Adjustment and Behavioral Disorders in Children

*What is Adjustment and Behavior Disorder?

The ability of the individual to establish a balanced relationship with the environment and to maintain this relationship in a healthy way is called adaptation.

Children acquire various skills during their growth process. With every skill gained, they face many problems. In the face of these problems, when the parents and the close environment exhibit appropriate attitudes and behaviors, the problem can be easily solved, while the problems experienced in the face of inappropriate attitudes can turn into permanent adaptation and behavior problems.

*How to Separate Adjustment Disorder from Normal Behavior?

It is difficult for parents to distinguish between the usual problems that the child experiences depending on the developmental period and the behaviors that are considered as adjustment disorders. The following points should be considered in order to understand whether the problem is caused by the developmental period or is a conduct disorder in the real sense:

Child’s developmental period: Behavior may be a temporary condition that occurs during a certain developmental period. For example: nocturnal urination up to 4-5 years of age, sleep disorders occurring at 2-3 years of age, short-term speech disorders do not require concern.

Frequency of symptom : It is important how often the child’s behavior is done. Occasional disobedience, misbehavior, and moody and irritable children at home but outwardly compliant are common. Behaviors that are contrary to everything that is said and that continue at school and in the environment should be examined from a spiritual point of view.

The severity of the behavior:It signals trouble when the intensity of the behavior increases.

Continuity of behavior: Behaviors that persist for a while and those that disappear cannot be kept at the same level. For example, the behavior of the child who is irritable and grumpy due to sibling jealousy can be described as normal. However, the continuation of problems for various reasons is considered as incompatibility.

Accompanying one behavior with other behaviorsFor example: It is not enough to just wet the bed at night, and if there are situations such as stuttering, fear, and anxiety, then it can be said that there is a conduct disorder.

Not expressing the problem: Not all children express their mental problems. A child who has many internal problems that do not show any external symptoms may pretend that they do not have behavioral problems, but the child cannot always be expected to behave in harmony and balance. He starts to show symptoms as a result of trying to cope with the problems he is experiencing and getting tired.

Examination of the child’s past lives: The past adaptation and positive characteristics of the child should also be examined. Temporary or permanent maladjustment may occur due to positive or negative family support and family attitudes in children with deviations in their developmental periods.

*What are the Causes of Adjustment and Behavioral Disorders?    

  • Neglect: Failure to meet the child’s physical, emotional and social needs on time and adequately.

  • Parental attitudes: Overly oppressive, coercive, lax or overprotective attitudes.

  • Violence: Physical, emotional or verbal harm to the child, humiliation, prolonged and excessive punishment.

  • Separation: Long-term separation from parents, frequent changes of caregivers.

  • Divorce

  • Death

  • Big and sudden changes in daily routine

  • sibling birth

  • Traumatic events such as accident, illness, disaster

*What are Adjustment and Behavioral Disorders in Children?

Adjustment and behavioral disorders can be listed under three main headings. These;

Habit disorders:Thumb sucking, nail biting, bedwetting, fecal incontinence, masturbation, hair pulling.

Behavioral disorders:Lying, stealing, stubbornness, harming.

Emotional disorders:Fear, anxiety, shyness, tic, stuttering, sleep and eating disorders.

*What are the Characteristics of These Behavior Disorders? How is it formed? How to Behave?

Finger sucking:

One of the most important reflexes that children have from birth is the sucking reflex. Thumb sucking is considered normal in the first year after birth. Sucking is a behavior that creates pleasure and provides psychological relaxation. It can develop as a result of psychological problems and tensions.

Situations such as tensions in the home environment, the birth of a new sibling, and the need for sucking are not sufficiently satisfied, which cause finger sucking behavior to be seen more frequently. Finger sucking behavior, which is usually expected to decrease or even disappear around the age of 2, continues in some cases until the child starts school. Sometimes it is seen that this behavior continues during school time. If thumb sucking continues after the age of 2, it is thought to be more likely to be seen as an adaptation and behavior problem.

How to Behave?

First of all, the causes of thumb sucking behavior and whether there is an anxiety-provoking event in the child should be investigated. Thumb sucking behavior continues unless the root cause is eliminated. The child’s need for sucking should be adequately met with both the mother’s breast and the use of pacifiers and bottles. The fact that sucking gives pleasure and that this behavior is normal up to the age of 2 should be accepted. Misbehaviors should not be exhibited, and the child should not be frightened with untrue ideas.

