Mark would like to thank his wife, Lisa, for her support, understanding, encouragement and love. He also wants to thank his children, Ashley and Jonathan, who provide healthy role models.
Epidemiology, Health Services Utilization, and Costs
However, children from low-income families were more likely than children from middle-high-income families to use emergency departments. Children from low-income families were more likely than children from middle-high-income families to have their parents report major difficulties in obtaining health care and receiving a referral to a specialist.
Genetic and Chromosomal Disorders
Researchers find that low-income families have problems with insurance coverage, health care utilization, and quality of care for their children. 2005) discovered that children from low-income families are more likely than children from middle-income families to be uninsured or have public insurance and less likely to be privately insured. Children from low-income families were less likely than children from middle-income families to have a medical office visit or a dental office visit, less likely to have prescribed medication or use hospital outpatient services.
Cerebral Palsy
Medicaid and SCHIP have not achieved the expected results as more than 70% of uninsured children are eligible for each of these public programs. Additionally, families of uninsured children face non-financial barriers to health care, such as lack of consistent care from a primary care professional and insufficient visitation time.
Autism Spectrum Disorders
Children and adolescents with ASD have high rates of mental health services, which increases the cost of health care expenditures. 2009) examined the economic costs of ASD in the UK using data on prevalence, level of intellectual disability, accommodation, annual costs of services and support, and opportunity costs of lost productivity. After discounting for a person with ASD and intellectual disability, the estimated lifetime cost was £1.23 million, while for an individual with ASD without intellectual disability the lifetime cost was estimated at £0.80 million.
ADHD
Based on the 1996 Medical Expenditure Panel Survey, Chan et al. 2002) compared the costs of treating children with ADHD with the costs of treating children with asthma and the general pediatric population. The researchers found that children with ADHD had higher average total health care costs ($1,151) than children with asthma ($1,091) and the general pediatric population ($712).
Psychiatric/Behavioral and Emotional Disorders
At age 18, they found that children and adolescents with BD had a higher rate of comorbid medical conditions than children and adolescents with other psychiatric disorders. Youth with BD suffered more toxic effects and side effects than youth with other psychiatric problems.
Eating Disorders
Forty percent of total expenditures ($197.8 million) for behavioral health care reimbursed by Medicaid were spent on 5,728 special education children, and 60% were spent on 15,092 children. The authors conclude that children in special education receive a disproportionate amount of Medicaid-reimbursed behavioral health services, and the Deficit Reduction Act could jeopardize funding for these services.
Obesity
In addition, they estimate that more than 1.4 million children may be in the early stages of liver disease. The authors found that between 1988 and 2006, the prevalence of chronic conditions among children and young people increased.
Diabetes Mellitus
Research on IDDM incidence by gender in Allegheny County, PA, revealed that white children had a slightly increased incidence in males (LaPorte et al., 1995). Based on a literature, Icks et al. 2007) reported that hospitalization due to poor metabolic control, education and acute complications account for the significant cost of treating children with type 1 DM.
Juvenile Asthma
Data on ER visits for children with asthma attacks provide a raw picture of the burden of severe and uncontrolled disease on children, families, and the health care system. Hospitalization entails significant costs for the children's families and for the health care system.
Juvenile Arthritis
HIV and AIDS
Children are affected by HIV in many ways, and their families and friends are also adversely affected by the epidemic (Brown et al., 2000). Research shows that highly active antiretroviral treatments can be effectively and safely administered to children in resource-poor settings (Klein et al., 2004).
Cancer and Leukemia
The incidence of ALL has varied with age. 1996) found a sharp peak in the incidence of ALL among young children aged 2–3 years. White children aged 2 to 3 years had a threefold higher incidence compared with African American children.
Cancer-Related Pediatric Health-Care Utilization and Costs
Health care for children and youth in the United States: annual report on patterns of coverage, utilization, quality, and expenditures. Health care for children and youth in the United States: 2002 report on trends in access, utilization, quality, and expenditures.
Chromosomal Abnormalities
In addition to maternal age, other parental characteristics may also be associated with an increased risk of certain congenital abnormalities in the offspring. Research shows that parental occupation and Hispanic ethnicity can increase the risk of certain birth defects.
Down Syndrome (DS)
The researchers found that the FXS group relied on more interesting forms in conversation than the DS group. The DS group shows more speech dysfluencies than the autism group, but not more than the FXS group.
