mental health disorders in young children and youth a primer for youth workers

Mental Health Disorders in Mental Health Disorders in Young Children and YouthYoung Children and Youth

A Primer for Youth WorkersA Primer for Youth Workers

Focus of TrainingFocus of Training

Understand the difference between Understand the difference between medical/mental health diagnosis and medical/mental health diagnosis and educational disabilityeducational disability

Recognize the characteristics of common Recognize the characteristics of common mental health problems/educational mental health problems/educational disabilitiesdisabilities

Respond to children and youth diagnosed Respond to children and youth diagnosed with mental health problems/educational with mental health problems/educational disabilitiesdisabilities

Diagnostic Information Diagnostic Information in Mental Healthin Mental Health

DSM-IV is the accepted guide to DSM-IV is the accepted guide to psychiatric diagnosispsychiatric diagnosis

Many disorders show similar Many disorders show similar symptomssymptoms

Some tend to occur together in the Some tend to occur together in the same childsame child

It may take years to reach an accurate It may take years to reach an accurate diagnosis as symptoms change with diagnosis as symptoms change with time and developmenttime and development

Educational ClassificationEducational Classification

Some, but not all, children with a Some, but not all, children with a mental health diagnosis will need mental health diagnosis will need special education assistancespecial education assistance

Usual school classifications will be Usual school classifications will be Emotional Disability, Other Health Emotional Disability, Other Health Impairment, or Autism Spectrum Impairment, or Autism Spectrum DisorderDisorder

Eligibility does not dictate classroom Eligibility does not dictate classroom placement; most of these students placement; most of these students succeed in a general education settingsucceed in a general education setting

Educational Eligibility: Educational Eligibility: Emotional DisabilityEmotional Disability

““Emotional disability” means an inability to learn Emotional disability” means an inability to learn or progress that cannot be explained by cognitive, or progress that cannot be explained by cognitive, sensory, or health factors. The student exhibits sensory, or health factors. The student exhibits one or more of the following characteristics over a one or more of the following characteristics over a long period of time and to a marked degree that long period of time and to a marked degree that adversely affects educational performance:adversely affects educational performance: A tendency to develop physical symptoms or fears A tendency to develop physical symptoms or fears

associated with personal or school problems;associated with personal or school problems; A general pervasive mood of unhappiness or A general pervasive mood of unhappiness or

depression;depression; An inability to build or maintain satisfactory An inability to build or maintain satisfactory

interpersonal relationships;interpersonal relationships; Inappropriate behaviors or feelings under normal Inappropriate behaviors or feelings under normal

circumstances;circumstances; Episodes of psychosis.Episodes of psychosis.

Educational Eligibility:Educational Eligibility:Other Health ImpairmentOther Health Impairment

““Other health impairment” means Other health impairment” means having limited strength, vitality, or having limited strength, vitality, or alertness, including a heightened alertness, including a heightened alertness to environmental stimuli, that alertness to environmental stimuli, that results in limited alertness with respect results in limited alertness with respect to the educational environment that:to the educational environment that: Is due to chronic or acute health problemsIs due to chronic or acute health problems Adversely affects a student’s educational Adversely affects a student’s educational

performance.performance.

Educational Eligibility:Educational Eligibility:Autism Spectrum DisorderAutism Spectrum Disorder

Autism spectrum disorder is a lifelong developmental Autism spectrum disorder is a lifelong developmental disability that includes autistic disorder, Asperger’s disability that includes autistic disorder, Asperger’s syndrome, and other pervasive developmental disorders, as syndrome, and other pervasive developmental disorders, as described in the current version of the American Psychiatric described in the current version of the American Psychiatric Association’s Diagnostic and Manual of Mental Disorders. Association’s Diagnostic and Manual of Mental Disorders. The disability is generally evident before three years of age The disability is generally evident before three years of age and significantly affects verbal, nonverbal, or pragmatic and significantly affects verbal, nonverbal, or pragmatic communication and social interaction skills and results in an communication and social interaction skills and results in an adverse effect on the student’s educational performance. adverse effect on the student’s educational performance. Other characteristics often associated include the following:Other characteristics often associated include the following:

Engagement in Engagement in Repetitive activitiesRepetitive activities Stereotyped movementsStereotyped movements

Resistance to Resistance to Environmental change; orEnvironmental change; or Change in daily routinesChange in daily routines

Unusual responses to sensory experiences. Unusual responses to sensory experiences.

