New approaches may help treat children - www.icareguam.org

Jan. 26, 2013 PDN article:  New Approaches may help treat children. 

In recent years, powerful new imaging technologies and other approaches have allowed scientists to track the development of the brain in young children.  These studies offer a way to understand how the intellectual abilities and behavioral maturity of children at various ages are rooted in the developing brain.   

These studies also offer the best possibility for understanding the origins of mental illness, which may lead to more targeted screening tools, development of new medications and therapeutic interventions. Research suggest that vulnerability to mental illness and resilience is rooted in development.  Both risk and resilience are shaped by genes and environment interacting together, through childhood and adolescence. 

Some of the most commonly diagnosable and treatable mental illness in children and youth are the following:  attention deficit hyperactivity disorder, anxiety disorder, bipolar disorder and depression.  Attention deficit hyperactivity disorder (ADHD) symptoms includes difficulty staying focused and paying attention, difficulty controlling behavior, and very high level of energy and activity.  Studies show that the number of children being diagnosed with ADHD is increasing, but it is unclear why. Using brain imaging technology like magnetic resonance imaging (MRI), scientists have observed that in some children, ADHD may be related to how the brain is wired or how it is structured.  For other children with ADHD, the brain development follows a normal but delayed pattern. 

Different types of psychotherapy are effective in treating ADHD.  Behavioral therapy helps teach practical skills such as how to organize tasks, manage time to complete homework assignments and to work through difficult emotions.  Therapists also teacher children social skills such as how to share toys, waiting their turn, and how to ask for help. 

Studies show that interventions that include intensive parent education programs can help decrease ADHD problem behavior because parents are better educated about the disorder and better prepared to manage their child’s symptoms.  They are taught organizational skills and how to develop and keep a schedule for their child.  They are also taught how to give immediate and positive feedback for behaviors they want to encourage, and how to ignore or immediately redirect behaviors they want to change. 

Anxiety can be a normal reaction to stress.  It can motivate and help us accomplish an important activity.  It can help us study harder for an exam, or keep focused on preparation of an important report or speech.   However, when anxiety becomes an excessive, irrational dread of everyday situation, it has then become a disabling condition.   

Examples of anxiety disorders are obsessive compulsive disorder, post traumatic stress disorder, social phobia, specific phobia, and generalized anxiety disorder.  Symptoms of many of these disorders begin in childhood or adolescence. High quality cognitive behavior therapy (CBT) with or without medication can effectively treat anxiety disorders in children. 

Research on early childhood stress is showing how early trauma can alter the brain’s stress response system and contribute to future risk of anxiety and mood disorders. 

Bipolar disorder, also known as manic-depressive illness, is a serious brain disorder characterized by episodes of mania , feeling very happy “up” or more active than usual, and very sad “down” which is depression.  These episodes are associated with unusual shifts in intense mood and energy.  Early onset bipolar disorder, which starts during childhood or during the teen years, may be more severe than forms that first appear in older teens and adults.  

Children who are depressed may complain of feeling sick, refuse to go to school, worry excessively that a parent may die and may become quite insecure and clingy.  Older children and teens may sulk, be negative, grouchy  and get into trouble at school. 

Girls are more likely than boys to experience depression, and as a child gets older the risk for depression increases.  According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age 15 to 44. 

A combination treatment of medication and psychotherapy works best for most youth with depression and youth are more likely to respond to treatment if they receive it early in the course of their illness. Depressed teens with coexisting disorder such as substance abuse problems, which mask the depression, are less likely to respond to treatment for depression.   

For more information on brain development and treatment of mental illness in children, visit the 
National Institute of Mental Health at www.nimh.nih.gov or www.samhsa.gov, or call I Famagu’on-ta at 477-5338. 

Annie F.B.Unpingco, LCSW Administrator, I Famagu’on-ta, Child Adolescent Services Division, Department of Mental Health and Substance Abuse.