Commentary
Framing childhood mental disorders within the context of disability

https://doi.org/10.1016/j.dhjo.2017.04.006Get rights and content

Section snippets

Disproportionate rise in disability related to child mental disorders

The threats to the health and well-being of children in the United States have changed dramatically over the past century.15 Widespread public health measures and medical advances have shifted the management of children's health from control of acute infectious diseases to the treatment of chronic conditions many of which are associated with limitations in how children function in their daily lives.15, 16 The epidemiology of chronic conditions of childhood has shifted substantially with a rise

Clinical approach

Despite these advances in the conceptualization of disability, most mental health professionals rely solely on impairment-related diagnostic criterion in the DSM-5 to clinically judge the extent functional impairment is attributable to a child psychiatric diagnosis. This criterion is significant because it is often used as the clinical threshold to differentiate normal and pathological symptom expressions.31 In contrast to the ICF, the DSM-5 is a classification system that provides consensus

Discussion

Data on childhood disability suggest that the proportion of children experiencing disability is steadily increasing regardless of the definition used, and that the conditions underlying those disabilities is shifting from a dominant mix of traditional medical conditions and orthopedic impairments to a preponderance of mental and neurodevelopmental conditions.7, 15 How much of this increase in prevalence is “real” and what proportion results from changes in recognition, diagnosis, availability

Funding

Dr. Zima was supported by the Behavioral Health Centers of Excellence for California (SB852). All of the authors have no financial relationships relevant to this article to disclose.

First page preview

First page preview
Click to open first page preview

References (50)

  • G.M. Reed et al.

    The relevance of the International Classification of Functioning, Disability and Health (ICF) to mental disorders and their treatment

    Eur J Disabil Res

    (2009)
  • A.L. Krain et al.

    Brain development and ADHD

    Clin Psychol Rev

    (2006)
  • I.M. Rosso et al.

    Amygdala and hippocampus volumes in pediatric major depression

    Biol Psychiatr

    (2005)
  • D.G. Amaral et al.

    Neuroanatomy of autism

    Trends Neurosci

    (2008)
  • R.W. Greene et al.

    Adolescent outcome of boys with attention-deficit/hyperactivity disorder and social disability: results from a 4-year longitudinal follow-up study

    J Consult Clin Psychol

    (1997)
  • A.V. Brereton et al.

    Psychopathology in children and adolescents with autism compared to young people with intellectual disability

    J autism Dev Disord

    (2006)
  • J.M. McClellan et al.

    A follow-up study of early onset psychosis: comparison between outcome diagnoses of schizophrenia, mood disorders, and personality disorders

    J autism Dev Disord

    (1993)
  • A.J. Houtrow et al.

    Changing trends of childhood disability, 2001-2011

    Pediatrics

    (2014)
  • T.F. Boat et al.

    Children with mental disorders who receive disability benefits: a report from the IOM

    JAMA

    (2015)
  • United States Government Accountability Office

    Supplemental Security Income: Better Management Oversight Needed for Children's Benefits

    (2012;June 26)
  • National Academies of Sciences Engineering and Medicine

    Mental Disorders and Disabilities Among Low-income Children

    (2015)
  • M.A. Buist-Bouwman et al.

    Functional disability of mental disorders and comparison with physical disorders: a study among the general population of six European countries

    Acta Psychiatr Scand

    (2006)
  • A.S. Alvarez

    The application of the International Classification of Functioning, Disability, and Health in psychiatry: possible reasons for the lack of implementation

    Am J Phys Med Rehabil

    (2012)
  • S.L. Einfeld et al.

    Comorbidity of intellectual disability and mental disorder in children and adolescents: a systematic review

    J Intellect Dev Disabil

    (2011)
  • N. Halfon et al.

    The changing landscape of disability in childhood

    Future Child

    (2012)
  • View full text