DIsorders

Overview

The term movement disorders refers to a group of nervous system (neurological) conditions that cause either increased movements or reduced or slow movements. These movements may be voluntary or involuntary.

Common types of movement disorders include:

• Ataxia. This movement disorder affects the part of the brain that controls coordinated movement. Ataxia may cause uncoordinated or clumsy balance, speech or limb movements, and other symptoms. There are many causes of ataxia, including genetic and degenerative disorders. Ataxia may also be caused by an infection or another treatable condition.
• Cervical dystonia. In cervical dystonia, the neck muscles contract involuntarily, causing the head to pull to one side or to tilt forward or backward. There may be shaking.
• Chorea. Chorea is characterized by repetitive, brief, irregular, somewhat rapid, involuntary movements. The movements typically involve the face, mouth, trunk and limbs. Chorea can look like exaggerated fidgeting.
• Dystonia. This condition involves sustained involuntary muscle contractions with twisting, repetitive movements. Dystonia may affect the entire body or one part of the body.
• Functional movement disorder. This condition may resemble any of the movement disorders. Functional movement disorder isn’t due to neurological disease and is treatable.
• Huntington’s disease. This is an inherited, progressive disease that can be confirmed with genetic testing. Huntington’s disease has three components: uncontrolled movements, cognitive problems and psychiatric conditions.
• Multiple system atrophy. This uncommon neurological disorder affects many brain systems and progressively worsens. Multiple system atrophy causes a movement disorder, such as ataxia or parkinsonism. It can also cause low blood pressure, impaired bladder function and acting out dreams.
• Myoclonus. This condition causes lightning-quick jerks of a muscle.
• Parkinson’s disease. This slowly progressive disease causes tremor, muscle stiffness, slow or decreased movement, or imbalance. It may also cause other symptoms not related to movement such as reduced sense of smell, constipation, acting out dreams and a decline in cognition.
• Parkinsonism. Parkinsonism is a general term for slowness of movement along with stiffness, tremor or loss of balance. There are many different causes. Parkinson’s disease and certain dopamine blocking medications are the most common causes. Other causes include degenerative disorders such as multiple system atrophy and progressive supranuclear palsy. Stroke or repeated head trauma also can cause parkinsonism.
• Progressive supranuclear palsy. This is a rare neurological disorder that causes problems with walking, balance and eye movements. It sometimes may resemble Parkinson’s disease but is a distinct condition.
• Restless legs syndrome. This movement disorder causes unpleasant feelings in the legs while relaxing or lying down, often relieved by movement.
• Tardive dyskinesia. This neurological condition is caused by long-term use of certain drugs used to treat psychiatric conditions, called neuroleptic drugs. Tardive dyskinesia causes repetitive and involuntary movements such as grimacing, eye blinking and other movements.
• Tourette syndrome. This is a neurological condition that starts between childhood and teenage years and is associated with repetitive movements and vocal sounds.
• Tremor. This movement disorder causes rhythmic shaking of parts of the body, such as the hands, head or other body parts. The most common type is essential tremor.
• Wilson’s disease. This is a rare, inherited disorder that causes excessive amounts of copper to build up in the body, causing neurological problems, dystonia, tremor, parkinsonism or ataxia.

Overview

Even the best-behaved children can be difficult and challenging at times. But oppositional defiant disorder (ODD) includes a frequent and ongoing pattern of anger, irritability, arguing and defiance toward parents and other authority figures. ODD also includes being spiteful and seeking revenge, a behavior called vindictiveness.

These emotional and behavioral issues cause serious problems with family life, social activities, school and work. But as a parent, you don’t have to try to manage a child with ODD alone. Your health care provider, a mental health professional and a child development expert can help.

Treatment of ODD involves learning skills to help build positive family interactions and to manage problem behaviors. Other therapy, and possibly medicines, may be needed to treat related mental health conditions.

Symptoms

Sometimes it’s difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It’s common for children to show oppositional behavior at certain stages of development.