504 Plans504 Plans

Federal law that protects qualified individuals Federal law that protects qualified individuals from discrimination based on their disability. from discrimination based on their disability.

Individuals with disabilities Individuals with disabilities are defined as are defined as persons with a physical or mental impairment persons with a physical or mental impairment which significantly limits one or more major life which significantly limits one or more major life activities. People who have a history of, or who activities. People who have a history of, or who are regarded as having a physical or mental are regarded as having a physical or mental impairment that substantially limits one or impairment that substantially limits one or more major life activities, are also covered.more major life activities, are also covered.

Major life activities include caring for one’s self, Major life activities include caring for one’s self, walking, seeing, hearing, speaking, breathing, walking, seeing, hearing, speaking, breathing, working, performing manual tasks, and working, performing manual tasks, and learning.learning.

About Mental Health About Mental Health DiagnosesDiagnoses

Disorders first Diagnosed in Infancy, Disorders first Diagnosed in Infancy, Childhood, or AdolescenceChildhood, or Adolescence

Fetal Alcohol SyndromeFetal Alcohol Syndrome Schizophrenia and other Psychotic Schizophrenia and other Psychotic

DisordersDisorders Mood DisordersMood Disorders Anxiety DisordersAnxiety Disorders Eating DisordersEating Disorders

Disorders First Diagnosed in Disorders First Diagnosed in Infancy, Childhood, or Infancy, Childhood, or

AdolescenceAdolescence Pervasive Developmental DisordersPervasive Developmental Disorders

Attention-Deficit and Disruptive Behavior Attention-Deficit and Disruptive Behavior DisorderDisorder

Tic DisordersTic Disorders

Other Disorders of Infancy, Childhood, or Other Disorders of Infancy, Childhood, or AdolescenceAdolescence

Pervasive Developmental Pervasive Developmental DisordersDisorders

Autistic DisorderAutistic Disorder Rett’s DisorderRett’s Disorder Childhood Disintegrative DisorderChildhood Disintegrative Disorder Asperger’s DisorderAsperger’s Disorder Pervasive Developmental Disorder - Pervasive Developmental Disorder -

Not Otherwise Specified (PDD-NOS)Not Otherwise Specified (PDD-NOS)

Characteristics of AutismCharacteristics of Autism

Markedly abnormal or Markedly abnormal or impaired development in impaired development in social interaction.social interaction.


Markedly abnormal or Markedly abnormal or impaired development in impaired development in communication.communication.


Markedly restricted Markedly restricted repertoire of activities and repertoire of activities and interestsinterests

Asperger’s SyndromeAsperger’s Syndrome

Previously thought of as “high functioning Previously thought of as “high functioning autism.”autism.”

The most outstanding characteristic of a The most outstanding characteristic of a child with Asperger’s is impairment in child with Asperger’s is impairment in social interactions, which may include social interactions, which may include failure to use or comprehend nonverbal failure to use or comprehend nonverbal gestures in others, failure to develop age-gestures in others, failure to develop age-appropriate peer relationships, and a lack appropriate peer relationships, and a lack of empathy.of empathy.

Autism Spectrum Disorder:Autism Spectrum Disorder:Strategies and Strategies and

AccommodationsAccommodations Create a structured, predictable environment. Create a structured, predictable environment.

Use visual supports when possible.Use visual supports when possible. Foster a climate of tolerance and understanding.Foster a climate of tolerance and understanding. Avoid long strings of verbal instruction.Avoid long strings of verbal instruction. Give advance warning of changes in schedules, Give advance warning of changes in schedules,

transitions, personnel, etc.transitions, personnel, etc. Learn each child’s “triggers” to prevent Learn each child’s “triggers” to prevent

meltdowns.meltdowns. Do not force eye contact.Do not force eye contact. Minimize visual and auditory distractions; modify Minimize visual and auditory distractions; modify

environment as reasonable for sensory issues.environment as reasonable for sensory issues.

