Module 7 Psychiatric disorders in Childhood and Adolescence . 1 HIV and Mental illness, Bahirdar July 2013
. Objectives 1.To identify treatable underlying problems related to child behavior a. medical conditions b. attention problems c. developmental and learning problems, d. substance use, and e. mood/anxiety problems. 2.To identify emergencies (in particular child maltreatment) - related to behavior problems 3. To use good communication skills to identify specific behavioral targets 4. To use good advice-giving skills to give parents instruction - child behavior strategies 2 HIV and Mental illness, Bahirdar July 2013
. Effect of HIV on children - behavioral /developmental problems • Depressed or chronically ill parents may be less nurturing or more irritable • The secrecy surrounds HIV - lead to difficult parent-child interactions • Ill children may be more irritable and harder to interact with • Learning problems, miss school, fall behind • HIV infection can causes developmental delay – impact on nutrition, – opportunistic infections, or – Direct HIV effects on the brain . 3 HIV and Mental illness, Bahirdar July 2013
. B. Presentation in primary care/ART treatment Getting information about child behavior problems 1.How is the child getting along with other members of the family ? 2.How is the child getting along with friends ? 3.Are there problems reported from school with behavior or learning? 4.For younger children, are there any problems with meal or bed-time behavior ? 4 HIV and Mental illness, Bahirdar July 2013
. 1. Mental retardation • Significantly sub-average general intellectual functioning • Concurrent impairment in adaptive behavior • Manifested during the developmental period, before the age of 18 5 HIV and Mental illness, Bahirdar July 2013
. Questions for detection of child developmental disability 1. Compared to other children, does or did the child have any serious delay in sitting, walking, or standing 2. When you tell the child to do something, does he or she seem to understand what you are saying? 3. Does the child learn to do things like other children? 4. Does the child speak at all? Can he or she make him or herself understood in words; can he or she say any recognizable words? 5. Compared to other children of the same age, does the child appear in any way mentally backward, dull, or slow? * and comorbid conditions 6 HIV and Mental illness, Bahirdar July 2013
. The milestones of development Milestones Normal Delayed Smiles at others 1-4 month 6 months Holds head steady 2-6 months > 6 months Sits without support 5-10 months 12 months Stands without support 9-14 months 18 months Walks well 10-20 months > 20 months Talks in 2-3 words 16-30 months > 3 rd year Can tell own name 2-3 years > 4 th year Toilet trained 3-4 years > 4 th year 7 HIV and Mental illness, Bahirdar July 2013
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