Child and Adolescent Psychiatry
“Today’s Children & Adolescents are Tomorrow’s future”
A CHILD IS NOT A VASE TO BE FILLED
BUT A LAMP TO BE LIT
With the changing times & increase of stress & competition & negative pressure has
increased the rate of child & adolescent mental health issues. To deal with children
and Adolescents aged below 16 years there is a requirement of a different set of
skills i.e. knowledge, understanding, support and empathy which only a Child
Psychiatrist excels in. Dr Swati Braroo at Asha Neuro Psychiatric Clinic is trained
at Asha Hospital in Hyderabad and has been working in the field of child psychiatry
since more than a 5 yrs.
The child psychiatrists work in close liaison with a Child Psychologist and Special
Educators for identifying and management of Common Childhood Problems:
- School refusal
- School refusal describes the disorder of a child who refuses to go to
school on a regular basis or has problems staying in school.
- Children with school refusal may complain of physical symptoms shortly
before it is time to leave for school or repeatedly ask to visit the
school nurse. If the child is allowed to stay home, the symptoms quickly
disappear, only to reappear the next morning. In some cases a child may
refuse to leave the house.
- Common physical symptoms include headaches, stomachaches, nausea, or
diarrhea. But tantrums, inflexibility, separation anxiety, avoidance,
and defiance may show up, too.
- Poor academic performance
- Poor Academic performance not only results in the child having a low
self-esteem, but also causes significant stress to the parents. There
are many reasons for children to under perform at school, such as,
medical problems, below average intelligence, specific learning
disability, attention deficit hyperactivity disorder, emotional
problems, poor socio-cultural home environment, psychiatric disorders
and even environmental causes.
- Spelling mistakes : Spelling errors are usually studied
in dictations, but teachers report that children with school
difficulties often make spelling mistakes when they copy a text too.
Difficult and Disobedient Behaviours
- Oppositional defiant disorder is a recurrent pattern of developmentally
inappropriate, negativistic, defiant, and disobedient behavior toward
authority figures. This behavior often appears in the preschool years.
Children with oppositional defiant disorder have substantially strained
relationships with their parents, teachers, and peers, and have high
rates of coexisting conditions such as attention-deficit/hyperactivity
disorder and mood disorders. Children with oppositional defiant disorder
are at greater risk of developing conduct disorder and antisocial
personality disorder during adulthood.
Psychological intervention with both parents and child can substantially
improve short- and long-term outcomes.
- ADHD is a neurological condition that involves problems with inattention
and hyperactivity-impulsivity that are developmentally inconsistent with
the age of the child.
- Symptom Domains:- Inattention, Hyperactivity, Impulsivity
- Psychiatric comorbidities:- Disruptive Behavioral disorders, Anxiety and
- Functional impairments:- Low self-esteem, Accidents and injuries,
Smoking/ substance abuse, Delinquency, Academic difficulties/
underachievement, Employment difficulties
- Poor peer relationships, Socialization deficit, Relationship
- Autism is a subtype of pervasive developmental disorders
- It is characterized by
- Impaired reciprocal social interactions
- Aberrant language delay
- Restricted behavioral repertoire
- It typically emerge in young children before the age of 3 years
- Parents often become concerned about a child by 18 months as language
development does not occur as expected.
- In view of the multidisciplinary nature of working with a child with
autism one clinician should be the primary therapist.
- The important areas to focus on are
- Education through psychosocial Interventions
- Help for the family
- Specific therapies
There are lots of reasons why your child may seem more angry
than other children, including:
Seeing other family members arguing or being angry with each other
- Friendship problems
- Being bullied
- Struggling with schoolwork or exams
- Feeling very stressed, anxious or fearful about something
- Coping with hormone changes during puberty
Believing that a child's anger is "just a phase" that he or she will
eventually outgrow is to deny what could be a serious problem. Before
uncontrollable angry behavior escalates to a point of no return, parents can
confront it and get the professional help they need.
- Bed Wetting
- Bedwetting in children and adults can result in emotional stress.
- Most bedwetting is a developmental delay—not an emotional problem or
physical illness. Only a small percentage (5% to 10%) of bedwetting
cases are caused by specific medical situations. Nocturnal enuresis is
considered primary (PNE) when a child has not yet had a prolonged period
of being dry. Secondary nocturnal enuresis (SNE) is when a child or
adult begins wetting again after having stayed dry.
- Treatments range from behaviour options such as bedwetting alarms to
medication. The psychiatrist counsel the parents, warning about
psychological damage caused by pressure, shaming, or punishment for a
condition children cannot control.
Speech and Language problems
As with other skills and milestones, the age at which kids learn
start talking can vary. Many babies happily babble "mama" and "dada" well
before their first birthday, and most toddlers can say about 20 words by the
time they're 18 months old. But what if a 2-year-old isn't really talking
yet or only puts two words together?
Knowing what's "normal" and what's not in speech and language development can
help parents figure out if there's cause for concern or if their child is
right on schedule.
- Speech is the verbal expression of language and
includes articulation (the way sounds and words are formed).
- Language is the entire system of giving and getting
information in a meaningful way. It's understanding and being understood
through communication — verbal, nonverbal, and written.
Speech and language problems differ, but often overlap. For
- A child with a language delay might pronounce words well but only be
able to put two words together.
- A child with a speech delay might use words and phrases to express ideas
but be difficult to understand. Speech problems, such as stuttering and
mispronunciation can be very frustrating.
- Delayed speech or language development is the most common developmental
problem. It affects five to ten percent of preschool kids.
- Social Communication Problems
- Social communication disorders may include problems with social
interaction, social cognition, and pragmatics. A social
communication disorder may be a distinct diagnosis or may occur
within the context of other conditions, such as autism spectrum
disorder (ASD), specific language impairment (SLI), learning
disabilities (LD), language learning disabilities (LLD),
intellectual disabilities (ID), developmental disabilities (DD),
attention deficit hyperactivity disorder (ADHD), and traumatic
brain injury (TBI).
- Social communication includes interactions with a variety of
communication partners, including family, caregivers, child care
providers, educators, and peers.
- Fears and Phobias
- Sleep Problems, Sleep talking, Night mares, Night terrors.
- Nightmares are frightening dreams that occur
during REM sleep and awaken a child. They usually occur in the
later part of the night.
- Sleeptalking occurs when the child talks,
laughs or cries out in his/her sleep.
- Sleep terrors occur early in the night. A child
may scream out and be distressed, although s/he is not awake or
aware during a sleep terror. Sleep terrors may be caused by not
getting enough sleep, an irregular sleep schedule, stress, or
sleeping in a new environment.
- Our team of clinical psychologists will undertake entire range of
assessments and psychological tests. Counselling for Children and
Parents for behavioural problems and coping with mental illness is also
Speciality clinics for ADHD, Autism and Intellectual Disability and
Dyslexia are also
planned for children.
We believe Children learn by Modelling & Reinforcement of Behaviour, so multiple
workshops are being planned to achieve it.