The brain must sift through The brain must sift through thousands of incoming thousands of incoming messages per second, messages per second,

attending to the important attending to the important signals and muffling the less signals and muffling the less

urgent. A child with an urgent. A child with an impaired sensory integration impaired sensory integration system may have no way to system may have no way to

sort out the flood of sort out the flood of information which assaults him information which assaults him

or her at all times.or her at all times.

Attention Deficit Hyperactivity Attention Deficit Hyperactivity Disorder: Symptoms and Disorder: Symptoms and

BehaviorsBehaviors Children with Children with inattentive disorderinattentive disorder may: may:

Have a short attention spanHave a short attention span Have problems with organizationHave problems with organization Fail to pay attention to detailsFail to pay attention to details Be unable to maintain attentionBe unable to maintain attention Be easily distractedBe easily distracted Have trouble listening even when spoken to Have trouble listening even when spoken to

directlydirectly Fail to finish their workFail to finish their work Make lots of mistakesMake lots of mistakes Be forgetfulBe forgetful


BehaviorsBehaviors Children with Children with hyperactive-impulsive hyperactive-impulsive

disorderdisorder may: may: Fidget and squirmFidget and squirm Have difficulty staying seatedHave difficulty staying seated Run around and climb on things excessivelyRun around and climb on things excessively Have trouble playing quietlyHave trouble playing quietly Be “on the go” as if “driven by a motor”Be “on the go” as if “driven by a motor” Talk too muchTalk too much Blurt out an answer before a question is Blurt out an answer before a question is

completedcompleted Have trouble taking turns in games or activitiesHave trouble taking turns in games or activities Interrupt or intrude on othersInterrupt or intrude on others


BehaviorsBehaviors

Children with combined attention Children with combined attention deficit hyperactivity disorder show deficit hyperactivity disorder show symptoms of both inattention and symptoms of both inattention and hyperactivity or impulsivity.hyperactivity or impulsivity.

Attention Deficit Hyperactivity Attention Deficit Hyperactivity Disorder: Disorder:

Strategies and Strategies and AccommodationsAccommodations

Provide consistent structure and clearly Provide consistent structure and clearly define your expectations.define your expectations.

Allow the child to move about with reason, Allow the child to move about with reason, and provide breaks for movement.and provide breaks for movement.

Have a “secret code” to let the child know Have a “secret code” to let the child know he has gotten off task and must refocus.he has gotten off task and must refocus.

Reduce stress and pressure when possible, Reduce stress and pressure when possible, as children with ADHD are easily frustrated.as children with ADHD are easily frustrated.

Oppositional Defiant Disorder: Oppositional Defiant Disorder: Symptoms and BehaviorsSymptoms and Behaviors

Sudden, unprovoked angerSudden, unprovoked anger Arguing with adultsArguing with adults Defiance or refusal to comply with Defiance or refusal to comply with

adult requests or rulesadult requests or rules Blaming others for their misbehaviorBlaming others for their misbehavior Easily annoyed by othersEasily annoyed by others Being resentful and angryBeing resentful and angry

Oppositional Defiant DisorderOppositional Defiant DisorderStrategies and Strategies and

AccommodationsAccommodations Try to avoid power struggles – state your position Try to avoid power struggles – state your position

clearly and concisely.clearly and concisely. Choose your battles wisely.Choose your battles wisely. Establish clear rules and enforce them Establish clear rules and enforce them

consistently.consistently. Avoid topics which may be a source of argument.Avoid topics which may be a source of argument. Discuss strategies for dealing with anger.Discuss strategies for dealing with anger. Provide consistency, structure, and clear Provide consistency, structure, and clear

consequences for misbehavior.consequences for misbehavior. Minimize downtime and plan transitions carefully.Minimize downtime and plan transitions carefully. Structure activities so the student with ODD is not Structure activities so the student with ODD is not

left out or always the last one picked.left out or always the last one picked.

