Definitions of “Disorders” and Other Terminology
As part of the adoption process, you'll be asked to assess your willingness to cope with any of the following concerns.
Think about which of these concerns you feel equipped to address and rank the severity (mild, moderate, severe, not at all) of each disorder that you would be willing to accept in an adopted child. This is something you will want to give very careful consideration to– and something you’ll want to discuss with your adoption social worker.
Anemia is a medical condition that occurs when a person does not have enough red blood cells. Red blood cells are important because they contain hemoglobin, a protein that carries oxygen from the lungs to the body’s muscles and organs. The body requires oxygen for energy. Therefore, when you are anemic, you may feel tired both mentally and physically.
Experts believe that anxiety disorders are caused by a combination of biological and environmental factors such as brain chemistry, life events, personality, and genetic predisposition. This makes an anxiety disorder much like other physical disorders, such as heart disease or diabetes.
Asthma is characterized by inflammation of the air passages resulting in the temporary narrowing of the airways that transport air from the nose and mouth to the lungs. Asthma symptoms can be caused by allergens or irritants that are inhaled into the lungs, resulting in inflamed, clogged and constricted airways. Symptoms include difficulty breathing, wheezing, coughing tightness in the chest. In severe cases, asthma can be deadly.
Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder is a common disorder in children and adolescents, with symptoms of inattention, and/or impulsiveness and hyperactivity. These symptoms should have been present before the age of seven, must be present in two or more different settings (school and home, for example), and should be causing some impairment in the child’s functioning, including causing difficulty in school or in social situations. If your child has the symptoms of attention deficit disorder, but it isn’t causing any impairment in his functioning, then he doesn’t have ADHD.
There are three main types of attention deficit disorder, including the Predominantly Inattentive Type, in which children have six or more of the following symptoms:
- Fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
- Has difficulty sustaining attention in tasks or play activities.
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
- Has difficulty organizing tasks and activities
- Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, such as schoolwork or homework.
- Loses things necessary for tasks or activities, such as toys, school assignments, pencils, books or tools.
- Is easily distracted by extraneous stimuli.
- Is forgetful in daily activities.
- Other children have a Predominantly Hyperactive Type of ADHD, and have six or more of the following symptoms:
- Fidgets with hands or feet or squirms in seat.
- Leaves seat in classroom or in other situations in which remaining seated is expected.
- Runs about or climbs excessively in situations in which it is inappropriate.
- Has difficulty playing or engaging in leisure activities quietly.
- Is often ‘on the go’ or often acts as if ‘driven by a motor’
- Often talks excessively.
- Blurts out answers before questions have been completed.
- Has difficulty waiting turn.
- Interrupts or intrudes on others.
Children may also have a Combined Type of ADHD, having six or more symptoms of inattention and six or more symptoms of hyperactivity and impulsivity.
Autism or Autism Spectrum Disorder
A spectrum of neuropsychiatric disorders characterized by deficits in social interaction and communication, and unusual and repetitive behavior. Some, but not all, people with autism are non-verbal.
Autism is normally diagnosed before age six and may be diagnosed in infancy in some cases. The degree of autism varies from mild to severe in different children. Severely afflicted patients can appear profoundly retarded.
The cause (or causes) of autism are not yet fully understood. However, it is believed that at least some cases involve an inherited or acquired genetic defect. Researchers have proposed that the immune system, metabolic, and environmental factors may play an important part as well. It is not caused by emotional trauma, as was once theorized.
Autism or autistic-like behavior may co-occur with many other neurological conditions.
The optimal treatment of autism involves an educational program that is suited to the child’s developmental level.
Autism is also called the Kanner syndrome or infantile autism.
Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupts the brain’s ability to adequately control movement and posture.
“Cerebral” refers to the brain and “palsy” to muscle weakness/poor control. Cerebral palsy itself is not progressive (i.e. brain damage does not get worse); however, secondary conditions, such as muscle spasticity, can develop which may get better over time, get worse, or remain the same. Cerebral palsy is not communicable. It is not a disease and should not be referred to as such. Although cerebral palsy is not “curable” in the accepted sense, training and therapy can help improve function.
