teaching the parents the skills to manage their chil-
dren’s behavior. Evidence for the effectiveness of
medications have been mixed but offer some prom-
ise.
Schizophrenia
Schizophrenia also is rarely diagnosed in chil-
dren, probably occurring in fewer than 1 in 1,000
children, and the DSM-IV does not even include
criteria for a specific category of childhood schizo-
phrenia. In childhood, although not in adolescence,
schizophrenia occurs more frequently in males than
females. Symptoms include hallucinations and delu-
sions, disorganized or incoherent speech, and disor-
ganized behavior. Onset is typically in late childhood
or adolescence following predominantly normal de-
velopment. Once it emerges, the course of schizo-
phrenia is characterized by episodes alternating with
periods of improvement and relapse. The causes of
schizophrenia are most likely genetic and other bio-
logical considerations. Treatment may involve the
same antipsychotic medications that are used with
adults. Research indicates that medications may be
most effective when combined with a program of
helping the family to manage the child’s behavior and
minimize stress levels.
Eating Disorders
The DSM-IV includes two eating disorders. An-
orexia nervosa is characterized mainly by refusal to
maintain even minimally normal body weight, symp-
toms of intense fear of gaining weight even though
underweight, and disturbance in the perception or
experience of one’s body weight or shape. The second
disorder, bulimia nervosa, is diagnosed when individ-
uals engage repeatedly in binge eating alternating
with inappropriate methods to prevent weight gain.
Eating disorder symptoms and associated behaviors
can also be measured with questionnaires. Eating dis-
orders tend to be more prevalent in industrialized
countries and are relatively rare, with prevalence esti-
mates typically fewer than 2 percent, nearly all girls.
Onset is typically around adolescence and may be as-
sociated with a stressful event. Causes are likely to in-
clude a combination of biological, family, and
sociocultural factors as well as individual psychologi-
cal characteristics of the child. Treatment, often re-
sisted, requires coordination between medical
attention and therapy, including behavioral interven-
tion, training in self-monitoring, and the develop-
ment of coping skills.
See also: ANTISOCIAL BEHAVIOR; ATTENTION
DEFICIT HYPERACTIVITY DISORDER; AUTISM
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Sherryl Hope GoodmanMENTAL RETARDATION
Mental retardation (MR) is a developmental disabili-
ty, defined by looking at three aspects of a child. IQ
score, adaptive functioning, and the age of onset de-
termine where a child lies in the continuum of mental
retardation.
A numerical component of MR is defined by an
IQ intelligence test. An IQ test measures and predicts
how well individuals learn in their environment. The
average IQ score of a typical developing child falls be-
tween 80 and 119. An IQ score below 70 to 75 charac-
terizes a child for further evaluations to determine ifMENTAL RETARDATION 265