Adjustment Disorders in Children

An adjustment disorder is an
unhealthy emotional or behavioral reaction to a stressful event or change in a person’s
life. The response happens within 3 months of the stressful event. Some events that
may
lead to this problem in a child or teen are:

• A family move
• Death of a parent, sibling, grandparent, or other significant
  person
• Parents’ divorce or separation
• Death of a pet
• A new brother or sister
• A sudden sickness in the child or a
  family member
• A long-lasting (chronic) illness in
  the child or a family member

Adjustment disorders are a reaction to stress. There is not one direct cause. Children
and teens differ in their personalities, past experiences, vulnerability, and coping
skills. Where they are in their development and ability to deal with a stressor may
also play a part in how they react. Stressors also vary in how long they last, how
strong they are, and what effect they have.

Adjustment disorders happen at all
ages and are quite common in children and teens. They happen equally in boys and girls.
They happen in all cultures. But the stressors and signs may vary based on cultural
influences.

Children and teens have different
symptoms of an adjustment disorder than adults. Children tend to have more behavioral
symptoms, such as acting out. Adults have more depressive symptoms. Age differences
also
affect how long symptoms last, how strong they are, and what effect they have.

In all adjustment disorders, the reaction to the stressor seems to be more than what
is thought to be normal. Or the reaction greatly interferes with how the child functions
day to day.

There are 6 subtypes of adjustment disorder. They are based on the type of major symptoms
a child may feel. Each child’s symptoms may vary. These are the most common symptoms
of each subtype:

• Adjustment disorder with depressed mood. A child may feel depressed, tearful, and hopeless.
• Adjustment disorder with anxiety.

  Symptoms may include nervousness, worry, and jitteriness. A child may also fear
  losing important people in their life.

• Adjustment disorder with anxiety and depressed mood. A child has a mix of symptoms from both of the above subtypes (depressed mood and
  anxiety).
• Adjustment disorder with disturbance of conduct. A child may violate other people’s rights or violate social norms and rules. Examples
  include not going to school, destroying property, driving recklessly, or fighting.
• Adjustment disorder with mixed disturbance of emotions and conduct. A child has a mix of symptoms from all of the above subtypes.
• Adjustment disorder unspecified. A child has reactions to stressful events that don’t fit in one of the above subtypes.
  These may include behaviors such as withdrawing from friends and school.

Symptoms of an adjustment disorder
can look like other health problems or mental illnesses. Have your child see their
healthcare provider for a diagnosis.

A mental health expert such as a
psychiatrist often makes the diagnosis after an evaluation. They talk with you, your
partner, and your child. They will ask for a full history of your child’s development,
life events, emotions, behaviors, school performance, and the stressful event.

Treatment will depend on your
child’s symptoms, age, and health. It will also depend on how severe the disorder
is.

Treatment may include:

• Psychotherapy using cognitive behavioral
  methods.
  A child learns how to better solve problems, communicate, and handle
  stress. They will also learn how to control impulses and anger.
• Family therapy. This therapy is often
  focused on making needed changes in the family. It may include improving
  communication skills and family interactions. It may also boost support among family
  members.
• Peer group therapy. This therapy
  develops social and interpersonal skills.
• Medicines. These are not often used.
  But a child may need them for a short time if a certain symptom is severe.

It’s not known how to prevent an adjustment disorder in a child. But spotting it early
and getting expert help for your child can ease severe symptoms. Taking these steps
can enhance a child’s normal growth and development. It can improve your child’s quality
of life.

You can do these things to help your child:

• Keep all appointments with your
  child’s healthcare provider.
• Talk with your child’s healthcare
  provider about other providers who will be included in your child’s care. Your child
  may get care from a team that may include counselors, therapists, social workers,
  psychologists, and psychiatrists. Your child’s care team will depend on your child’s
  needs and how serious the adjustment disorder is.
• Work closely with school staff. Your
  child’s adjustment disorder may significantly interfere with his or her ability to
  learn. If this is the case, the Americans with Disabilities Act (ADA) or Section 504
  of the Civil Rights Act may allow the school to offer reasonable accommodations in
  the school setting.
• Tell others about your child’s
  adjustment disorder. Work with your child’s healthcare provider and school to create
  a treatment plan.
• Reach out for support from local
  community services. Being in touch with other parents who have a child with an
  adjustment disorder may be helpful.

Call your child’s healthcare provider if your child has:

• Symptoms that don’t get better, or get worse
• New symptoms

• An adjustment disorder is an unhealthy
  emotional or behavioral reaction to a stressful event or change in a child’s
  life.

• Adjustment disorders happen
  equally in boys and girls and in all cultures. But the stressors and signs of the
  disorder may vary based on cultural influences.

• Symptoms happen within 3 months of the
  stressful event.

• There are 6 subtypes. They are based
  on the major symptoms a child may feel, such as depression or anxiety.

• psychiatric evaluation can help
  diagnose it.

• Personal, family, and group therapy
  can help.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
  or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child.
  Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose
  for that visit.
• Know how you can contact your child’s provider after office hours. This is important
  if your child becomes ill and you have questions or need advice.