(Formerly known as mental retardation.)
Some common conditions include development from childhood at below average rate, and/or difficulty in learning and social adjustments. Ranges from mild to profound, with vast majority being mild.
Co-Morbid diagnosis is simply multiple diagnoses in one child. For example, one child diagnosed with ADHD, PTSD, and ODD.
A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.
A developmental delay occurs when your child has the delayed achievement of one or more of his milestones. This may affect your child’s speech and language, his fine and gross motor skills, and/or his personal and social skills.
A genetic disorder that is caused by the presence of an extra chromosome, which results in varying degrees of physical and mental abnormality. Physical characteristics of the syndrome include a flattened face, widely spaced and slanted eyes, comparatively smaller head size and lax joints. Although not present in all cases, mental retardation is typical. Those who are affected with the syndrome display a wide variety in mental, behavior and developmental capabilities, and will have a high propensity to suffer from common health problems, include a low resistance to infection, pronounced hearing loss, gastrointestinal problems, and heart defects.
Down syndrome is usually caused by an error in cell division called non-disjunction. There are also two other types of chromosomal abnormalities (mosaicism and translocation) that to a lesser extent are also implicated as possible causes of Down syndrome. Regardless of the type of Down syndrome a person may have, all people with Down syndrome have an extra, critical portion of the number 21 chromosome present in all or some of their cells. The presence of this additional genetic material alters the normal course of development, which results in the development of the characteristics that are normally associated with the syndrome.
There are many unknowns involved in trying to predict the outcomes of infants and children exposed to drugs. While we know that there are certain physical problems that may remain with the child, in a structured and nurturing environment, many of these children are able to grow and develop quite normally. A small percentage of children have been found to have moderate to severe developmental problems.
But regardless of their health status, all children who have a history of prenatal substance exposure should receive developmental evaluations on a regular basis: at least once during the first six months; at twelve months; and at least every year thereafter until school age. Early identification of social, language, cognitive and motor development problems is essential.
A severe, pervasive, or chronic emotional/affective condition which prevents a child from performing everyday tasks. This condition is characterized by an inability to build or maintain relationships, inappropriate behaviors or feelings under normal circumstances, a pervasive mood of unhappiness or depression, or a tendency to develop physical symptoms or fears related to personal or school problems. Children may require special classrooms and teachers trained to help children with these special needs. School systems may have varying “levels” and processes for educational planning.
Wernicke encephalopathy is a serious disorder caused by thiamine deficiency. Korsakoff amnestic syndrome is a late neuropsychiatric manifestation of Wernicke encephalopathy with memory loss and confabulation; hence, the condition is usually known as Wernicke-Korsakoff syndrome or psychosis. It is most often seen in alcoholics, but it can be seen in disorders associated with malnutrition and also in chronic hemodialysis patients, and in patients with AIDS. Although not frequently diagnosed, the disease is more frequent than commonly supposed.
The American Psychiatric Association recognizes two elimination disorders, encopresis and enuresis. Encopresis is an elimination disorder that involves repeatedly having bowel movements in inappropriate places after the age when bowel control is normally expected. Encopresis is also called fecal incontinence.
Enuresis, more commonly called bed-wetting, is an elimination disorder that involves release of urine into bedding, clothing, or other inappropriate places. Both of these disorders can occur during the day (diurnal) or at night (nocturnal). They may be voluntary or involuntary. Encopresis and enuresis may occur together, although most often they occur separately.
Elimination disorders may be caused by a physical condition, a side effect of a drug, or a psychiatric disorder. It is much more common for elimination disorders to be caused by medical conditions than psychiatric ones. In most cases in which the cause is medical, the soiling is unintentional. When the causes are psychiatric, the soiling may be intentional, but it is not always so.
The heart is divided into four chambers; two are on the left side of the heart and two are on the right. The blood returning from the body is pumped to the lungs where it’s oxygenated, then pumped through the arteries to the rest of the body. After the oxygen has been used, the blood returns to the heart through the veins and is pumped through the lungs again.
