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Malnutrition

Failure to thrive (FTT) has classically been the term used to describe children who are not growing as expected. Studies have advocated using the term malnutrition to describe this cohort of children with specifically defined classification based on anthropometric measurements. In this chapter, malnutrition refers to undernutrition and is defined as an imbalance between nutrient requirements and intake or delivery that then results in deficits—of energy,…

Nutrition, Food Security, and Health

Malnutrition as the Intersection of Food Insecurity and Health Insecurity Undernutrition is usually an outcome of three factors, often in combination: household food supply, childcare practices, and access to health and water/sanitation services. In famine and emergency settings, food shortage is the foremost factor, but in many countries with widespread undernutrition, food production or access to food might not be the most limiting factor. More important…

Feeding Healthy Infants, Children, and Adolescents

Early feeding and nutrition are of importance in the origin of adult diseases such as type 2 diabetes, hypertension, obesity, and the metabolic syndrome. Therefore, appropriate feeding practices should be established in the neonatal period and continued throughout childhood and adolescence to adulthood. Healthful feeding in children requires partnerships between family members, the healthcare system, schools, the community, and the government. Feeding During the First Year…

Nutritional Requirements

Nutrition for infants, children, and adolescents should maintain current weight and support normal growth and development. Growth during infancy is rapid, critical for neurocognitive development, and has the highest energy and nutrient requirements relative to body size than any other period of growth. It is followed by growth during childhood, when 60% of total growth occurs, and finally by puberty. Nutrition and growth during the 1st…

Autism Spectrum Disorder

Definition Autism spectrum disorder (ASD) is a neurobiologic disorder with onset in early childhood. The key features are impairment in social communication and social interaction accompanied by restricted and repetitive behaviors. The presentation of ASD can vary significantly from one individual to another, as well as over the course of development for a particular child. There is currently no diagnostic biomarker for ASD. Accurate diagnosis therefore…

Developmental Delay and Intellectual Disability

Intellectual disability (ID) refers to a group of disorders that have in common deficits of adaptive and intellectual function and an age of onset before maturity is reached. Definition Contemporary conceptualizations of ID emphasize functioning and social interaction rather than test scores. The definitions of ID by the World Health Organization (WHO) International Classification of Diseases, Tenth Edition (ICD-10) , the U.S. Individuals with Disabilities Education…

Language Development and Communication Disorders

Most children learn to communicate in their native language without specific instruction or intervention other than exposure to a language-rich environment. Normal development of speech and language is predicated on the infant's ability to hear, see, comprehend, remember, and socially interact with others. The infant must also possess sufficient motor skills to imitate oral motor movements. Normal Language Development Language can be subdivided into several essential…

Math and Writing Disabilities

Math Disabilities Kenneth L. Grizzle Keywords dyscalculia math disability Individual with Disabilities Education Act IDEA individualized education plan IEP response to intervention specific learning disorder with impairment in mathematics Data from the U.S. National Center for Educational Statistics for 2009 showed that 69% of U.S. high school graduates had taken algebra 1, 88% geometry, 76% algebra 2/trigonometry, and 35% precalculus. These percentages are considerably higher than those…

Dyslexia

The most current definition of dyslexia is now codified in U.S. Federal law (First Step Act of 2018, PL: 115–391): “The term dyslexia means an unexpected difficulty in reading for an individual who has the intelligence to be a much better reader, most commonly caused by a difficulty in the phonological processing (the appreciation of the individual sounds of spoken language), which affects the ability of…

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood, among the most prevalent chronic health conditions affecting school-aged children, and one of the most extensively studied neurodevelopmental disorders of childhood. ADHD is characterized by inattention, including increased distractibility and difficulty sustaining attention; poor impulse control and decreased self-inhibitory capacity; and motor overactivity and motor restlessness ( Table 49.1 and Fig. 49.1 ). Definitions vary…

Neurodevelopmental and Executive Function and Dysfunction

Terminology and Epidemiology A neurodevelopmental function is a basic brain process needed for learning and productivity. Executive function (EF) is an umbrella term used to describe specific neurocognitive processes involved in the regulating, guiding, organizing, and monitoring of thoughts and actions to achieve a specific goal. Processes considered to be “executive” in nature include inhibition/impulse control, cognitive/mental flexibility, emotional control, initiation skills, planning, organization, working memory,…

Childhood Psychoses

Psychosis is a severe disruption of thought, perception, and behavior resulting in loss of reality testing. Psychosis can occur as part of a mood disorder, such as major depressive disorder or bipolar I disorder; between mood disorder episodes, as in schizoaffective disorder; or without mood disorder episodes, as in schizophrenia. Transient psychotic episodes can arise during times of psychological or physiologic stress in patients who are…

Lying, Stealing, and Truancy

Lying There are various reasons why a child might lie. For children between ages 2 and 4 yr, lying can be used as a method of playing with language. By observing the reactions of parents, preschoolers learn about expectations for honesty in communication. Lying can also be a form of fantasy for children, who describe things as they wish them to be rather than as they are.…

Disruptive, Impulse-Control, and Conduct Disorders

The disruptive, impulse-control, and conduct disorders are interrelated sets of psychiatric symptoms characterized by a core deficit in self-regulation of anger, aggression, defiance, and antisocial behaviors. The disruptive, impulse-control, and conduct disorders include oppositional defiant, intermittent explosive, conduct, other specified/unspecified disruptive/impulse control/conduct, and antisocial personality disorders, as well as pyromania and kleptomania. Description Oppositional defiant disorder (ODD) is characterized by a pattern lasting at least 6 mo…

Eating Disorders

Eating disorders (EDs) are characterized by body dissatisfaction related to overvaluation of a thin body ideal, associated with dysfunctional patterns of cognition and weight control behaviors that result in significant biologic, psychological, and social complications. Although usually affecting white, adolescent females, EDs also affect males and cross all racial, ethnic, and cultural boundaries. Early intervention in EDs improves outcome. Definitions Anorexia nervosa (AN) involves significant overestimation…

Suicide and Attempted Suicide

Youth suicide is a major public health problem. In 2014 for all youth between ages 10 and 19 yr in the United States, suicide was the 2nd leading cause of death, with approximately 5,500 lives lost each year. The suicide rate for youth age 15-19 yr was 9.8 per 100,000 persons (14.2 for males, 5.1 for females), while the rate for youth age 10-14 yr was 2.0/100,000 (2.4 for…