Conduct Disorder: Conduct Disorder: Symptoms and BehaviorsSymptoms and Behaviors

Bullying or threatening other childrenBullying or threatening other children Poor attendance or chronic truancyPoor attendance or chronic truancy Little empathy for others and lack of Little empathy for others and lack of

appropriate feelings of guilt or remorseappropriate feelings of guilt or remorse Low self-esteem masked by bravadoLow self-esteem masked by bravado Lying to peers or adultsLying to peers or adults Frequent physical fights; use of weaponsFrequent physical fights; use of weapons Destruction of propertyDestruction of property

Conduct DisorderConduct DisorderStrategies and Strategies and

AccommodationsAccommodations Remember that praise is important, but needs to Remember that praise is important, but needs to

be sincere.be sincere. Be aware that adults can unconsciously form and Be aware that adults can unconsciously form and

express negative impressions. Try to monitor your express negative impressions. Try to monitor your emotions and communicate a positive regard for emotions and communicate a positive regard for the child.the child.

Remember that children with conduct disorder Remember that children with conduct disorder like to argue – maintain calm, respect, and like to argue – maintain calm, respect, and detachment.detachment.

Give the student options.Give the student options. Avoid escalating prompts, such as shouting, Avoid escalating prompts, such as shouting,

touching, nagging, or cornering the child.touching, nagging, or cornering the child. Rules should be few, fair, clear, displayed, taught, Rules should be few, fair, clear, displayed, taught,

and consistently enforced.and consistently enforced.

Tourette Syndrome: Tourette Syndrome: Symptoms and BehaviorSymptoms and Behavior

Repetitive eye blinkingRepetitive eye blinking Repetitive clearing of the throatRepetitive clearing of the throat Repetitive coughingRepetitive coughing Repetitive lip lickingRepetitive lip licking Repetitive fist clenchingRepetitive fist clenching Imitating or echoing the words of othersImitating or echoing the words of others Imitating or echoing the motions of othersImitating or echoing the motions of others Leg jerksLeg jerks Vocal outburstsVocal outbursts

Tourette Syndrome: Tourette Syndrome: Strategies and Strategies and

AccommodationsAccommodations Concentrate on helping the child develop Concentrate on helping the child develop

friendships, experience trust, feel competent in friendships, experience trust, feel competent in completing activities – not stopping the tics.completing activities – not stopping the tics.

Teach relaxation and deep breathing exercises.Teach relaxation and deep breathing exercises. Teach the child to tune into and recognize their Teach the child to tune into and recognize their

emotions and levels of frustration – increased emotions and levels of frustration – increased frustration or anxiety can cause an increase in frustration or anxiety can cause an increase in tic behavior.tic behavior.

Do not punish the child for engaging in tics or Do not punish the child for engaging in tics or what may appear to be strange habits.what may appear to be strange habits.

Build a culture of tolerance and acceptance.Build a culture of tolerance and acceptance. Try to identify sensory triggers (bright lights, Try to identify sensory triggers (bright lights,

loud noises, chaotic activity) and take steps to loud noises, chaotic activity) and take steps to structure the environment to avoid these structure the environment to avoid these triggers.triggers.

Reactive Detachment DisorderReactive Detachment DisorderSymptoms or BehaviorsSymptoms or Behaviors

Destructive to self or othersDestructive to self or others Absence of guilt or remorseAbsence of guilt or remorse Denial of accountability – always blaming othersDenial of accountability – always blaming others Poor eye contactPoor eye contact Extreme defiance and control issuesExtreme defiance and control issues StealingStealing Lack of cause and effect thinkingLack of cause and effect thinking Mood swingsMood swings False abuse allegationsFalse abuse allegations Sexual acting outSexual acting out Inappropriately demanding or clingyInappropriately demanding or clingy Poor peer relationshipsPoor peer relationships Abnormal eating patternsAbnormal eating patterns Preoccupied with gore, firePreoccupied with gore, fire Toileting issuesToileting issues No impulse controlNo impulse control Chronic nonsensical lyingChronic nonsensical lying Unusual speech patterns or problemsUnusual speech patterns or problems Bossy – needs to be in controlBossy – needs to be in control Manipulative – superficially charming and engagingManipulative – superficially charming and engaging

Reactive Detachment DisorderReactive Detachment DisorderStrategies and AccommodationsStrategies and Accommodations

Be predictable, consistent, and repetitive. Be predictable, consistent, and repetitive. Students with RAD are sensitive to changes Students with RAD are sensitive to changes in schedules, transitions, surprises, and in schedules, transitions, surprises, and chaotic social situations.chaotic social situations.