Prader–Willi Syndrome (PWS)
Individuals with PWS are at increased risk for emotional, behavioral, and cognitive problems (Whitman et al., 2002). GHRT has shown significant positive psychosocial and behavioral effects in individuals without PWS (Whitman et al., 2002).
Angelman Syndrome (AS)
The authors recommend using GHRT to treat PWS. 2007) assessed the QOL of those diagnosed with PWS who underwent growth hormone therapy. Results indicated that those with PWS had significant improvement in terms of both psychological and physical well-being.
Patau Syndrome (PS)
In partial PS of the distal segment, there is evidence of a distinctive facial appearance with a short upturned nose, a longer than normal area between the upper lip and nose and bushy eyebrows. With partial PS of the proximal segment, there may be a variety of facial features, including a receding jaw, large nose, and a short upper lip.
Edwards Syndrome (ES)
In almost all cases, the baby has breathing problems and heart defects, including holes between the chambers of the heart, holes in the valves of the lungs and heart, and malformed ducts that lead to abnormal direction of blood flow and misplacement of the heart in the right side of the chest. She had polydactyly in the left hand, congenital clubfoot and convex soles, and ocular hypertelorism.
Cri du Chat Syndrome (CdCS)
Researchers have examined factors that cause variability in mental retardation and associated symptoms in persons with CdCS. These two genes may be involved in cerebral development and their deletion may cause mental retardation in individuals with CdCS.
Wolf–Hirschhorn Syndrome (WHS)
Eradication of these sleep disturbances can be effective if they are influenced and positively reinforced by their parents' responses. One case study of a 6-year-old girl with WHS showed that eradication of sleep problems was effective and maintained at follow-up (Curfs et al., 1999).
Velocardiofacial Syndrome (VCFS)
Children with VCFS tend to have relative strength in reading, spelling and memorization and relative weakness in mathematics and abstract reasoning (De Smedt et al., 2003). Based on a sample of children and adolescents with VCFS, Oskarsdottir et al. 2005) showed that children with this syndrome have various neurological, motor and cognitive difficulties.
Turner Syndrome (TS)
Children with TS are typically of normal intelligence and have good verbal and reading skills. Finally, Marco and Skuse (2006) cited an association between the x chromosome and autism and evaluated the prevalence of autism with TS and Klinefelter syndrome.
Klinefelter Syndrome (KS)
In early childhood, those with TS may have frequent middle ear infections, which in some cases can lead to hearing loss. As with other abnormalities of sex chromosomes, TS has been associated with a higher incidence of neuropsychiatric disorders.
Developmental Disabilities (DD)
Persons with DDs are more likely to have mental health problems and psychiatric disorders than those in the general population. The difficulties that health professionals have in diagnosing mental health problems and inappropriate treatment can exacerbate the mental health problems of persons with DDs.
Family Well-Being and Social Functioning
In a study of families of children with CdCS, Hodapp (2008) showed that the child's level of maladaptive behavior was the best indicator of family stress. In a longitudinal study of children with DS, Hauser-Cram et al. 2001) showed that children's type of disability was the best predictor of changes in maternal, but not paternal, child-associated stress.
The Health-Care Experiences of Families
They concluded that several factors, such as cognitive development, family factors, and newborn history, predict social adjustment of children with this disorder. Using the results of focus groups, King et al. 2006) discovered through changes in their views of the world, values and priorities, parents of children with DS or autism can gain a sense of coherence and control.
School Programs for Children with Chromosomal Abnormalities
Researchers investigate the evolution of behavioral and psychiatric symptoms of children with chromosomal abnormalities from primary school to adulthood. 2002) analyzed changes in behavioral and psychiatric symptoms in children, adolescents and adults with PWS. A variety of factors can contribute to their academic underachievement. 2004) analyzed the academic performance of a group of children with PWS and a comparison group of children with LD.
Case Study
Analysis of speech characteristics in children with velocardiofacial syndrome (VCFS) and children with phenotypic overlap without VCFS. Pre-academic and early academic performance in children with velocardiofacial syndrome (del22q11.2) of borderline or normal intelligence.
Autism
Epidemiology of Autism: Is There an Autism Epidemic?
Genetics of Autism
Family studies, as summarized in The Genetics of Autism, show that autism in siblings recurs at 2-8%, a rate much higher than the prevalence of autism in the general population (Muhle et al., 2004). GABA is an inhibitory neurotransmitter, and downregulation of GABA receptors may explain both the comorbid seizures and the cognitive impairments characteristic of autism (Fatemi et al., 2009).