Symptoms of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. Oppositional and defiant behaviors are frequent and ongoing. They cause severe problems with relationships, social activities, school and work, for both the child and the family.

Emotional and behavioral symptoms of ODD generally last at least six months. They include angry and irritable mood, argumentative and defiant behavior, and hurtful and revengeful behavior.

Angry and irritable mood

• Often and easily loses temper.
• Is frequently touchy and easily annoyed by others.
• Is often angry and resentful.

Argumentative and defiant behavior

• Often argues with adults or people in authority.
• Often actively defies or refuses to follow adults’ requests or rules.
• Often annoys or upsets people on purpose.
• Often blames others for their own mistakes or misbehavior.

Hurtful and revengeful behavior

• Says mean and hateful things when upset.
• Tries to hurt the feelings of others and seeks revenge, also called being vindictive.
• Has shown vindictive behavior at least twice in the past six months.

Severity

ODD can be mild, moderate or severe:

• Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.
• Moderate. Some symptoms occur in at least two settings.
• Severe. Some symptoms occur in three or more settings.

For some children, symptoms may first be seen only at home. But with time, problem behavior also may happen in other settings, such as school, social activities and with friends.

When to see a doctor

Your child isn’t likely to see their own behavior as a problem. Instead, your child will probably complain about unreasonable demands or blame others for problems.

If you think your child may have ODD or other problem behavior, or you’re concerned about your ability to parent a challenging child, seek help from a child psychologist or a child psychiatrist with expertise in behavior problems. Ask your child’s pediatrician or other health care provider for a referral to a mental health provider.

Causes

There’s no known clear cause of oppositional defiant disorder. Causes may include a combination of genetic and environmental factors:

• Genetics. A child’s natural personality or character — also called temperament — may contribute to developing ODD. Differences in the way nerves and the brain function also may play a role.
• Environment. Problems with parenting that may involve a lack of supervision, inconsistent or harsh discipline, or abuse or neglect may contribute to developing ODD.

Risk factors

Oppositional defiant disorder is a complex problem. Possible risk factors for ODD include:

• Temperament — a child who has a temperament that includes difficulty managing emotions, such as reacting with strong emotions to situations or having trouble tolerating frustration.
• Parenting issues — a child who experiences abuse or neglect, harsh or inconsistent discipline, or a lack of proper supervision.
• Other family issues — a child who lives with parent or family relationships that are unstable or has a parent with a mental health condition or substance use disorder.
• Environment — problem behaviors that are reinforced through attention from peers and inconsistent discipline from other authority figures, such as teachers.

Complications

Children and teenagers with oppositional defiant disorder may have trouble at home with parents and siblings, in school with teachers, and at work with supervisors and other authority figures. Children and teens with ODD may struggle to make and keep friends and relationships.

ODD also may lead to other problems, such as:

• Poor school and work performance.
• Antisocial behavior.
• Legal problems.
• Impulse control problems.
• Substance use disorder.
• Suicide.

Many children and teens with ODD also have other mental health conditions, such as:

• Attention-deficit/hyperactivity disorder (ADHD).
• Conduct disorder.
• Depression.
• Anxiety disorders.
• Learning and communication disorders.

Treating these other mental health conditions may help reduce ODD symptoms. It may be difficult to treat ODD if these other conditions are not evaluated and treated appropriately.

Prevention

There’s no sure way to prevent oppositional defiant disorder. But positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better.

Treatment can help restore your child’s self-esteem and rebuild a positive relationship between you and your child. Your child’s relationships with other important adults in their life — such as teachers and care providers — also will benefit from early treatment.

Overview

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term “Asperger’s syndrome,” which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

Symptoms

Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they’ve already acquired. Signs usually are seen by age 2 years.

Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It’s generally based on the level of impairments and how they impact the ability to function.

Below are some common signs shown by people who have autism spectrum disorder.

