Headaches are classified as primary or secondary. Primary headaches are benign, are not caused by underlying disease or structural problems, and include migraines, tension-type headaches (TTHs), and the trigeminal autonomic cephalgias (TACs). Migraines and TTHs are the most common primary…
Chronic Pain Chronic pain is often defined as recurrent or persistent pain lasting ≥3 months. The child may have a definable medical condition but often does not have a specific disease diagnosis or identifiable etiology for the pain other than…
Autism spectrum disorder (ASD) is a neurobiologic disorder with onset in early childhood; it is characterized by impaired social communication and interaction accompanied by restricted and repetitive behaviors. With definitions that vary dependent on agencies, schools, and clinicians, there is…
The history is the most important tool for identifying a psychiatric disorder. The initial focus in conducting the history is to establish rapport and to ensure the child’s safety. Safety should always be assessed and should include risk of suicide,…
An irritable infant is a challenge to the caregiver and medical provider and is a common presenting complaint in early infancy. An irritable infant is defined here as a patient younger than 1 year of age who, according to the…
With advancing genomic technology, disorders previously identified to be unique phenotypes are now recognized as sharing common pathways or developmental mechanisms. The clinical diagnostic paradigm is evolving to a “genomic” first approach and is less reliant on the detailed phenotype…
The etiology of intellectual developmental disabilities includes a wide spectrum of disorders that may present at different periods of development (infantile, juvenile, adult) and with different trajectories ( Fig. 28.1 ). Some are static encephalopathies (cerebral palsy, hypoxic-ischemic encephalopathy), while…
Definitions Intellectual disability (ID) has replaced the older term mental retardation (MR), reflecting a more enlightened and progressive attitude toward individuals with disabilities, both physical and cognitive. ID is characterized by significant limitations in intellectual functioning and in adaptive behavior…
The term disorders of sex development (DSD) replaces the former terms intersex and hermaphroditism ( Table 26.1 ). The most common presenting symptom of DSD is atypical (ambiguous) genitalia at birth. Other presenting signs and symptoms include lack of some…
Prepubertal Vaginal Bleeding The source of abnormal vaginal bleeding during prepubertal childhood is much more likely to be the vulva or vagina rather than the uterus. There are unique characteristics making history and physical examination effective in narrowing the diagnostic…