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Reactive Attachment Disorder (RAD)
There are several different sub-types of Reactive Attachment Disorders. The ambivalent sub-type can be described as an "in-your-face" child. This is the child who is angry, oppositional, and who can be violent. The anxious sub-type is clingy, anxious, shows separation anxieties, among other symptoms. The avoidant sub-type is often overlooked. This child is very compliant, agreeable, and superficially engaging. This child often has a lack of depth to his emotions and functions as an "as-if" child; meaning that he tries to do and say what you want, but is not genuine, authentic, or real in emotional engagement. Finally, there is the disorganized subtype, this child often presents with bizarre symptoms. The words 'attachment' and 'bonding' are now used interchangeably. Children with Reactive Attachment Disorder exhibit many of the following symptoms: IN INFANTS: Weak Crying Response. Rage. Constant Whining. Sensitivity to Touch/Cuddling. Poor Sucking Response. Poor Eye Contact. No Reciprocal Smile Response. Indifference to Others. IN CHILDREN: Lack of Conscience Development. Superficially Charming. Lack of Eye Contact (except when lying). Inability to give and Receive Affection. Extreme Control Issues. Destructive to Self, Others, Animals and Property. No Impulse Control. Unusual Eating Patterns (hoarding, gorging, or refusal to eat). Unsuccessful Peer Relationships. Incessant Chatter in Order to Control. Very Demanding. Unusual speech patterns, mumbling, robotic speech, talking very softly except when raging. Associated Features Learning Delays and Disorders. Depressed I.Q. scores. Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.ADD. Anti-Social Personality Disorder. Conduct Disorder. Oppositional Defiant Disorder. Fetal Alcohol Syndrome. Developmental Disorder of Receptive Language. Socio-Emotional Problems. Mental Retardation. Schizophrenia. Rett's syndrome. Cause: From conception through approximately the third year of life the child needs to bond in order to develop physical, psychological and emotional health. This early attachment is the foundation for the child's ability to feel empathy, compassion, trust and love. Children with attachment issues and those with Reactive Attachment Disorder have experienced a break in this bonding cycle. This break can be the result of: Genetic Predisposition. Maternal Ambivalence Toward the Pregnancy. Traumatic Prenatal Experience. In-Utero Exposure to Alcohol and/or Drugs. Birth Trauma. Neglect. Abuse. Abandonment. Separation from Birth Parents. Inconsistent or Inadequate Day Care. Divorce. Multiple Moves and/or Placements. Institutionalization (e.g. children adopted from orphanages). Undiagnosed or Untreated painful illness (e.g. untreated ear infections). Medical Conditions which Prohibit Adequate Touch (e.g. child who is in an incubator or body cast).
Mental Retardation
According to the American Association on Mental Retardation (AAMR), an individual is considered to have mental retardation based on the following three criteria: Intellectual functioning level (IQ) is below 70-75. Significant limitations exist in two or more adaptive skill areas and the condition is present from childhood (defined as age 18 or less.). The person's intellectual functioning is markedly below average (IQ of 70 or less on a standard, individually administered test). In 2 or more of the following areas, the patient has more trouble functioning than would be expected for age and cultural group: Communication Self-care Home living Social and interpersonal skills Using community resources Self-direction Academic ability Work Free time Health Safety Starts before age 18. Associated Features: Under developed motor skills Under developed language skills Under developed self-help skills Developing at a far slower rate than the child's peers. Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. None Detailed Causes Mental retardation can be caused by any condition which impairs development of the brain before birth, during birth, or in the childhood years. Several hundred causes have been discovered, but in about one-third of the people affected, the cause remains unknown. The three major known causes of mental retardation are the genetic conditions of Down Syndrome, Fragile X, and Fetal Alcohol Syndrome, the result of alcohol consumption during pregnancy.
Asperger's Disorder
Asperger Syndrome is a neurobiological disorder named after the Viennese physician, Hans Asperger, who in 1944 published a research paper which described a pattern of behaviors in several young boys who had normal intelligence and language development, but who also exhibited autistic-like behaviors and marked deficiencies in social and communication skills. It wasn't until 1994 that Asperger Syndrome was recognised a a unique disorder. Qualitative impairment in social interaction with at least two demonstrations of impaired social interaction. The person: Shows a marked inability to regulate social interaction by using multiple non-verbal behaviors such as body posture and gestures, eye contact and facial expression. Doesn't develop peer relationships that are appropriate to the developmental level. Doesn't seek to share achievements, interests or pleasure with others. Lacks social or emotional reciprocity. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: Preoccupation with abnormal (in focus or intensity) interests that are restricted and stereotyped (such as spinning things). Rigidly sticks to routines or rituals that don't appear to have a function. Has stereotyped, repetitive motor mannerisms (such as hand flapping). Persistently preoccupied with parts of objects. The symptoms cause clinically important impairment in social, occupational or personal functioning. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. The patient doesn't fulfill criteria for Schizophrenia or another specific Pervasive Developmental Disorder. Associated Features: Associated features of Asperger's Syndrome which are not required for diagnosis but are commonly present include delay in motor development often seen as clumsiness, extreme sensitivities to sensations, and excessive, but non-interactive, speech when related to areas of interest. In addition, many children with Asperger's will have behavior problems due to their difficulty in understanding the world around them Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Age-appropriate Behaviors in Active Children. Mental Retardation. Under Stimulating Environments. Oppositional Behavior. Another Mental Disorder. Pervasive Developmental Disorder. Psychotic Disorder. Other Substance-Related Disorder Not Otherwise Specified. Cause: Asperger's Disorder is a milder variant of Autistic Disorder. Both Asperger's Disorder and Autistic Disorder are in fact subgroups of a larger diagnostic category. This larger category is called either Autistic Spectrum Disorders or Pervasive Developmental Disorders.
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