Department of Pediatrics
Fudan University Shanghai Medical School
Children’s Hospital of Fudan University
PSYCHOLOGICAL DEVEOPEMENT
& MENTAL HEALTH IN CHILDREN
小儿心理 卫生
Learning Theory - Watson,Bandura
Psychoanalytic Theory - Freud,Erikson
Cognitive Development - Piaget
MAIN THEORIES ON PSYCHOLOGICAL
DEVELOPMENT
MAIN THEORIES ON PSYCHOLOGICAL
DEVELOPMENT
Freud Erikson Piaget
0-18m Oral Basic trust-mistrust Sensorymotor
18m-3y Anal Autonomy-
shame,doubt
Symbolic
(preoperational)
3-6y Oedipal Initiative-guilt Intuition
(preoperational)
6-11y latency Industry-inferiority Concrete
operation
12-17y Adolescenc
e
(genital)
Identity-role
confusion
Formal operation
Perception development
? Visual perception
? Auditory perception
? Taste,smell and cutaneous sensation
Language development
? Receptive language
9mo — follow one-step commands
18mo — follow two-step commands
2 ye — understand short stories
6-7ye — double denied sentences,passive sentence
? Expressive language
12 mo — One word
18-24 mo — two-word phrase
3 ye — completed sentence,1000 words
4 ye — talk freely,1600-2000 words
Psychological development
? Attention development
? Menmory development
? Emotional development
Behavioral problems and
Psychological disorders in children
? Tantrum,nail biting,thumb suck,
? Developmental disorders,autism,mental
retardation,learning disorders
? Attention deficit hyperactivity disorders,
conduct disorders,tic disorders
? Eating,sleep,excretion disorders
? Mood disorders,anxiety disorders,OCD
? Somatoform disorders
? Schizophrenia
Affected factors of child mental
health
? Genetic influences
? Acquired brain disorders
? marital status,parents mental health,
parenting,
? Separation,deprivation,grief
? Personality and temperment
Assessment and diagnosis
? Both physical and behavioral aspects
? Developmental issues
? Psychosocial problems
? Clinical interview,rating scales,
psychological test,physical
examination and test
Systems of classification of mental
disorders
? DSM-IV
? ICD-10
? CCMD-3
Treatment and prevention
? Family involved
? Integrative
? Delete remote cause
? Individuation
? Medication
? Psychotherapy,Behavior therapy,BCT,
Family therapy,Play therapy
Attention deficiency hyperactive
disorders
? Epidemiology
prevalence rate 4%-12%
male, female= 3-4, 1
? Etiology
multiple factors,genetic,environmental
Clinical manifestations
? Poor sustained attention
? Inappropriate or excessive activity
? Difficulties in inhibiting impulses
? Difficulties getting along with others
? School underachievement
? low self-esteem
Diagnosis
? Behavior rating scales
? Clinical interview
? Physical examination
? Neuropsychological examination
DSM-IV Diagnostic criteria for ADHD
? 6 or more symptoms of innattention
? 6 or more symptoms of hyperactivity -
impulsivity
? Symptoms were present before 7yr of age
? Symptoms persisted at least 6 mo.
? Symptoms were present in 2 or more settings
? Significant function impairment
? Exclude other psychotic disorders
Differential diagnosis
? Age-appropriate overactivity
? Adjustment disorder
? Conduct disorder
? Learning disorders
? Tic disorder
? Emotional disorders
? Developmental disorders,Autism,MR
Visual and auditory problems,physical
diseases
Treatment
? Psychosocial interventions
? Behavior management
training
? Medication
Prognosis
? 80% persist into adolescence and
adults
? hyperactivity decreased
? Prominent, Inattention,impulsivity,
disorganization,relationship difficulties
? Symptoms are significantly ameliorated
after effective intervention