CHAPTER

14

L

ela and Carlos Enriquez have three children: Javier, Pia,

and Richie. It’s been a very challenging year for the fam-

ily, full of heartache. All three children have been having

various diffi culties at home or at school. Lela and Carlos

are trying to fi gure out what, exactly, the problems are and

what can be done about them.

The most troubling problem concerns their youngest son, Richie.

He’s almost 2 years old, but he has yet to smile at his parents—or

anyone. He’s not talking either, and although he seems to under-

stand what people say to him, he is a bit slow to respond. Whereas

most toddlers are talking in (at least) 2- or 3-word sentences, Richie

doesn’t even say single words. His doctor wasn’t that worried when

she saw him at his last physical exam a few months ago: “Well, kids

sometimes take a while to talk. Let’s give him a few more months

and if he hasn’t started talking by then, give me a call.” Richie also

seems shy in the extreme—he doesn’t even look people in the eye.

Richie’s older siblings have also been having problems. Javier is

10 years old, and he’s had both academic and social problems at

school; his teacher suggested he receive a thorough evaluation. His

8-year-old sister, Pia, has been a bit of a puzzle. On her last report

card, her teacher noted that she’s very bright but doesn’t seem to be

working as hard as she could.

Like Richie, Pia, and Javier, many children have problems so-

cially or academically or achieve developmental milestones, such as

walking and talking, later than the average child. When are such

diffi culties part of the range of normal development, and when do

they signal a larger problem? This chapter addresses this question by

exploring various disorders listed in DSM-IV-TR that typically are

fi rst diagnosed during infancy, childhood, or adolescence. For these

disorders, the timing of the diagnosis contrasts with that of most of

the disorders discussed in previous chapters (e.g., anxiety, depression,

substance-related disorders), which typically are fi rst diagnosed dur-

ing adulthood. Nonetheless, children can be diagnosed with many of

the Axis I disorders discussed in previous chapters.

We begin this chapter by examining mental retardation—a dis-

order that can profoundly affect the lives of children and their fami-

lies and that may require special schools or residential placements

as well as other special services. We then examine a set of disorders

referred to as pervasive developmental disorders, which are often

comorbid with mental retardation and may require special school

placements and special services. We next turn to disorders that may

625

Childhood Disorders

Chapter Outline

Mental Retardation

What Is Mental Retardation?

Understanding Mental Retardation

Treating Mental Retardation

Pervasive Developmental Disorders

Autism Spectrum Disorders

Other Pervasive Developmental Disorders

Learning Disorders: Problems

with the Three Rs

What Are Learning Disorders?

Understanding Learning Disorders

Treating Learning Disorders

Disorders of Disruptive Behavior

and Attention

What Is Conduct Disorder?

What Is Oppositional Defi ant Disorder?

What Is Attention-Defi cit/Hyperactivity

Disorder?

Understanding Disorders of Disruptive

Behavior and Attention

Treating Disorders of Disruptive Behavior

and Attention

Other Disorders of Childhood

Separation Anxiety Disorder

Other Types of Disorders of Childhood,

in Brief

Alan Baker/Heart Agency