Common Childhood Problems

1. Sleep Walking

Sleepwalking, also known as somnambulism, is a sleep disorder belonging to the parasomnia family. Sleepwalking occurs during the first third of the night during the deepest phase of sleep. Sleep walkers appear to be awake but are unresponsive to individuals who attempt to communicate with them and have no memory of their actions or movements upon walking. 

Symptoms: The DSM-IV specifies six diagnostic criteria for sleepwalking disorder:

* Repeated episodes of rising from bed during sleep.

* Unresponsive to attempts at communication.

* Child typically has no memory of the sleepwalking events.

* No impairment of mental activity upon waking.

* Causes significant distress to life.

* Not due to substance use or abuse.

Causes

Several factors may be involved in the development of sleepwalking, such as genetics (traits that run in families), environmental, medical conditions and stress.

Sleepwalking may also be triggered by fever, general illness, alcohol use, sleep deprivation and emotional stress. Hormonal changes can also be triggers for sleepwalking. According to psychologists, sleepwalking episodes are more likely during times of psychological stress.

Management

Sleepwalking is not usually a sign that something is emotionally or psychologically wrong with a child, and it doesn’t cause any emotional harm. The major risk associated with sleepwalking is accidental injury. Parents should take precautions to block stairways, lock windows, keep floors cleared of harmful objects, etc.

In children, sleepwalking is relatively common and is not cause for concern and usually disappears without treatment by age 15. If sleepwalking episodes persists into adulthood, treatment is recommended.

2. Night Terror

Night terror, also known as a sleep terror, is a parasomnia disorder characterized by extreme terror and a temporary inability to regain full consciousness. They typically occur during non-rapid eye movement sleep.

It primarily affects children. Children from age two to six are most prone to night terrors, and they affect about 15 % of all children.

Symptoms

* Sudden bouts of apparent awakening.

* Overwhelming fear, terror, or strange behavior occurring at night.

* Rapid heartbeat.

* Screaming or crying.

*Confusion.

* Sweating.

* No memory of the event

* Inability to fully awaken.

* Irritable and difficult to sooth back to sleep.

Causes

The causes of sleep terror are for the most part unknown. Some researchers suggest that sleep terror are caused by a delay in the maturation of the child’s CNS. Factors such as sleep deprivation, psychological stress, and fever may also trigger episodes of the sleep terror.

Management

Establish a regular routine and stick to it every night. The child should sleep in the same room every night. Involve in less activity and conversation just before sleep. The bedroom should be free from disruptive stimuli like a loud radio, a television, toy, or other loud noises.

A warm bath just before bed is a relaxing and pleasant sleep-inducing. The bedroom should be dimly lit. Read your child a pleasant, happy story at bedtime. Warm milk at night really can help.

3. Nail Biting

Nail biting is a very common habit that mostly affects kid but it can be present in adults. It is manifested by biting one’s fingernails or toenails during periods of nervousness, stress or boredom. It can be a sign of mental or emotional disorder but is commonly seen in intellectuals.

Approximately 28 % to 33 % of the children ages 7 -10 are biting their nails, as well as the 44% of the adolescents, 19 % to 29 of young adults and 5 % of the older adults.

Causes

 The exact mechanisms and triggers are still unknown, but they seem to increase with boredom, tension or frustration and it appears that the movements are self-stimulatory and sometimes pleasurable. Nail biting is, according to Freudian theory, a symptom of oral fixation.

Management

Behavior treatment, as it is cheap and widely available, is a special clear nail polish that has to be applied to the nails. It releases a bitter flavor on contact with the mouth which discourages the habit and has demonstrated its effectiveness.

Wear a rubber band on their wrist. Keep the kid’s hands occupied. Cut the fingernails short so there is nothing to tempt the kid to bit.

4. Bed Wetting

Bedwetting is involuntary urination while asleep. Bedwetting is the most common pediatric- health issue. Most bed wetting is a developmental delay, not an emotional problem or physical illness.

DSM-IV, defines nocturnal enuresis as repeated urination into bed or clothes, occurring twice per week in a child of at least 5 years of age and not due to either a drug side effect.

