"Helping you to help your ADD ADHD child"by Anthony Kane, MD
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Finally, child development is dynamic and purposeful. Children have a natural curiosity and an even wider capacity for growth and change. This is good news for parents. This capacity allows children to regenerate and heal from childhood traumas that lead to disorders. It is the ally parents and professionals count on to make effective interventions and allows the child to have a normal, healthy life. What this means, in the area of childhood mental health disorders, is that children and their disorder, can change over time. In fact, they are developmentally driven to change. It is the parents and the professional's job to help steer children in the right directions.
A more detailed look at child development at different ages and stages can be found by going to http://parentingtoolbox.com/hand/development.html
A "Tangled Ball of String"
One important string, connected to the well being of the child, is his or her family. Disorders affect members of the family and are affected by those same members. This is why professionals will say that the family is a system and that the treatment for the disorder may require that all members of that family system be involved, even if they do not have the disorder. As such, the family system may increase or decrease the symptoms of the childhood mental health disorder, much the way a heating systems thermostat regulates the rooms temperature. Too hot and the heat shuts off. Too cold and the heat turns on.
Conversely, family members can be affected by another member's mental health disorder. A common example occurs when one child in a home takes a large chunk of a parents time and energy (not to mention finances) to help the child cope with his of her disorder, leaving the other children in the home feeling ignored. Resentment, anger, and aggressive behaviors are typical in siblings of children with mental health disorders and often, must be addressed by the professional working with the family.
DSM-IV: The Diagnoses BibleWhen diagnosing a child, mental health professionals use a book called the Diagnostic and Statistical Manual of Mental Disorders, now in the fourth edition (or DSM-IV). The book is divided into sections for adult mental health disorders and "disorders usually first evident in infancy, childhood, or adolescence." Professionals use this book to communicate with one another (and insurance companies) about childhood mental health disorders. It is a classification system for understanding and labeling the defining features of childhood mental health disorders.
The DSM-IV defines a mental health disorder "as a clinically significant behavioral and psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one of more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom (1)."
Stated simply, a mental health disorder is a problem that affects a child's ability to function in his or her world. An important note, made by the DSM-IV, is that a classification is not about classifying the person or child buy his or her mental health disorder. This clarification can have profound effects on the self-image of the child. Being a problem and having a problem are very different things and create very different reactions from others.
Mental health professionals make a diagnosis, based on the classifications listed in the DSM-IV, on five axes or levels of diagnoses.
Axis I is used for Clinical Disorders or Other Conditions That May Be a Focus of Clinical Attention.
Axis II is used for the listing of Personality Disorders and Mental Retardation.
Axis III describes the General Medical Conditions.
Axis IV is used for Psychosocial and Environmental Problems.
Axis V is the Global Assessment of Functioning.
This multiaxial system provides for a comprehensive format for organizing and describing a child's disorder.
While there has been criticisms about the use of the DSM-IV, it is not within the scope of this guide to discuss it. Emphasis is given to parents who need to know what a professional is referring to and using in the diagnosis of their child.
1. Diagnostic And Statistical Manual Of Mental Disorders - Fourth Edition (1994). American Psychological Association, Washington, D.C.
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Anthony Kane, MD
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