Clinical Reference Systems: Pediatric Advisor 10.0

A child with a major psychiatric disorder has a very serious illness affecting several areas of his or her life. These areas may include emotions, social and intellectual ability, and the use of language. Children with major psychiatric disorders may also have physical problems and may also be mentally retarded.

When a child is examined to see if he or she has a major psychiatric disorder, these are some of the signs experts look for or ask parents about:

• failure to look or smile at parents or other caregivers
• very strange actions or appearance
• lack of movement or facial expression
• lack of interest in or awareness of other people
• odd way of speaking or private language that no one else can understand
• strange conversations with self
• odd or repetitive movements such as spinning, hand- flapping, or head-banging
• panic in response to a change in surroundings.

There are many different kinds of major psychiatric disorders. The specific name given to a child's illness will depend on the symptoms and how severe the illness is.

Major psychiatric disorders often last a long time and may be lifelong. However, when children with these disorders begin treatment early, their health and ability to perform everyday tasks usually improve.

When parents are concerned that their child may have a major psychiatric disorder, they should seek a comprehensive evaluation as soon as possible. Observant parents, physicians, teachers, and others who see the child regularly can compare the child with others in his or her age group. Their observations are very helpful in the initial assessment of the child's problem.

A comprehensive evaluation and treatment plan will then involve a child and adolescent psychiatrist. The psychiatrist will coordinate his or her own findings with those of parents, special educators, pediatricians, neurologists, and developmental and psychological tests.

Comprehensive treatment will involve coordinating several of the following:

• psychotherapy
• specific learning programs
• specific social skill and behavior programs
• psychiatric medication
• special schools or hospitals
• active involvement by the family.

Perhaps because children change so much as they grow, diagnosis of major psychiatric disorders in youngsters is one of the most difficult areas of medicine. Thus, it is extremely important that physicians with adequate training and experience be involved in helping the child and that parents seek help as soon as they begin to be worried about their child.