Social communication and interaction

A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

• Fails to respond to his or her name or appears not to hear you at times
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
• Has poor eye contact and lacks facial expression
• Doesn’t speak or has delayed speech, or loses previous ability to say words or sentences
• Can’t start a conversation or keep one going, or only starts one to make requests or label items
• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
• Repeats words or phrases verbatim, but doesn’t understand how to use them
• Doesn’t appear to understand simple questions or directions
• Doesn’t express emotions or feelings and appears unaware of others’ feelings
• Doesn’t point at or bring objects to share interest
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice

Patterns of behavior

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn’t engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture

As they mature, some children with autism spectrum disorder become more engaged with others and show fewer disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.

When to see a doctor

Babies develop at their own pace, and many don’t follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.

If you’re concerned about your child’s development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

• Doesn’t respond with a smile or happy expression by 6 months
• Doesn’t mimic sounds or facial expressions by 9 months
• Doesn’t babble or coo by 12 months
• Doesn’t gesture — such as point or wave — by 14 months
• Doesn’t say single words by 16 months
• Doesn’t play “make-believe” or pretend by 18 months
• Doesn’t say two-word phrases by 24 months
• Loses language skills or social skills at any age

Causes

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
• Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

No link between vaccines and autism spectrum disorder

One of the greatest controversies in autism spectrum disorder centers on whether a link exists between the disorder and childhood vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods.

Avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), measles or mumps.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It’s not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. These may include:

• Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents’ ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

Prevention

There’s no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

Children with a sensory processing disorder may have an increased or decreased sensitivity to sensory input, such as light, sound, and touch. They may avoid or seek out sensory stimulation as a result.

What is sensory processing disorder?

Sensory processing disorder is a neurological condition in children that can affect the way the brain processes information from the senses. People with sensory processing disorder may be extra sensitive to or not react to sensory input, depending on how they are affected.

Examples of sensory input may include:

• light
• sound
• taste
• touch
• smell

Children who have sensory issues may have an aversion to things that overstimulate their senses, such as loud environments, bright lights, or intense smells. Or, they may seek out additional stimulation in settings that don’t stimulate their senses enough.

Not a great deal is known about sensory issues or sensory processing disorder. More research is still needed.

Keep reading to learn more about the potential causes and symptoms of sensory processing disorder and how sensory issues can be treated.

What is sensory processing?

You may have learned about the five senses in elementary school, but the truth is, you experience the world with more than just your five senses.

Sensory processing is typically divided into eight main types. They can include:

Proprioception. Proprioception is the “internal” sense of awareness you have for your body. It’s what helps you maintain posture and motor control, for example. It also tells you about how you’re moving and occupying space.
Vestibular. This term refers to the inner ear spatial recognition. It’s what keeps you balanced and coordinated.
Interoception. This is the sense of what’s happening in your body. It may be best understood as how you “feel.” This includes whether you feel hot or cold and whether you feel your emotions.
Five senses. Lastly, there are the 5 common senses — touch, hearing, taste, smell, and sight.
It’s important to note that sensory processing disorder isn’t officially recognized by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). There is a lack of research-based evidence to support diagnosing this disorder on its own. Many doctors and experts believe that sensory issues are actually a component of another condition or disorder, such as autism spectrum disorder.

The term “sensory processing disorder“ is more commonlyTrusted Source used in the field of occupational therapy.

But what is known about sensory processing disorder can help parents, healthcare professionals, and other caregivers understand the condition and provide support.

What are the signs and symptoms of sensory processing disorder?
The symptoms of having sensory processing issues may depend on the way a child processes different sensations.

Children who are easily stimulated may have hypersensitivity. This means they have an increased sensitivity to sensory inputs like light, sound, and touch. These sensations may bother them more, cause them to lose focus in the presence of too much sensory information, or cause them to act out.

Children may also experience hyposensitivity. This means they may have reduced sensitivity to sensory output.

