attending school, the role of its peers starts to increase dramatically. The relationships with friends derive great impact on the child’s psyche, as intimacy with them replaces the previous parental intimacy. The kids trust each other but are often quite short-spoken when it comes to their parents. A pre-adolescent child with a mental disorder like ADHD does experience significant difficulties when forming relationships with their equals. As the child will often be socially rejected because of their antisocial semiotics, he will experience problems in the development of their social communication, and will not be able to assume the values of his peers.
A child that is having trouble with his social skills and perceptiveness, as well as poor athletic abilities due to lack of concentration and coordination shall not be successful in making close friends and fail to get peer acceptance. Another syndrome that has a significant impact on the children’s ability to develop and use communication skills is called Autism Spectrum Disorder (ASD), or Pervasive Developmental Disorder (PDD). It severely damages the ability to think, feel, use language, as well as the ability to effectively communicate. ASD is a group of syndromes that ranges from Asperger syndrome – the mildest form to an illness called an autistic disorder. These syndromes are usually diagnosed early in life. The parents may complain that the baby is “different” since birth. It appears to be unresponsive to surroundings and focusing on the people narrowly for a long time.
The child may also transform from being a normal toddler to silent, unresponsive, indifferent, and self-abusive. Autism is a disability that results from a disorder that is neurologic, and which affects normal processes in the brain. The communication skills, reasoning, and social skills are developing abnormally. Boys are four times more vulnerable to this disorder than girls. Children seem normal until the 30 months barrier, however earlier cases of autism determination have been reported (Rice & Warren, 2004). The symptoms that indicate autism include communicative disability, social interaction impairment. The patients are fixed on intimate objects and react unfavorably to dynamics in their daily routine. The children repeat words/phrases, seem to be lacking the eye contact ability, and the ability to verbally express their needs. They are also sometimes insensitive to pain. Over time their behavior may or may not change. About 65 percent of children that have autism are mentally retarded, 25 percent develop seizures (Hollander, 2003). It is still unclear why children get autism, but probably not because of psychological reasons. Neurologically, brain dysfunction can be determined as a cause of the disorder. There is a genetic component to it as well, as autism is occurring according to certain patterns in some families. Autism spectrum disorder plays a crucial role in language impairment, especially its delay. It affects expressive, as well as receptive language ability. Delay of speech is the most common reason for referral to the clinic. It might be accompanied by a delay in general development and/or seizures. Delayed language skills are a reason for poor adaptive skills and bad school achievement. Language-communication skills can be measured by determining the number of words and phrases used daily, measurements of receptive/expressive vocabulary. In the previous years, it was impossible to perform psychometric measurements of early language (under 12 months old). Now, however, thanks to such methods, as Reynell Scales, Mullen Scales of Early Learning, and Vineland Adaptive Behavior Scales it is possible to measure language delay and communication ability of a child down to 1 month old, and predict later behavior. Autism can be diagnosed, based on three criteria: communication, stereotyped and repetitive patterns of behavior, interests, and activities, as well as on social interaction (American Psychological Association, 1994). The key symptoms within communication are considered to be a lack of verbal/non-verbal sides of communication (Kurita, 1985; Lord & Paul, 1997). Thus, pragmatic deficits of understanding language and general discourse as a communication-intended system describe autism best. Another common problem that affects communication in children is stuttering.
Some specialists believe stuttering to be a psychological problem, while others say that it has a physiological basis, or that the child may have a genetic predisposition towards this disorder. Children’s anxiety, for example during ADHD may also be the reason for the development of stuttering. It is most likely that it has quite a few reasons. This syndrome can frustrate the child a lot. Some children try to avoid this problem by acting shy and not speak to others. Any type of excitement may worsen the stuttering case that is why stressful events in a child’s life, such as birthdays, starting the new school year, speaking in front of an audience, and even talking on the phone pose a particular difficulty for the patient. Because of associations with stuttering incidents in the past they do all they can to avoid having to speak in these fear-inducing situations. A speech pathologist can help a child become confident using nonthreatening speaking situations (Van Riper, 1939). However, some stuttering children are not quite inhibited or self-conscious about their speech problems. This is so especially at a younger age, and if the parents are relaxed about the stuttering problem (Chiat, 2000). There is no evidence that this disorder affects academic performance in any way, but there it is certain that stuttering affects communication in terms of its development and effective use.
The job of a speech-language pathologist is to help people, who cannot make speech sounds or do not make clear ones. For example, those people who have problems with language production and comprehension, or individuals suffering from cognitive impairments of communication, such as, memory, attention, and problem-solving disorders. Speech specialists use various assessment methods, such as special instruments, standardized tests, that help to assess the degree of communication impairment and help their patients to communicate more effectively, through developing efficient social skills. These doctors usually are in close collaboration with physicians, psychologists, social workers, and other specialists. In schools, they collaborate with special educators, teachers, school personnel, counselors, parents to give each subject an individually developed therapy program (Mccauley, 2001). As communication, in general, includes speech, reading, writing, understanding signs and gestures, speech pathologists help those individuals who have difficulties communicating. Some patients that can benefit from speech therapy are kids with difficult-to-understand speech, cleft palate babies (speech-specialists advise on feeding), children suffering from autism spectrum disorder, stuttering, victims of accidents with brain injuries, patients with various intellectual disabilities.
The doctor can assist the child that has difficulties reading; assist in better comprehension of the teacher’s speech content. There is one more disorder often treated by speech pathologists. It is called receptive language disorder and characterized by the child’s inability to understand what is being said to him. It usually starts and is revealed before the age of four. As a child can effectively communicate only if he well understands the language spoken to him, an expressive language disorder (has trouble speaking) usually follows the above illness. According to recent estimations, about 5 percent of all children have some form of this perception/expression deficit, or they are both present.
The cause of this disorder is unknown, however, it may have a genetic predisposition, be associated with autism, child’s language exposure, or any type of brain injury. The most popular way to treat this disability is through speech therapy. One of the strategies used by speech pathologists is called language intervention activity. It involves interacting and playing with the child, using books, toys, different objects that may induce language associations within the brain. Another method is articulation therapy, where the specialist demonstrates to the patient the correct way to pronounce sounds and syllables. The therapy must start as soon as possible, as children under 4 years of age tend to show better results than the older ones.
References
Atkinson, M., & Hornby, G. (2002). Mental Health Handbook for Schools. London: Routledge/Falmer.
Chiat, S. (2000). Understanding Children with Language Problems. Cambridge, England: Cambridge University Press.
Hollander, E. (Ed.). (2003). Autism Spectrum Disorders. New York: Marcel Dekker.
Mccauley, R. J. (2001). Assessment of Language Disorders in Children. Mahwah, NJ: Lawrence Erlbaum Associates.
Rice, M. L. & Warren, S. F. (Eds.). (2004). Developmental Language Disorders: From Phenotypes to Etiologies. Mahwah, NJ: Lawrence Erlbaum Associates.
Sagvolden, T. & Archer, T. (Eds.). (1989). Attention Deficit Disorder Clinical and Basic Research. Hillsdale, NJ: Lawrence Erlbaum Associates.
Van Riper, C. (1939). Speech Correction: Principles and Methods. New York: Prentice-Hall.
Wender, P. H. (1987). The Hyperactive Child, Adolescent, and Adult: Attention Deficit Disorder through the Lifespan (3rd ed.). New York: Oxford University Press.
Wender, P. H. (2000). ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford: Oxford University Press.