diagnosed in childhood include pica, which is the persistent eating of nonfood substances that is severe enough to require clinical attention, and rumination disorder, which is the repeated regurgitation of food. cause there are a number of factors that could potentially contribute to the development of feeding and eating disorders of infancy or early childhood. these factors include: physiological – a chemical imbalance effecting the child's appetite could cause a feeding or eating disorder. developmental – developmental abnormalities in oral-sensory, oral-motor, and swallowing can impact the child's eating ability and elicit a feeding or eating disorder. environmental – simple issues such as inconsistent meal times can cause a feeding or eating disorder. giving the child food that they are not developmentally acquired for can also cause these disorders. family dysfunction and sociocultural issues could also play a role in feeding or eating disorders. relational – when the child is not securely attached to the mother, it can cause feeding interactions to become disturbed or unnatural. other factors, such as parental emotional unavailability and parental eating disorders, can cause feeding and eating disorders in their children. psychological and behavioral – these factors include one involving the child's temperament. characteristics such as being anxious, impulsive, distracted, or strong-willed personality types are ones that could affect the child's eating and cause a disorder. the individual could have learned to reject food due to a traumatic experience such as choking or being force fed. symptoms physical and emotional changes are often the most indicative symptoms of feeding and eating disorders of infancy or early childhood. the child's growth and development may be delayed due to the lack of necessary nutrients. the child will usually weigh much less than other children. withdrawal and irritability are often associated with children that are malnourished. treatment since feeding and eating disorders in children can cause dangerous risks to the child, it is important to seek treatment as soon as possible. cognitive behavioral therapy can be incredibly beneficial to children with feeding or eating disorders. family therapy is usually encouraged in order to keep all members involved in nourishing the child. tic disorders dsm-iv-tr 307.23 tourette's disorder 307.22 chronic motor or vocal tic disorder 307.21 transient tic disorder: must meet the following criteria in order to be diagnosed: a. either one or multiple motor and/or vocal tics, for example, motor or vocal noises that are rapid, repeated, sudden, and nonrhythmic. b. the tics happen multiple times over the course of the day, almost every day for at least 4 weeks, but do not occur continually for any longer than 1 year. c. symptoms are present before the age of 18. d. the tics are not a result of any effects due to drug use, or any other medical condition, for example, huntington's disease. e. the individual does not have symptoms that meet the criteria for tourette's disorder or chronic motor or vocal tic disorder. 307.20 tic disorder nos: this category is for disorders characterized by tics but do not meet the diagnostic criteria of the dsm-iv-tr. cause no definitive cause of tic disorders has been declared, but for the most part, the cause lies within biological, chemical, or environmental factors. studies have shown that abnormal neurotransmitters, such as dopamine and serotonin, which are active in chemical messages in the brain, can serve as a cause of tic disorders. researchers have also found abnormal changes in certain parts of the brain that cause strain on the blood flow within the brain, which is likely a contributor of tic disorders. 75% of tic disorders have a genetic component. it appears that tic disorders can be caused or worsened by recreational or prescription drug use. tics can form simply if a person repeats sounds or words they hear over the course of a normal day. symptoms children with a tic disorder may exhibit the following symptoms: overwhelming urge to make movement jerking of arms clenching of fists excessive eye blinking shrugging of shoulders kicking raising eyebrows flaring of nostrils production of repetitive noises such as grunting, clicking, moaning, snorting, squealing, or throat clearing treatment as part of the treatment, family members and friends are advised not to call attention to the tics when the child is performing them. if they do, the child may develop more tics more frequently. behavioral therapy and medication are often the choices of treatment for tic disorders in children. elimination disorders dsm-iv-tr 307.6 enuresis (not due to a general medical condition) 307.7 encopresis, without constipation and overflow incontinence 787.6 encopresis, with constipation and overflow incontinence cause encopresis: the most common cause of encopresis is constipation. when a child becomes constipated, feces build up in and stretch the rectum. this stretching causes the nerve endings to become dull. the child may not feel when they need to eliminate the feces or if the waste is coming out. inside the rectum, the feces could become too large or solid to eliminate without feeling pain. while the mass of feces is stuck in the child's rectum, liquid feces could leak from around the mass and out of the child's body. the main causes of constipation are diet, lack of sufficient amounts of water, stress, not enough exercise, and inconsistent bathroom routines. enuresis: the cause of enuresis is thought to be unclear and usually is attributed to many factors. genetic – there is a genetic component within enuresis and it tends to run in families. inability to feel that the bladder is full and be aroused from sleep. insufficient size of bladder – the child's bladder is too small to contain the amount of urine produced. psychological factors – these are not main factors that contribute to enuresis, but stress may be a cause. maturational delay – the child's recognition that the bladder is full and they need to go to the bathroom is a developmental issue. many children with enuresis will develop this skill as they grow older. symptoms the majority of children with enuresis show no other symptoms besides wetting the bed at night. if other symptoms are present, such as blood stains in their underwear or unusual pain, the child is likely to have a more serious medical problem. children with encopresis are likely to exhibit symptoms such as; loss of appetite, loose or watery stools, abdominal pain, scratching or itching of anal area because of irritation, withdrawal from friends, or secretive attitude associated with bowel movements. treatment children usually "grow out" of their