All children display behaviors which can be difficult to manage at some point in time. Parents are challenged to understand why certain behaviors manifest and struggle to help a distressed child try to control them. When behaviors occur persistently and impair the normal development of the child or adolescent’s formation of interpersonal relationships with peers and authority figures, a Behavior Disorder may be diagnosed.
Of course, all disruptive behaviors are not the same and have different remedies and causes, and while there are many disorders which can negatively impact behavior, only a few are specifically categorized as behavior disorders. These are: Attention Deficit Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder, and Disruptive Behavior Not Otherwise Specified.
Symptoms of Behavior Disorders may include externalizing behaviors (sometimes called “acting out”) with a pervasive disruptive pattern, problems in directing attention or controlling impulses, engaging in hostile social interactions, or defying adult directions. A creative arts therapist can help remedy disruptive behaviors through individualized and targeted use of the arts to help achieve therapeutic goals. Creative arts therapy can promote improved awareness of internal states, in turn providing improved control over external behaviors. The creative arts therapist will also target any relevant problems related to impulsivity, attention, and interpersonal relationships, and will seek to build strengths and skills in these areas.
ITA therapists have facilitated creative arts therapy sessions at Therapeutic Day Schools and Alternative High Schools working with children and adolescents struggling with being able to identify their emotions and express themselves in a healthy manner. ITA also runs in-house groups for these individuals where concerns can be addressed in a social setting promoting understanding of how one’s behaviors impact others.
Definition of Developmental Disabilities:
From the DSM-5:
The neurodevelopmental disorders are a group of conditions with onset in the developmental period. The disorders typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning. The range of developmental deficits varies from very specific limitations of learning or control of executive functions to global impairments of social skills or intelligence. The neurodevelopmental disorders frequently co-occur; for example, individuals with autism spectrum disorder often have intellectual disability (intellectual developmental disorder), and many children with attention-deficit/hyperactivity disorder (ADHD) also have a specific learning disorder. For some disorders, the clinical presentation includes symptoms of excess as well as deficits and delays in achieving expected milestones. For example, autism spectrum disorder is diagnosed only when the characteristic deficits of social communication are accompanied by excessively repetitive behaviors, restricted interest, and insistence on sameness.
Types of Developmental Disabilities:
From the DSM-5:
Attention-Deficit/Hyperactivity Disorder (ADHD): “The essential feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Inattention manifests behaviorally in ADGD as wandering off task, lacking persistence, having difficulty sustaining focus, and being disorganized and is not due to defiance or lack of comprehension. Hyperactivity refers to excessive motor activity (such as a child running about) when it is not appropriate, or excessive fidgeting, tapping, or talkativeness. In adults, hyperactivity may manifest as extreme restlessness or wearing others out with their activity. Impulsivity refers to hasty actions that occur in the moment without forethought and that have high potential for harm to the individual (e.g., darting into the street without looking). Impulsivity may reflect a desire for immediate rewards or an inability to delay gratification. Impulsive behaviors may manifest as social intrusiveness (e.g., interrupting others excessively) and/or as making important decisions without consideration of long-term consequences (e.g., taking a job without adequate information).”
Intellectual Disability (Intellectual Developmental Disability): ‘The essential feature of intellectual disability (intellectual developmental disability are deficits in general mental abilities and impairment in everyday adaptive functioning, in comparison to an individual’s age-, gender-, and socioculturally matched peers. Onset is during the developmental period. The diagnosis of intellectual disability is based on both clinical assessment and standardized testing of intellectual and adaptive functions.’
Developmental Coordination Disorder: ‘The diagnosis of developmental coordination disorder is made by a clinical synthesis of the history (developmental and medical), physical examination, school or workplace report, and individual assessment using psychometrically sound and culturally appropriate standardized tests. The manifestation of impaired skills requiring motor coordination varies with age. Young children may be delayed in achieving motor milestones (e.g., sitting, crawling, walking), although many achieve typically motor milestones. They also may be delayed in developing skills such as negotiating stairs, pedaling, buttoning shirts, completing puzzles, and using zippers. Even when the skill is achieved, movement execution may appear awkward, slow, or less precise than that of peers. Older children and adults may display slow speed or inaccuracy with motor aspects of activities such as assembling puzzles, building models, playing ball games (especially in teams), handwriting, typing, driving, or carrying out self-care skills.’
Stereotypic Movement Disorder: ‘The essential feature of stereotypic movement disorder is repetitive, seemingly driven, and apparently purposeless motor behavior. These behaviors are often rhythmical movements of the head, hands, or body without obvious adaptive function. The movements may or may not respond to efforts to stop them. Among typically developing children, the repetitive movements may be stopped when attention is directed to them or when the child is distracted from performing them. Among children with neurodevelopmental disorders, the behaviors are typically less responsible to such efforts. In other cases, the individual demonstrates self-restraining behaviors (e.g., sitting on hands, wrapping arms in clothing, finding a protective device).
Tic Disorders: ‘Tic disorders comprise four diagnostic categories: Tourette’s disorder, persistent (chronic) motor or vocal tic disorder, provisional tic disorder, and the other specified and unspecified tic disorders. Diagnosis for any tic disorder is based on the presence of motor and/or vocal tics, duration of tic symptoms, age at onset, and absence of any known cause such as another medical condition or substance use. The tic disorders are hierarchical in order (i.e., Tourette’s disorder, followed by persistent [chronic] motor or vocal tic disorder, followed by provisional tic disorder, followed by the other specified and unspecified tic disorders), such that once a tic disorder at one level of the hierarchy is diagnosed, a lower hierarchy diagnosis cannot be made.
‘Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations. An individual may have various tic symptoms over time, but at any point in time, the tic repertoire recurs in a characteristic fashion. Although tics can include almost any muscle group or vocalization, certain tic symptoms, such as eye blinking or throat clearing, are common across patient populations. Tics are generally experienced as involuntary but can be voluntarily suppressed for varying lengths of time.’
References:
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Neurodevelopmental Disorders (31-41, 59-65, 74-85). Arlington, VA, American Psychiatric Association, 2013.
Additional Resources
Music, Art Therapy Helps Kids to Find Their Creative Side
Art Therapist Blog about Developmental Disability
Music Therapy and Developmental Disability
Disclaimer: Due to the nature of this post, this information is meant to be inform and not serve as a diagnosis for developmental disabilities. If you believe you or someone you know need help in regards to a developmental disability, please seek out a doctor or professional for a proper diagnosis.