The word murmur describes a swishing sound made as the blood flows through any of the heart’s chambers or valves or even through a hole within the heart.
Hydrocephalus is the abnormal buildup of cerebrospinal fluid in the ventricles of the brain. In most instances, hydrocephalus is a lifelong condition in that the patient is treated rather than “cured.” Presently, there is no known way to prevent or cure hydrocephalus and shunts are the primary method to treat hydrocephalus.
Some issues that may accompany hydrocephalus include:
- Learning disabilities
- Memory deficits
- Psychological deficits
- Motor Skill disabilities
- Vision problems
- Hearing difficulties
- Hormonal imbalances
- Sensitivity to sound, pressure and bright lights
Juvenile Rheumatoid Arthritis
Arthritis is best described by four major changes in the joints that may develop. The most common features of JRA are: joint inflammation, joint contracture (stiff, bent joint), joint damage and/or alteration or change in growth. Other symptoms include joint stiffness following rest or decreased activity level (also referred to morning stiffness or gelling), and weakness in muscles and other soft tissues around involved joints. However, because JRA affects each child differently, your child may not experience all of these changes. Children also vary in the degree to which they are affected by any particular symptom.
An autoimmune disease that occurs when T cells attack and decimate the beta cells in the pancreas that are needed to produce insulin, so that the pancreas makes too little insulin (or no insulin). Without the capacity to make adequate amounts of insulin, the body is not able to metabolize blood glucose (sugar), to use it efficiently for energy, and toxic acids (called ketoacids) build up in the body. There is a genetic predisposition to type 1 diabetes.
Learning Disabilities (LD) are neurologically-based processing problems. These processing problems can interfere with learning basic skills such as reading, writing, or math. They can also interfere with higher level skills such as organization, time planning, and abstract reasoning.
The types of LD are identified by the specific processing problem. They might relate to getting information into the brain (Input), making sense of this information (Organization), storing and later retrieving this information (Memory), or getting this information back out (Output). Thus, the specific types of processing problems that result in LD might be in one or more of these four areas.
A legal risk child is one that has been placed for adoption, before the parental rights have been terminated. This means that there is still the possibility that the child could be reunited with a birth parent, even though they are being placed for adoption. This may mean that you will have to take the child for visits with birth parent(s), or have contact with them. In some cases, termination of parental rights is delayed until a specific adoptive family has been identified.
Infants with microcephaly are born with either a normal or reduced head size. Subsequently the head fails to grow while the face continues to develop at a normal rate, producing a child with a small head, a large face, a receding forehead, and a loose, often wrinkled scalp. As the child grows older, the smallness of the skull becomes more obvious, although the entire body also is often underweight and dwarfed. Development of motor functions and speech may be delayed. Hyperactivity and mental retardation are common occurrences, although the degree of each varies. Convulsions may also occur. Motor ability varies, ranging from clumsiness in some to spastic quadriplegia in others.
Generally there is no specific treatment for microcephaly. Treatment is symptomatic and supportive.
In general, life expectancy for individuals with microcephaly is reduced and the prognosis for normal brain function is poor. The prognosis varies depending on the presence of associated abnormalities.
Oppositional Defiant Disorder
A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
- often loses temper
- often argues with adults
- often actively defies or refuses to comply with adults’ requests or rules
- often deliberately annoys people
- often blames others for his or her mistakes or misbehavior
- is often touchy or easily annoyed by others
- is often angry and resentful
- is often spiteful or vindictive
Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.
D. Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.
Organic Brain Syndrome
Organic brain syndrome is a general term referring to physical disorders (usually not psychiatric disorders) that cause decreased mental function.
OBS; Organic mental disorder; Chronic organic brain syndrome
Pervasive Developmental Disorder
PDDs are a wide spectrum of social and communication disorders, including autism, that can be complicated to diagnose. However, there are acknowledged criteria for determining if a child has a PDD and there are ways to help children with these disorders at an early age. Typically, the symptoms should be recognizable before a child is 3 years old. Although a toddler’s behaviors might seem to fit the criteria, they also might just be part of a youngster’s developing personality.