Other Risk Factors Associated with Autism
Vaccines and Autism
Pathophysiology of Autism
Many experts now follow gluten- and casein-free diets as an alternative treatment for autism (Millward et al., 2008). The hypothesis that autism is related to autoimmune disorders was first proposed by Money et al.
Comorbidities of Autism
Animal models suggest that during fetal brain development, high levels of serotonin can disrupt serotonergic function and cause the behavioral and social dysfunction characteristic of autism (McNamara et al., 2008). A subset of autistic individuals have an abnormal immune system, but it is unclear how dysfunctional immunity contributes to the development and/or persistence of autistic symptoms (Wills et al., 2007).
Physical Conditions Associated with Autism
Psychosocial Impact of Autism
Research on the general well-being of siblings of children with chronic disorders found that siblings are at risk for negative psychological symptoms such as anxiety and depression (Sharpe & Rossiter, 2002). Siblings of autistic children may have adjustment problems that increase during adolescence, although study findings on this topic are inconsistent (Orsmond & Seltzer, 2007).
Screening
During childhood and adolescence, siblings of children with autism have been found to have less interaction with their siblings than typically developing siblings: some evidence suggests that it may be more difficult to interact with siblings and become involved as the degree of disability increases (Stoneman, 2001). Although siblings report positive aspects of their relationship with an autistic brother or sister, siblings still worry about feeling ashamed or isolated and worry about their brother or sister's destructive behavior and future ( Orsmond and Seltzer, 2007).
Diagnosis
Course and Prognosis
Opportunities for Intervention
Pharmacological Interventions
In this study, 83% of children were prescribed a drug from one of 125 drug classes, and 70% were prescribed some form of psychotropic medication during 1 year (Oswald and Sonenklar, 2007). Significantly, the effect of psychotropic medications on the developing human brain has not been thoroughly studied (with the exception of stimulants used to treat attention deficit hyperactivity disorder).
Comprehensive Psychosocial Interventions Discrete Trial Training
Medication typically targets symptoms of aggression, self-injury, anxiety, hyperactivity, and hyperarousal (Ozonoff et al., 2003). Thus, the short-term benefits of managing behavior with psychotropic medication must be weighed against the possibility and unknown risk of permanently altering the brain's neurochemistry.
TEACCH
The Learning Experiences, an Alternative Program for Preschoolers and Their Parents (LEAP)
Floor Time”
The Denver Model
Alternative Therapies
The Role of Parents
Specialized terminology emerged from this culture; For example, the term “autistic cousins” is used to describe people without a primary diagnosis of autism, and the phrase “different brain” is preferred.
Policy
Health Care
Education
Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: associations with child characteristics. A ten to fifteen year follow-up of a subgroup of children with Autism Spectrum Disorders (ASD) who received a comprehensive developmental, individual-differences, relationship-based (DIR) approach.
Symptoms and Risk Factors
A second type of CP is athetotic or dyskinetic cerebral palsy, which affects about one in five people with CP. This condition is the least common of the main forms of CP and affects balance and coordination.
Quality of Life
In another study, Dunn et al. 2007) found that parents of CP children rated their child's abilities and attributes lower than the children did. Based on a cross-sectional study in Europe, Parkes et al. 2008) evaluated psychological symptoms in 818 CP children.
Quadriplegia
Adolescents
They concluded that a significant number of adolescents and young adults with CP without severe learning difficulties were limited in their social participation. In another study by Wiegerink et al. 2006) examined 14 studies among adolescents and young adults with CP and found that self-efficacy and sexual self-esteem, as well as their interrelationships with the way parents raise their children and successful experiences in social situations, are important factors were in the development of social and sexual relationships.
Treatment Physical Therapy
Sterba (2006) investigated the effect of adaptive alpine skiing on gross motor function in children with spastic CP. Many children with CP have problems with drooling and dysarthria (difficulty formulating words caused by weakness of the speech muscles).
Devices and Gadgets
Surgical and Medical Interventions
Children who showed greater standing knee flexion four or more years postoperatively had more surgical procedures, a greater postoperative popliteal angle, and a smaller knee extension range of motion. 2006) investigated the efficacy of neuromuscular electrical stimulation (NMES) and threshold electrical stimulation (TES) in strengthening leg muscles in children with CP. They found that BTXA was a safe and effective treatment for upper limb dystonia in children with CP.
Parents and Other Caregivers of Children with CP
Effectiveness of physiotherapy and follow-up education interventions in children with cerebral palsy: a focused review. Increasing ankle strength to improve gait and function in children with cerebral palsy: a pilot study.
