Formal diagnosis of an emotional disorder requires that a clinician decide whether or not a child or adolescent meets the criteria for the disorder as described in one of these classification systems. During the diagnostic process, the clinician typically observes and interacts with the child, and considers reports from adults who know the child well. Yet even with the use of these very detailed classification systems, diagnosing emotional disorders in children and adolescents can be extremely difficult. There are several reasons why this is the case. First, the criteria used to describe and distinguish most of these disorders in children are based on the criteria used for adults. However, the signs, symptoms, and course of a disorder in children may be very different from those in adults. Little systematic research has examined how well the diagnostic criteria actually apply to children. Diagnosis is further complicated by the fact that children often lack the verbal skills to describe their experiences, emotions or thought processes. Thus, clinicians often find themselves in the position of having to make diagnoses without key pieces of information. Diagnosis is also made difficult because children and adolescents undergo many changes as they grow and develop. Signs or symptoms such as angry outbursts, irritability, sadness, shyness, or fearfulness are key features of certain emotional disorders; however, they are also normal childhood behaviors under certain circumstances or at certain stages of development. In reaching diagnoses, clinicians are thus often required to make subtle distinctions, based on their assessment of the intensity and/or developmental appropriateness of behavior. Cultural factors can also impact the expression and interpretation of signs and symptoms (Westermeyer and Janca 1997). Finally, it is not uncommon for children to have multiple orco-occurring disorders. It can be difficult for clinicians to determine whether a set of symptoms is more consistent with a single diagnosis or with two or more diagnoses, particularly since one disorder—or the treatment for one disorder—can alter, conceal, and/or amplify the symptoms or signs of another disorder.
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Some characteristics of Emotional Disorders include hyperactivity, aggression, withdrawal, emotional immaturity, and learning difficulties that cannot be described by other disorders. The difference between children with Emotional Disorders and children without are that children with Disorders exhibit one or more sign for an extended period of time with no clear cause. For example, a student that seems to be having a bad day and may burst into tears upon being disciplined, while exhibiting signs of emotional disturbance, is not considered emotionally disturbed for that reason alone.
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Arkansas Special Education lists several indications that could lead to a child being referred for further testing.
1. Academic. Students cannot acquire skills, they have learning deficiencies, skipping class, short attention span, little or no motivation.
2. Behavior. The student exhibits obvious mood swings, displays abnormal responses to peers, teacher,and the classroom, complains about neurotic issues, struggles with interpersonal relationships, and has an obviously lessened self-concept.
3. Communication. The student does not respond to stimulus, responds unusually or inappropriately.
4. Physical. Students complain of physical pain, has repetitive motor behavior, sucks fingers or sleeps during the day.
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