Post Traumatic Stress Disorder
Post Traumatic Stress Disorder is a complex health condition that can develop in response to a traumatic experience – a life-threatening or extremely distressing situation that causes a person to feel intense fear, horror or a sense of helplessness. PTSD can cause severe problems at home or at work. Anyone can develop PTSD – men, women, children, young and old alike. Fortunately, PTSD is treatable.
Reactive Attachment Disorder/Attachment Disorder (RAD) (AD)
Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. They often show nearly a complete lack of ability to be genuinely affectionate with others. They typically fail to develop a conscience and do not learn to trust. They do not allow people to be in control of them, due to this trust issue. This damage is done by being abused or physically or emotionally separated from a primary caregiver during the first 3 years of life.
- Superficially engaging & charming
- Lack of eye contact on parents’ terms
- Indiscriminately affectionate with strangers
- Not affectionate on parents’ terms (not cuddly)
- Destructive to self, others and material things (accident prone)
- Cruelty to animals
- Lying about the obvious (crazy lying)
- No impulse controls (frequently acts hyperactive)
- Learning lags
- Lack of cause-and-effect thinking
- Lack of conscience
- Abnormal eating patterns
- Poor peer relationships
- Preoccupation with fire
- Preoccupation with blood & gore
- Persistent nonsense questions & chatter
- Inappropriately demanding & clingy
- Abnormal speech patterns
- Triangulation of adults
- False allegations of abuse
- Presumptive entitlement issues
- Parents appear hostile and angry
Sensory Integration Dysfunction
Sensory integration dysfunction is the brain’s inability to correctly process information brought in by the senses. For example the nervous system can overreact to heat and cold or repetitive noises, bringing out hostility, withdrawal, and/or clumsiness in the child.
Sensory integration dysfunction can result when babies are unable to explore their surroundings and are left alone in their cribs for long periods of time and do not receive the loving touch of a caretaker. As a result, the body’s senses interpret information inappropriately. It is very hard to tell from a video if a child has a sensory integration dysfunction.
Sensory integration dysfunction can be treated through therapy. Occupational therapists familiar with sensory integration can be very helpful in deducing what stimulations are comforting and what stimulations need to be avoided – and how to go about avoiding those “bad” stimuli.
Everyone’s spine has natural curves. These curves round our shoulders and make our lower back curve slightly inward. But some people have spines that also curve from side to side. Unlike poor posture, these curves can’t be corrected simply by learning to stand up straight.
This condition of side-to-side spinal curves is called scoliosis. On an X-ray, the spine of an individual with scoliosis looks more like an “S” or a “C” than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person’s waist or shoulders appear uneven.
Gilles de la Tourette syndrome (Tourette Syndrome or TS) is a neurological disorder which becomes evident in early childhood oradolescence between the ages of 2 and 15. Tourette syndrome is defined by multiple motor and vocal tics lasting for more than one year. Many people have only motor tics or only vocal tics. The first symptoms usually are involuntary movements (tics) of the face, arms, limbs or trunk. These tics are frequent, repetitive and rapid. The most common first symptom is a facial tic (eye blink, nose twitch, grimace), and is replaced or added to by other tics of the neck, trunk, and limbs.
These involuntary (outside the patient’s control) tics may also be complicated, involving the entire body, such as kicking and stamping. Many persons report what are described as premonitory urges—the urge to perform a motor activity. Other symptoms such as repetitive thoughts, movements, and compulsions can occur.
There are also verbal tics. These verbal tics (vocalizations) usually occur with the movements; later they may replace one or more motor tics. These vocalizations include grunting, throat clearing, shouting and barking. The verbal tics may also be expressed as coprolalia (the involuntary use of obscene words or socially inappropriate words and phrases) or copropraxia (obscene gestures). Despite widespread publicity, coprolalia/copropraxia is uncommon with tic disorders.
Neither echolalia (echo speech) nor coprolalia/copropraxia is necessary for the diagnosis of Tourette syndrome. All patients have involuntary movements and some have vocalizations. Echo phenomena are also reported, although less frequently. These may include repeating word of others (echolalia), repeating ones own words (palilalia), and repeating movements of others.