Who We Treat

Disorders Emerging in Childhood

This group of disorders involves conditions and diagnoses that usually begin in childhood or adolescence. Nonetheless, many of the disorders in this section will persist or worsen in adulthood without treatment. It is also important to note that many disorders such as Schizophrenia and Bipolar Disorders, described in other sections, at times may also have childhood or adolescent onset.

Intellectual Developmental Disorder, formerly known as Mental Retardation, is a condition that starts before the age of 18 and which involves substantially subaverageintellectual function as defined as a psychological intelligence quotient (IQ) testing score of below 70. The patient also shows impairment or deficits in adaptive functioning in at least two areas such as communication, home living, self-care, social skills, academic functioning, self-direction, and the ability to independently manage health, safety, and leisure activities. Individuals with Intellectual Developmental Disorder may be further diagnosed as Mild, Moderate, Severe, or Profound depending on the patient’s IQ score.

Learning Disorders, Motor Skills Disorder, and Communication Disorders are a group of diagnoses that have interference with academic, work, and social relationships as a prominent symptom.

  1. •  Reading Disorder is a Learning Disorder diagnosed when reading achievement, as measured by standardized psychological tests, is substantially below what would be expected given the child’s age and overall intelligence. These symptoms significantly interfere with academic, work, or social relationships.
  2. •  Mathematics Disorder is a Learning Disorder diagnosed when mathematical ability, as measured by standardized psychological tests, is substantially below what would be expected given the child’s age and overall intelligence. These symptoms significantly interfere with academic, work, or social relationships.
  3. •  Disorder of Written Expression is a Learning Disorder diagnosed when writing skills, as measured by standardized psychological tests, are substantially below what would be expected given the child’s age and overall intelligence. These symptoms significantly interfere with academic, work, or social relationships.
  4. •  Developmental Coordination Disorder is a Motor Skills Disorder in which performance in day-to-day activities that require motor coordination is substantially below what would be expected given the patient’s intellectual abilities and age. These symptoms significantly interfere with academic, work, or social relationships.
  5. •  Expressive Language Disorder is a Communication Disorder diagnosed when expressive language development, as measured by standardized psychological tests, are substantially below what would be expected given the child’s age and overall intelligence. Examples include a limited vocabulary, making errors in tense, or difficulty writing age-appropriate sentences expected given length and complexity. The child does not meet diagnostic criteria for other Language Disorders or Pervasive Developmental Disorder. These symptoms significantly interfere with academic, work, or social relationships.
  6. •  Mixed Receptive-Expressive Language Disorder is a Communication Disorder in which performance in receptive and expressive language development, as measured by standardized psychological tests, are substantially below what would be expected given the patient’s intellectual abilities and age. Symptoms of Expressive Language Disorder are present as well as difficulty understanding aspects of language such as words and sentences. The child does not meet diagnostic criteria for Pervasive Developmental Disorder and, if he or she has Intellectual Developmental Disorder, the language difficulties exceed what would be otherwise expected. These symptoms significantly interfere with academic, work, or social relationships.
  7. •  Phonological Disorder, formerly known as Developmental Articulation Disorder, is a Communication Disorder in which the patient is unable to articulate age-appropriate speech sounds.  These symptoms significantly interfere with academic, work, or social relationships. If the patient is also diagnosed with an Intellectual Developmental Disorder, speech problems are in excess of what would be expected given this diagnosis.
  8. •  Stuttering is a Communication Disorder in which fluency and time patterning of age-appropriate speech is impaired by frequent occurrences of sound repetitions, prolongations, or interjections, pausing within a word, pauses between words, word substitutions, or repetition of single syllable words such as “I.” If the patient also has speech, motor, or sensory deficits, speech problems are in excess of what would be expected given these diagnoses. These symptoms significantly interfere with academic, work, or social relationships.
  9. •  Communication Disorder Not Otherwise Specified (NOS) is diagnosed when the patient has symptoms of a communication disorder but does not meet the criteria for any specific Communication Disorder diagnosis.

Pervasive Developmental Disorders are disorders in which the patient has severe impairment in several areas of development. The patient also exhibits stereotyped behavior, activities, and interests.  Overall impairment is distinctly more severe than the patient’s intelligence and age. Autistic Disorder, a serious Pervasive Developmental Disorder is described here.  Other less severe diagnoses in this section, such as Asperger’s Disorder, are under substantial revision for the upcoming DSM-5 and at present will not be described.

  1. •  Autistic Disorder is a condition in which the patient has substantial impairment in social interactions and communication, and he or she engages in repetitive and stereotyped behavior, interests, and activities.  Before the age of three, the patient also exhibits delays in social relationships, language, or imaginative play.

Attention-Deficit Hyperactivity Disorder is a condition in which the patient has a continuous pattern of problems with attention or impulsive and excessively active behavior that is more persistent and severe than would be expected given the individual’s age and general development. The patient must exhibit several symptoms of inattention and/or several symptoms of impulsive and hyperactive behavior in order to be diagnosed. Some symptoms must be present before the age of seven, impairment must be present in two or more settings, such as school and home, and symptoms must be present for at least a year. These symptoms significantly interfere with academic, work, or social relationships. Patients with Attention-Deficit Hyperactively Disorder may be further classified into Inattentive, Hyperactive-Impulsive, or Combined Type if they meet criteria for both inattention and hyperactivity.

Conduct Disorder is a condition in which the patient consistently shows a pattern of behavior in which the rights of others and other age-appropriate social norms are violated.  Symptoms occur in four groups: aggression toward people or animals, destroying property, stealing or deceitfulness, and serious violation of rules. These symptoms significantly interfere with academic, work, or social relationships.

Oppositional Defiant Disorder is a condition in which the patient exhibits a pervasive and excessive pattern of negative, defiant, and hostile behavior toward others for at least six months.  Symptoms may include excessive anger, resentment, vindictiveness, or argumentativeness, temper outbursts, deliberately annoying others, disobeying adult rules, blaming others for mistakes, and excessive touchiness or easily annoyed. These symptoms significantly interfere with academic, work, or social relationships.

Tic Disorders are disorders in which sudden, rapid, and stereotyped motor movement or vocalization is a prominent symptom. Examples of motor tics are facial grimacing, eye blinking, repetitive hand gestures, and sudden expression of vulgar of obscene words. One Tic Disorder is described in this section.

  1. •  Tourette’s Disorder is a condition in which the patient shows multiple motor and vocal tics over the course of illness. Tics occur on a daily basis or repeatedly over the course of at least one year, and the patient has not been free of tics for three months or longer. The disorder must be present before the age of 18.

Elimination Disorders include problems with urination and defecation that are more persistent and severe than would be expected given the individual’s age and general development.

  1. •  Encopresis is a disorder in which the patient routinely and intentionally or unintentionally passes feces in inappropriate places such as in clothing or on the floor. The patient must be four years of age or older, and is having at least one incident every three months.
  2. •  Enuresis is a disorder in which the patient age five or older frequently urinates in clothing or in bed. The symptom must be clinically significant in that it significantly interferes with academic, work, or social relationships, or that there is a frequency of twice weekly for at least three consecutive months.

Separation Anxiety Disorder is diagnosed when the patient has excessive anxiety about separation from home or attachment relationships, accompanied by other characteristic symptoms. Characteristic symptoms may include distress, worry about harm falling to attachment figures, worry about being separated from attachment figures, school refusal, fear of being alone or sleeping without an attachment figure nearby, recurring nightmares, and the development of physical symptoms such as stomach aches when impending separation from attachment figures. The disorder must be present before the age of 18 years and last at least a month. These symptoms significantly interfere with academic, work, or social relationships.