elimination disorders by the time they reach their teens. if treatment is necessary, the most effective choice for enuresis is behavior modification, which involves a special pad that the child sleeps on at night. if the pad gets wet, an alarm goes off and the child is directed to go to the bathroom. stool softeners or laxatives are the choice of treatment for encopresis. other disorders of infancy, childhood, or adolescence dsm-iv-tr 309.21 separation anxiety disorder 313.23 selective mutism 313.89 reactive attachment disorder of infancy or early childhood 307.3 stereotypic movement disorder 313.9 disorder of infancy, childhood, or adolescence nos: this category is a residual category for disorders with onset in infancy, childhood, or adolescence that do not meet criteria for any specific disorder in the classification. cause there are multiple factors that contribute to the cause of other disorders of infancy, childhood, or adolescence. the majority of the factors are going to be physical or environmental. some of the disorders could be caused by parental influence, such as their inability to properly take care of their child. most of the other disorders diagnosed in infancy, childhood, or adolescence involve anxiety. if the child is continually put in anxiety producing situations, they could show symptoms of these disorders. usually, the symptoms will be mild and the child will not get help, which may cause the symptoms to become worse. symptoms separation anxiety disorder excessive stress when separated from home or family fear of being alone refusal to sleep alone clinginess excessive worry about safety and getting lost frequent medical complaints with no cause refusal to go to school selective mutism unable to speak in certain social situations, even though they are comfortable speaking at home or with friends difficulty maintaining eye contact may have blank facial expressions stiff body movements may have a worrisome personality may be incredibly sensitive to sound difficulty with verbal and nonverbal expression may appear shy, when in reality, they have a fear of people. reactive attachment disorder of infancy or early childhood withdrawing from others aggressive attitude towards peers awkwardness or discomfort watching others but not engaging in social interaction stereotypic movement disorder head banging nail biting hitting or biting oneself hand waving or shaking rocking back and forth treatment separation anxiety disorder cognitive behavioral therapy is often used to treat separation anxiety disorder. family therapy may also be helpful to get to the core of the issue. systemic desensitization techniques are usually used to help the child get used to being comfortable away from home. selective mutism it is important not to "enable" the child with selective mutism by allowing them to remain silent in the social settings that they are uncomfortable in. both parents and teachers need to be involved in the treatment of selective mutism. the most important factor to remember is that the child does not have a speech disorder; it is an anxiety disorder. reactive attachment disorder of infancy or early childhood treatment almost always involves the child and their parents or caregivers parents may need to take parenting skills classes and attend family therapy with the child. individual therapy with the child and therapist is effective. another technique is keeping close physical contact between the child and their parents. stereotypic movement disorder behavioral techniques and psychotherapy are the most effective treatment for children with this disorder. it is important to change the child's environment so that they are unable to harm themselves. medication is also effective. icd-10(f90–f98) behavioural and emotional disorders with onset usually occurring in childhood and adolescence (f90) hyperkinetic disorders (f90.0) disturbance of activity and attention attention-deficit hyperactivity disorder attention deficit syndrome with hyperactivity (f90.1) hyperkinetic conduct disorder (f90.8) other hyperkinetic disorders (f90.9) hyperkinetic disorder, unspecified (f91) conduct disorders (f91.0) conduct disorder confined to the family context (f91.1) unsocialized conduct disorder (f91.2) socialized conduct disorder (f91.3) oppositional defiant disorder (f91.8) other conduct disorders (f91.9) conduct disorder, unspecified (f92) mixed disorders of conduct and emotions (f92.0) depressive conduct disorder (f92.8) other mixed disorders of conduct and emotions (f92.9) mixed disorder of conduct and emotions, unspecified (f93) emotional disorders with onset specific to childhood (f93.0) separation anxiety disorder of childhood (f93.1) phobic anxiety disorder of childhood (f93.2) social anxiety disorder of childhood (f93.3) sibling rivalry disorder (f93.8) other childhood emotional disorders identity disorder overanxious disorder (f93.9) childhood emotional disorder, unspecified (f94) disorders of social functioning with onset specific to childhood and adolescence (f94.0) elective mutism (f94.1) reactive attachment disorder of childhood (f94.2) disinhibited attachment disorder of childhood (f94.8) other childhood disorders of social functioning (f94.9) childhood disorder of social functioning, unspecified (f95) tic disorders (f95.0) transient tic disorder (f95.1) chronic motor or vocal tic disorder (f95.2) combined vocal and multiple motor tic disorder (de la tourette) (f95.8) other tic disorders (f95.9) tic disorder, unspecified (f98) other behavioural and emotional disorders with onset usually occurring in childhood and adolescence (f98.0) nonorganic enuresis (f98.1) nonorganic encopresis (f98.2) feeding disorder of infancy and childhood (f98.3) pica of infancy and childhood (f98.4) stereotyped movement disorders (f98.5) stuttering (stammering) (f98.6) cluttering (f98.8) other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence attention deficit disorder without hyperactivity excessive masturbation nail-biting nose-picking thumb-sucking (f98.9) unspecified behavioural and emotional disorders with onset usually occurring in childhood and adolescence perception stigma it is not uncommon for children with mental health disorders to be faced with stigma. stigma against those with mental health disorders can be seen through stereotyping, prejudice, and discrimination. this stigma can come from the public (those without the disorder) and by oneself (those with the disorder). both public and self-stigma can diminish the self-esteem of those with mental health disorders; especially children. typically, children with mental health disorders are first exposed to stigma within their family unit before later being exposed to it in the school setting and the public. while some