Model and teach appropriate social Model and teach appropriate social behaviors.behaviors.

Avoid power struggles – try not to respond Avoid power struggles – try not to respond emotionally.emotionally.

Identify a (supervised) place for the child Identify a (supervised) place for the child to go to regain composure during times of to go to regain composure during times of frustration and anxiety.frustration and anxiety.

Fetal Alcohol Spectrum Fetal Alcohol Spectrum DisordersDisorders

Symptoms or BehaviorsSymptoms or Behaviors Early ChildhoodEarly Childhood

Speech or gross motor delaysSpeech or gross motor delays Extreme tactile sensitivity or insensitivityExtreme tactile sensitivity or insensitivity Erratic sleeping and/or eating habitsErratic sleeping and/or eating habits Poor habituationPoor habituation Lack of stranger anxietyLack of stranger anxiety Poor or limited abstract reasoning ability Poor or limited abstract reasoning ability

(action/consequence connection, judgment and (action/consequence connection, judgment and reasoning skills, sequential learning)reasoning skills, sequential learning)


Symptoms or BehaviorsSymptoms or Behaviors Elementary YearsElementary Years

Normal, borderline, or high IQ, but immatureNormal, borderline, or high IQ, but immature Blames others for all problemsBlames others for all problems Volatile and impulsive, impaired reasoningVolatile and impulsive, impaired reasoning School becomes increasingly difficultSchool becomes increasingly difficult Socially isolated and emotionally disconnectedSocially isolated and emotionally disconnected High need for stimulationHigh need for stimulation Vivid fantasies and perseveration problemsVivid fantasies and perseveration problems Possible fascination with knives and/or firePossible fascination with knives and/or fire


Symptoms or BehaviorsSymptoms or Behaviors Adolescent YearsAdolescent Years

No personal or property boundariesNo personal or property boundaries Naïve, suggestible, a follower, a victim, Naïve, suggestible, a follower, a victim,

vulnerable to peersvulnerable to peers Poor judgment, reasoning, and memoryPoor judgment, reasoning, and memory Isolated, sometimes depressed and/or Isolated, sometimes depressed and/or

suicidalsuicidal Poor social skillsPoor social skills Doesn’t learn from mistakesDoesn’t learn from mistakes


Strategies and Strategies and AccommodationsAccommodations Be as consistent as possible. The way something is learned Be as consistent as possible. The way something is learned

the first time will have the most lasting effect.the first time will have the most lasting effect. Use a lot of repetition – these children need more time and Use a lot of repetition – these children need more time and

more repetition to learn.more repetition to learn. Use multi-sensory instruction to build more neurological Use multi-sensory instruction to build more neurological

connections.connections. Be specific, yet brief – be as concrete as possible.Be specific, yet brief – be as concrete as possible. Increase supervision when possible – with emphasis on Increase supervision when possible – with emphasis on

positive reinforcement of appropriate behavior.positive reinforcement of appropriate behavior. Model appropriate behavior – point it out when you see it.Model appropriate behavior – point it out when you see it. Post all rules and schedules in a fashion the child can Post all rules and schedules in a fashion the child can

understand.understand. Apply consequences immediately.Apply consequences immediately. Ensure the child’s attention and check for understanding.Ensure the child’s attention and check for understanding. Encourage the use of positive self-talk.Encourage the use of positive self-talk.