The type of sensitivity someone experiences may largely determine what their symptoms are. For example, children who are hypersensitive may react as though everything is too loud or too bright. These kids may have difficulty being in noisy rooms. They may also have adverse reactions to smells.

Sensory hypersensitivity may cause:

• a low pain threshold
  
  
• appearing clumsy
• fleeing without regard to safety
• covering eyes or ears frequently
• picky food preferences or gagging when eating foods of certain textures
• resisting hugs or sudden touches
• feeling that soft touches are too hard
• difficulty controlling their emotions
• difficulty focusing attention
• difficulty adapting response
• behavior problems.

In contrast, children who are hyposensitive and experience reduced sensitivity crave interaction with the world around them. They may engage more with their surroundings to get more sensory feedback

In fact, this may make them appear hyperactive, when in reality, they may simply be trying to make their senses more engaged.

Sensory hyposensitivity may cause:

• a high pain threshold
• bumping into walls
• touching things
• putting things into their mouth
• giving bear hugs
• crashing into other people or things
• not regarding personal space
• rocking and swaying

What causes sensory issues in children?

It’s not clear what causes sensory issues in children, though researchers Trusted Source believe it may have something to do with the way the sensory pathways in the brain process and organize information. Sensory processing difficulties are common in autistic people.

It’s also not clear if sensory issues can occur on their own or if they are caused by another disorder. Some doctors and healthcare professionals believe sensory processing issues are a symptom of another issue rather than a diagnosis in itself.

According to a 2020 review and a small 2017 studyTrusted Source,sensory processing disorder may be related to prenatal or birth complications, which can include:

• premature birth
• low birth weight
• parental stress
• alcohol or drug consumption during pregnancy

Overexposure to certain chemicals and a lack of sensory stimulation in childhood may also be risk factors for developing sensory processing disorder.

Possible abnormal brain activity could change how the brain responds to senses and stimuli.

Are sensory issues part of another condition?

Many doctors don’t believe sensory issues on their own account for a separate disorder. But what is clear is that some people do have issues processing what they feel, see, smell, taste, or hear.

In most cases, sensory issues occur in children, but adults can experience them too. Many children with altered sensory processing are on the autism spectrum.

Conditions or disorders connected to sensory issues can include:

• Autism spectrum disorder (ASD). Autistic people may have changes to the neural pathways in their brain responsible for processing sensory information.
• Attention deficit hyperactivity disorder (ADHD). ADHA affects the ability to filter out unnecessary sensory information, which can lead to sensory overload.
• Schizophrenia. In people with schizophrenia,abnormal mechanisms in the brain’s sensory pathway and in the way it creates and organizes connections between neurons can cause altered sensory and motor processing.
• Sleep disorders. Sleep disorders, such as sleep deprivation, may result in delirium, which can cause temporary sensory processing issues.
• Developmental delay. Developmental delaysare also not uncommon in people with sensory issues.
• Brain injury.Traumatic brain injury (TBI)may be another potential cause of sensory processing disorder, according to 2019 researchTrusted Source.

It’s important to note, however, that children with ADHD experience hyperactivity for a different reason than children who have sensory issues.

People who have ADHD may have trouble concentrating or sitting still. People with sensory issues may have trouble sitting still because they crave sensory interactions with the world around them, or are bothered by their environment.

How are sensory issues diagnosed?

Sensory processing disorder isn‘t an officially recognized neurological condition. This means there is no formal criteria for a diagnosis.

Instead, doctors, educators, or healthcare professionals who help children with issues processing sensory information work from what they see in the child’s behaviors and interactions to determine how to best support them. Generally, these sensory issues are highly visible.

In some cases, professionals may use questionnaires such as the Sensory Integration and Praxis Tests (SIPT) or the Sensory Processing Measure (SPM). Both of these tests can help healthcare professionals and educators better understand a child’s sensory functioning.

Sometimes, a child’s doctor may be able to work with the child’s school psychologist or special education educator to help them access in-school supports like occupational therapy.