Attention-Deficit Hyperactivity Disorder
Using a sample of 149 families, Pfiffner et al. 2005) showed that negative and ineffective disciplining by mothers was associated with ADHD children with comorbid ODD and CD. Similar findings were obtained from a sample of 916 persons aged 7 to 18 from the longitudinal study GAZEL Youth (Galera et al., 2008).
Controversies About ADHD
Based on a sample of 129 patients referred to an anxiety disorder clinic, Van Ameringen et al. Researchers assessed the possible link between ADHD in childhood and adolescence and suicidal behavior (Sourander et al.,2009; Galera et al ., 2008).
ADHD Symptoms
Comorbid Disorders
Using a sample of 181 children with Tourette syndrome and ADHD and 172 controls, one report showed that children with Tourette syndrome and ADHD were more likely to be exposed to low birth weight, prematurity, breathing problems and maternal smoking compared with children with Tourette Syndrome only (Pringsheim et al., 2009). Using teacher ratings on the Strengths and Difficulties Questionnaire (SDQ), Iizuka et al. 2010) discovered that ADHD children had more evidence of hyperactivity, inattention and conduct problems than children with high-functioning autism spectrum disorder (HFAS).
Causes/Risk Factors
Genetic Factors
A combination of different genes, especially those that affect dopamine transporters, can influence the development of the condition. Although genetic factors may play a role, no single gene has been identified as playing a role in the etiology of the condition (Acosta et al., 2004).
Environmental Factors
Dopamine transporter, dopamine D4 receptor, dopamine beta-hydroxylase, monoamine oxidase A, catecholamine methyl transferase and serotonin transporter promoter (SLC6A4), 5-hydroxytryptamine receptor 2A (5-HT2A), 5-hydroxytryptamine receptor 1B (5-HT1B) are some candidate genes (Roman et al., 2004). ADHD does not adhere to the traditional genetic disease model due to the variety of targets thought to cause the disorder.
Diet Factors
Social and Behavioral Factors
Alternative Theories of ADHD
Social construct theorists do not believe that the condition is primarily a biological condition (Stead et al., 2005). The diagnosis of ADHD is a clinical one as there is no objective test for the condition (Joughin et al., 2003).
Treatment
Hypothyroidism, anemia, lead poisoning, chronic diseases, hearing or vision impairment and side effects of medication are some of the medical problems that must be considered (Smucker and Heydayat, 2001). Additionally, problems related to substance abuse and child abuse must be ruled out before ADHD is diagnosed.
ADHD Medications
Nineteen percent of physicians in the sample reported being concerned about the diversion of ADHD medications. About 38% of doctors in the survey preferred to treat children or adolescents with ADHD with a non-stimulant.
Behavior Treatment Approaches
The effectiveness of BPT may also depend on whether ADHD children have comorbid ODD and CD (Chronis et al., 2004). One Dutch study compared the effectiveness of BPT (12 sessions in a group format) as an adjunct to routine clinical care (RCC) (family support and medication when appropriate) (van den Hoofdakker et al., 2007).
ADHD Children in School
A comparison of behavioral parent training programs for fathers of children with attention deficit/hyperactivity disorder. Parenting children with attention-deficit/hyperactivity disorder (ADHD): the role of parental ADHD symptomatology.
Sensory Integration Dysfunction
Three Types of SID
Another aspect of sensory modulation disorders is sensory defensiveness, where children and some adults overreact to sensory stimuli. Children with Type 1 Disorder: Sensory Modulation Disorder may become fearful or anxious and develop negative and/or stubborn behavior.
Hyposensitivity and Hypersensitivity
Children and some adults with Type 1: Sensory Modulation Disorder may over- or under-react to sensory stimuli or engage in behaviors that stimulate their senses (Case-Smith, 2005; Miller et al., 2007). One component of sensory modulation disorder consists of sensory registration problems, which refer to problems with the child's central nervous system processing sensory stimuli.
Other Disorders
During an auditory evaluation, the child may be asked to listen to signals from headphones and determine where the signals are coming from. The auditory evaluation may be inconclusive if the child is distracted, bored, or unsure of the test's verbal instructions.
Sensory Integration Treatment
Parents and teachers can modify the child's environment in many ways to help them cope with sensory integration problems (Kane, 2004). For children who have problems with positional awareness, it is recommended that teachers use markers or masking tape to demarcate the child's personal space (Kane, 2004).