Schizophrenia: Symptoms and Schizophrenia: Symptoms and BehaviorsBehaviors

Confused thinking (fiction versus nonfiction)Confused thinking (fiction versus nonfiction) Vivid and bizarre thoughts and ideasVivid and bizarre thoughts and ideas HallucinationsHallucinations Hearing, seeing, feeling, or smelling things that are not Hearing, seeing, feeling, or smelling things that are not

presentpresent DelusionsDelusions Having beliefs that are fixed and false (i.e., aliens are out to Having beliefs that are fixed and false (i.e., aliens are out to

get them)get them) Severe anxiety and fearfulnessSevere anxiety and fearfulness Extreme moodinessExtreme moodiness Severe problems in making and keeping friendsSevere problems in making and keeping friends Feelings that people are “out to get them”Feelings that people are “out to get them” Odd behavior, including behavior resembling that of a much Odd behavior, including behavior resembling that of a much

younger childyounger child Disorganized speechDisorganized speech Lack of motivationLack of motivation

Schizophrenia: Strategies and Schizophrenia: Strategies and AccommodationsAccommodations

Reduce stress by going slowly when Reduce stress by going slowly when introducing new situations.introducing new situations.

Encourage other adolescents to be Encourage other adolescents to be kind and to extend their friendship.kind and to extend their friendship.

Try to identify and capitalize on Try to identify and capitalize on individual strengths.individual strengths.

Mood Disorders: DepressionMood Disorders: DepressionCommon SymptomsCommon Symptoms

Sadness that won’t go awaySadness that won’t go away HopelessnessHopelessness IrritabilityIrritability School avoidanceSchool avoidance Changes in eating and sleeping patternsChanges in eating and sleeping patterns Frequent complaints of aches and painsFrequent complaints of aches and pains Thoughts of death or suicideThoughts of death or suicide Self-deprecating remarksSelf-deprecating remarks Persistent boredom, low energy, or poor Persistent boredom, low energy, or poor

concentrationconcentration Increased activityIncreased activity

Mood Disorders: DepressionMood Disorders: DepressionStrategies and Strategies and

AccommodationsAccommodations Help children use realistic and positive statements Help children use realistic and positive statements

about their performance and outlook for the future.about their performance and outlook for the future. Acknowledge but don’t minimize the child’s Acknowledge but don’t minimize the child’s

feelings.feelings. Openly recognize and acknowledge positive Openly recognize and acknowledge positive

contributions and performance.contributions and performance. Depressed children may see things in black and Depressed children may see things in black and

white terms – all bad or all good. It may help to white terms – all bad or all good. It may help to have someone else share things from another have someone else share things from another perspective.perspective.

Encourage gradual social interaction.Encourage gradual social interaction. Ask parents what is helpful at home.Ask parents what is helpful at home. Don’t be afraid to suggest that parents seek Don’t be afraid to suggest that parents seek

outside help.outside help.

Mood Disorders: Bipolar Mood Disorders: Bipolar DisorderDisorder

Also know as “manic-depressive” disorder.Also know as “manic-depressive” disorder. A brain disorder that causes unusual shifts A brain disorder that causes unusual shifts

in a person’s mood, energy, and ability to in a person’s mood, energy, and ability to function.function.

Much more severe than the typical “ups Much more severe than the typical “ups and downs.”and downs.”

One percent of the population over 18 One percent of the population over 18 may have bipolar disorder.may have bipolar disorder.

In children and younger adolescents, the In children and younger adolescents, the episodes are less clearly defined and may episodes are less clearly defined and may cycle much more quickly, even up to many cycle much more quickly, even up to many times per day.times per day.


Symptoms and BehaviorsSymptoms and Behaviors An expansive or irritable moodAn expansive or irritable mood DepressionDepression Rapidly changing moods lasting a few hours to a few daysRapidly changing moods lasting a few hours to a few days Explosive, lengthy, and often destructive ragesExplosive, lengthy, and often destructive rages Separation anxietySeparation anxiety Defiance of authorityDefiance of authority Hyperactivity, agitation, and distractibilityHyperactivity, agitation, and distractibility Strong and frequent cravings, often for carbohydrates and Strong and frequent cravings, often for carbohydrates and

sweetssweets Impaired judgment, impulsivity, racing thoughts, and Impaired judgment, impulsivity, racing thoughts, and

pressure to keep talkingpressure to keep talking Dare-devil behaviorsDare-devil behaviors Inappropriate or precocious sexual behaviorInappropriate or precocious sexual behavior Delusions and hallucinationsDelusions and hallucinations Grandiose belief in one’s own abilities that defy the laws of Grandiose belief in one’s own abilities that defy the laws of

logic (become a rock star overnight, for example)logic (become a rock star overnight, for example)


Strategies and Strategies and AccommodationsAccommodations Understand that the child with bipolar Understand that the child with bipolar

disorder may cycle rapidly and be disorder may cycle rapidly and be unpredictable – something which seems to unpredictable – something which seems to be “working” may suddenly cause problems.be “working” may suddenly cause problems.