Causes

Neurological-developmental delay is the most common cause of bedwetting. Most bedwetting children are simply delayed in developing the ability to stay dry and have no other developmental issues.

Genetics: Bedwetting has a strong genetic component.

Psychological issues are established as a cause of secondary nocturnal enuresis (a return to bedwetting).

Management

Almost all children will outgrow bedwetting. Physicians also frequently suggest bedwetting alarms which sound a loud lone when they sense moisture. Desmopressin tablets area synthetic replacement for anti-diuretic hormone, the hormone that reduces urine production during sleep. Diapers are commonly used by all ages of bedwetters. Dry bed training consists of a strict schedule of waking the child at night. Restrict the intake of fluids late in the evening.

5. Thumb-Sucking

Thumb-sucking is normal in babies and young children during their first few months of life. Babies have a natural urge to suck, which usually decreases after the age of 6 months. But many babies continue to suck their thumbs to sooth themselves. They use it to comfort themselves when they feel hungry, afraid, restless, quite, sleepy or bored. Thumb-sucking in children younger than 4 is usually not a problem.

Management

Little by little, most children stop on their own between ages 3 and 6. Talk to your child openly about the effects of thumb-sucking. Put gloves on your child’s hands or wrap with an adhesive or a cloth. Use a special nontoxic, bitter-tasting nail coating. Apply it like fingernail polish to the thumbnail whenever you see your child sucking his or her thumb. This treatment is most successful when it is combined with a reward system and child should be offered strong emotional support.

6. Autism

Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. The prevalence of autism is about 1-2 per 1000 people.

It is distinguished by a characteristic triad of symptoms:

1. Impairments in social interaction

2. Impairments in communication

3. Restricted interests and

4. Repetitive behavior.

Causes

How autism occurs is not well understood. Autism has a strong genetic basis. Its mechanism can be divided into two areas: The pathophysiology of brain structures and processes associated with autism, and the neuropsychological linkages between brain structures and behaviors.

The under-connectivity theory of autism hypothesizes that autism is marked by under functioning high- level neural connections and synchronization, along with an excess of low-level processes. Researchers suggested Autistics have weak functional connections between the frontal lobe and the rest of the cortex.

Management

No single treatment is best. The main goals of treatment are to lessen associated deficits and family distress, and to increase quality of life and functional independence. Intensive, sustained special education programs and behavior therapy early in life can help children acquire self-care, social and job skills. It should be given as early as possible in their life. Available approaches include applied behavior analysis (ABA), development models, structured teaching, speech and language therapy, social skills therapy and occupational therapy.

Prognosis

It is not known how often recovery happens. A few autistic children have acquired speech at age 5 or older. Most children with autistic lack social support, meaningful relationships, and future employment opportunities or self-determination. Although core difficulties tend to persist, symptoms often become less severe with age.

7. ADHD

Attention-deficit hyperactivity disorder or ADHD is a common childhood illness that can be treated. ADHD is a neurobehavioral developmental disorder, is primarily characterized by the co-existence of attention problems and hyperactivity. About 3 to 5 % of children globally are with symptoms starting before seven years of age. ADHD is diagnosed two to four times as frequently in boys as in girls.

Causes

Any specific cause of ADHD is not known. However, a number of factors may contribute to ADHD; they include genetics, diet, social and physical environments.

According to the low arousal theory, people with ADHD need excessive activity as self-stimulation because of their state of abnormality low level of arousal. The theory states that those with ADHD cannot self-moderate, and their attention can only be gained by means of environmental stimuli, which in turn results in description of attention capacity and an increase in hyperactive behavior.

Management

ADHD management usually involves some combination of medication, behavior modification and life style changes. Psychological therapies used to treat ADHD include psycho-educational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), family therapy, school-based interventions, social skills training and parent management training

Prognosis

Children diagnosed with ADHD have significant difficulties in adolescence, regardless of treatment. Those with ADHD as children are at increased risk of a number of adverse life outcomes once they become teenagers. These include a greater risk of auto crashes, injury and higher medical expenses.