Conduct Disorder and Oppositional Defiant Disorder
Demographic Characteristics
Using a representative sample of 10,438 children aged 5–15 years from the 1999 British Child Mental Health Survey, Maughan et al. 2004) found that CD was more prevalent among boys than girls. ODD age patterns vary depending on its overlap with how CD is classified and diagnosed (Maughan et al., 2004).
Causes of CD
Individuals with ODD have a younger onset than individuals with CD (Office for Children and Family Policy, 2008). Individuals with childhood-onset CD must have one condition criterion before age 10 (Office for Children and Family Policy, 2008).
Assessment
In their meta-analysis of randomized controlled trials, Munoz-Solomando et al. 2008) discovered that CBT has not been shown to be effective in the treatment of behavior-related behaviors. Community-based residential programs have been used to treat children with CD and ODD (Conner, 1998-2000).
Prognosis
Among youth with CD at the onset of adolescence, there is less gender disparity (Encyclopedia of Children's Health, undated). In contrast, for youth with childhood-onset CD, the incidence of the disorder is higher for boys than for girls.
Prevention
Impact of CD on Family Functioning
He was later placed in a therapeutic school for children and adolescents with emotional and/or behavioral problems. Family functioning and psychosocial characteristics in children with attention deficit hyperactivity disorder with comorbid oppositional defiant disorder or conduct disorder.
Depressive Disorders in Children and Adolescents
Epidemiology
Risk Factors
For example, rapid and intense excitement has been associated with an increased risk of depression (Purper-Ouakil et al., 2002). In addition, youth who have conduct disorder (CD) and other disruptive problems are at increased risk for depression (Purper-Ouakil et al., 2002).
Types of Depression
Children and adolescents who are victims of bullying and other forms of violence in schools and communities are exposed to an increased risk of depression, anxiety, suicide and other problems such as eating disorders and somatic symptoms (Brunstein Klomek et al., 2007; Like adults, children and adolescents experience grief associated with a major loss, such as the death of a family member.
Disorder
Dysthymic disorder is characterized by a depressed and/or irritable mood for most of the day and for more days if not for at least 1 year. The symptoms of cyclothymic disorder cause significant distress or impairment in social and/or school functioning.
Disorder
The use of selective serotonin reuptake inhibitors (SSRIs) should be the first-line therapy for the acute treatment of depression in children and adolescents (Emslie et al., 2005). In contrast, older children and adolescents would benefit from psychodynamic therapy or CBT (Weller et al., 1996).
Impact on Social, Family, and School Functioning
People with this condition can be classified as either restrictive type, eg, the person loses weight by dieting, fasting, or excessive exercise, or binge eating (BE)/purging type, eg, the individual takes part regularly in EU or clearing or both. . Individuals with BN can be classified as having a purging type, eg, the individual regularly engages in self-induced vomiting or abuses laxatives, diuretics, or enemas, or a non-purging type, eg, the person engages in activities other inappropriate compensatory behaviors, such as fasting or excessive exercise, but does not regularly engage in purging behaviors.
Etiology and Risk Factors
Other family characteristics, behaviors, and dynamics may increase the risk of developing EDS (Rome et al., 2003). Research has led to the speculation that impaired serotonergic function may increase the risk of AN and BN (Rome et al., 2003).
Screening and Assessment
If a physician suspects that a patient has ED, the patient should be screened for suicidal risk (Rome et al., 2003). In order to ensure patient cooperation and support, the patient should be closely monitored during and 1 hour after eating (Rome et al., 2003).
Complications
The authors suggest that CBT-GSH is useful as first-line therapy for most patients with recurrent BE without BN or AN. 2010) report that behavioral weight loss treatment (BWL) and CBT-GSH induced a short-term reduction in BE in obese patients with BED. The researchers conclude that CBT-GSH should be the first-line therapy for the majority of patients with BED.
The Impact of EDs on Family Functioning
The authors compared BWL and CBT-GSH with IPT using a sample of 205 women and men with a BMI between 27 and 45 who met DSM-IV criteria for BED. To what extent do children with ED agree with their parents' perceptions of family functioning.
Psychosocial Adjustment in Young Adulthood of Individuals Who Had an ED During Adolescence
Using a sample of women in an outpatient ED program, Dancyger et al. 2005) showed that mothers rated family functioning as healthier and less dysfunctional than their daughters with ED. What may account for these different perceptions of family functioning between mothers and their adolescent daughters. 2006) found that daughters' general mistrust of people explained differences between mothers' and daughters' scores on problem solving, communication, affective responsiveness, and general functioning.