Identify a “safe” place where the child can Identify a “safe” place where the child can go until he regains control.go until he regains control.

Children with bipolar disorder generally have Children with bipolar disorder generally have very poor social skills, and would benefit very poor social skills, and would benefit from direct instruction in social interaction from direct instruction in social interaction skills.skills.

Don’t be afraid to suggest that parent’s seek Don’t be afraid to suggest that parent’s seek outside help.outside help.

Anxiety DisordersAnxiety Disorders

The most common anxiety disorders The most common anxiety disorders affecting children are:affecting children are: Generalized Anxiety DisorderGeneralized Anxiety Disorder PhobiasPhobias Social PhobiaSocial Phobia Panic DisorderPanic Disorder Obsessive-Compulsive DisorderObsessive-Compulsive Disorder Post Traumatic Stress DisorderPost Traumatic Stress Disorder Adjustment DisorderAdjustment Disorder

Write the “Pledge of Allegiance” under Write the “Pledge of Allegiance” under the following conditions: the following conditions:

Keep a running count of the Keep a running count of the number number of times you write the letter of times you write the letter “e” – if “e” – if you lose count, you must start you lose count, you must start overover

Every time you hear the smack on Every time you hear the smack on the the table, jerk your head sharply to the table, jerk your head sharply to the

rightright

Anxiety DisordersAnxiety DisordersObsessive-Compulsive DisorderObsessive-Compulsive Disorder

Recurrent, persistent, intrusive Recurrent, persistent, intrusive thoughts or impulsesthoughts or impulses

May perform behaviors in a ritualistic May perform behaviors in a ritualistic mannermanner

Children with OCD may experience a Children with OCD may experience a high level of anxiety and shame high level of anxiety and shame about their thoughts and behaviorabout their thoughts and behavior

Anxiety Disorders: Post Anxiety Disorders: Post Traumatic Stress DisorderTraumatic Stress Disorder

Flashbacks, hallucinations, nightmares, recollections, Flashbacks, hallucinations, nightmares, recollections, re-enactment, or repetitive play referencing the eventre-enactment, or repetitive play referencing the event

Emotional distress from reminders of the eventEmotional distress from reminders of the event Physical reactions from reminders of the eventPhysical reactions from reminders of the event Fear of certain places, things, or situations that Fear of certain places, things, or situations that

remind them of the eventremind them of the event Denial of the eventDenial of the event A sense of foreshortened futureA sense of foreshortened future Difficulty concentrating and easily startledDifficulty concentrating and easily startled IrritabilityIrritability ImpulsivenessImpulsiveness Anger and hostilityAnger and hostility Depression and overwhelming sadness or Depression and overwhelming sadness or

hopelessnesshopelessness

Anxiety Disorders: Strategies Anxiety Disorders: Strategies and Accommodationsand Accommodations

Try to accommodate situations the child has no Try to accommodate situations the child has no control overcontrol over

Educate the child’s peers about particular Educate the child’s peers about particular symptoms, such as the compulsions of OCDsymptoms, such as the compulsions of OCD

Be attentive to changes in the child’s behavior, Be attentive to changes in the child’s behavior, which may indicate added stresswhich may indicate added stress

Avoid belittling a child’s fear or anxiety; instead, Avoid belittling a child’s fear or anxiety; instead, validate the concern without confirming that the validate the concern without confirming that the fear is real.fear is real.

Model positive self-talkModel positive self-talk Help children verbalize their feelings and fearsHelp children verbalize their feelings and fears Teach relaxation and deep breathing techniquesTeach relaxation and deep breathing techniques

Adjustment Disorder: Adjustment Disorder: Symptoms and BehaviorsSymptoms and Behaviors

Appear subdued, irritable, anxious, or Appear subdued, irritable, anxious, or withdrawnwithdrawn

Resist going to sleepResist going to sleep Have frequent tantrumsHave frequent tantrums Regress in the ability to toilet independentlyRegress in the ability to toilet independently Have increased separation anxietyHave increased separation anxiety Exhibit acting out behaviors that are Exhibit acting out behaviors that are

uncharacteristic for the child, such as biting uncharacteristic for the child, such as biting or hittingor hitting

Adjustment DisorderAdjustment Disorder

Can be further categorized by the specific Can be further categorized by the specific symptoms experienced:symptoms experienced: Adjustment disorder with depressed moodAdjustment disorder with depressed mood Adjustment disorder with anxietyAdjustment disorder with anxiety Adjustment disorder with mixed anxiety and Adjustment disorder with mixed anxiety and

depressed mooddepressed mood Adjustment disorder with disturbance of Adjustment disorder with disturbance of

conductconduct Adjustment disorder with mixed disturbance of Adjustment disorder with mixed disturbance of

emotions and conductemotions and conduct Adjustment disorder, unspecifiedAdjustment disorder, unspecified

Adjustment Disorder: Adjustment Disorder: Strategies and Strategies and

AccommodationsAccommodations Be attuned to how environmental changes Be attuned to how environmental changes

impact a childimpact a child Help prepare children for changesHelp prepare children for changes Allow the child time to adjust to changeAllow the child time to adjust to change Do all you can to reassure the child that Do all you can to reassure the child that

someone is in control and that their life will someone is in control and that their life will go on with as little disruption as possiblego on with as little disruption as possible

Share concerns with parents, being sure to Share concerns with parents, being sure to focus on the child’s behaviors and avoid focus on the child’s behaviors and avoid drawing conclusions about whether the drawing conclusions about whether the behaviors are indicative of a mental health behaviors are indicative of a mental health problemproblem

Eating Disorders: Anorexia Eating Disorders: Anorexia and Bulimiaand Bulimia

Increasingly seen in younger and Increasingly seen in younger and younger children, with children as younger children, with children as young as 4 or 5 expressing the need young as 4 or 5 expressing the need to diet. to diet.

Mostly seen in females, although 10-Mostly seen in females, although 10-20 percent of adolescents with 20 percent of adolescents with eating disorders are male.eating disorders are male.

Anorexia and bulimia can exist Anorexia and bulimia can exist together or separately.together or separately.

Eating DisordersEating DisordersSymptoms or Behaviors of Symptoms or Behaviors of

NoteNote Perfectionist attitudePerfectionist attitude Impaired concentrationImpaired concentration All or nothing thinkingAll or nothing thinking Depressed mood or mood swingsDepressed mood or mood swings Self-deprecating statementsSelf-deprecating statements IrritabilityIrritability LethargyLethargy AnxietyAnxiety Fainting spells and dizzinessFainting spells and dizziness HeadachesHeadaches Hiding foodHiding food Avoiding snacks or activitiesAvoiding snacks or activities Frequent trips to the bathroomFrequent trips to the bathroom

Eating DisordersEating DisordersStrategies and Strategies and

AccommodationsAccommodations Stress acceptance in your setting; Stress acceptance in your setting;

successful people come in all shapes and successful people come in all shapes and sizes.sizes.

Watch what you say. Comments like “You Watch what you say. Comments like “You look terrible,” “I wish I had that problem” look terrible,” “I wish I had that problem” are often hurtful and discouraging.are often hurtful and discouraging.

Stress progress, not perfection.Stress progress, not perfection. Avoid high levels of competition.Avoid high levels of competition. Reduce stress when possible.Reduce stress when possible.

EvaluationEvaluation

Please complete the evaluation and leave Please complete the evaluation and leave itit

Be sure to note any topics for future Be sure to note any topics for future trainingtraining

mental health disorders in young children and youth a primer for youth workers

Documents

health impairment

mental health disorders

health factors

medicalmental health

mental health dsmiv

educational disability

educational eligibility

accurate diagnosis