It should be stated in a calm language that this behavior is not pleasant and should be encouraged to try to quit. Appropriate time should be chosen to discourage the habit. A child’s illness or the arrival of a new sibling are not good times to discourage the habit.

Nail biting:

Nail biting is one of the most common behavioral problems. It usually does not start before the age of 3-4 years. Nail biting behavior is observed in 33% of children. This rate lasts until early adolescence. The rate of children who bite their nails in adolescence increases to 40-45%. Implementation of an over-pressured and authoritarian education in the family, constant criticism of the child, lack of interest and love, jealousy, distress and tension, parental conflicts, excessive anxiety of parents, excessive protection of the child can be counted among the main factors that cause nail biting. In addition, nail biting is a behavior that can be acquired through imitation.

How to Behave?

The most effective method is to ignore this habit by the parent until the age of 4. Making warnings such as “bite your nail, take your hand out of your mouth” causes the behavior to increase rather than decrease. The main thing is to identify the factors that cause the child to acquire this habit and try to eliminate it. However, if the child feels insecure, it is seen that this habit starts again.

Bedwetting:

It is thought that there are basically two reasons why a child who has been toilet trained has a bedwetting problem; The child is experiencing either an emotional or physical problem. First of all, it should be determined whether there is an organic problem. Febrile diseases, urinary tract infections, diabetes, neurological diseases lead to the behavior of bedwetting. Bedwetting behavior caused by a physical problem is short-lived and temporary. It goes away with treatment of the disease. The most important reason for bedwetting, especially in boys, is that it is hereditary. If one of the parents has this problem in the past, the probability of its occurrence in the child increases by 25%, and if both parents have it, it increases by 65%.

It is seen that bedwetting, which is caused by genetic reasons, disappears during adolescence. One of the reasons for bedwetting is that the child’s sleep is very deep and he does not realize that his toilet is coming. However, if the child’s development is normal, if toilet training is given at an appropriate age, if there is intermittent bedwetting behavior at night and/or day even though he has completed toilet training, then it is considered to be of psychological origin. Reasons such as moving to a new place, divorce, death of a family member, the arrival of a new sibling or forcing or punishing the child during toilet training may bring up the problem of emotional bedwetting.

How to Behave?

It is necessary to determine whether the bed-wetting behavior has a medical cause. It is important that the family is consistent and determined in the communication established with their child. For toilet training, the family should wait for the child to reach a certain maturity in urine control. Parents should take care not to cause fear and anxiety to the child while toilet training. Parents should never express their discomfort in the presence of the child about their child’s diapering. Bedwetting seen in children alone may not be anxiety-provoking in balanced, happy and harmonious children. In order to solve the problem of bedwetting caused by the child’s deep sleep, it is appropriate to take the child to the toilet frequently and not to give too watery foods at night. When the bedwetting problem reaches serious dimensions, help from a specialist should be sought.

Stool incontinence:

It is a more severe indicator of spiritual disharmony than wetting the bed. It is usually caused by not having acquired the habit of holding stools due to insufficient and loose education. It may also be disrupted a while after defecation becomes regular. It occurs due to psychological factors such as bed-wetting. Various fears and anxieties such as the birth of a sibling, separation from the mother, and hospitalization can lead to regression in the child. This behavior can be done both to attract the attention of the mother and to rebel. Some children resist going to the toilet. While holding his stool at school, he may leak stool at home. Children with stool problems are generally children who behave younger than their age, have poor adaptation to school, have bad friendships, are dependent and stubborn.

How to Behave?

It is necessary to determine whether the child’s fecal incontinence problem is due to a medical reason. Unnecessary pressures on the child should be removed and excessive rigorous attitudes should be abandoned. It is helpful to establish a positive communication with the child and make him/her feel valued. Instead of being disgusted by the child’s stool, it is necessary to reward him when he goes to the toilet. The child should be seated on the toilet 3-4 times at regular intervals.

             Masturbation:

It is the situation where the child stimulates himself by playing with his sexual parts and provides relief. In order to define childhood masturbation, it is very important to determine that there is no physical problem in the child’s genital area. Sometimes, some genital problems cause itching and irritation in the area and cause the child to focus on that area. Apart from this, some children may resort to masturbation to explore their bodies, some to cope with various emotional difficulties, and some to relax while falling asleep.

Masturbation is most common between the ages of 3-6. The child in this period now knows his sexual identity and attaches great importance to discovering his body. He can stimulate himself by rubbing against something, rubbing an object against himself or with his hand in order to experience the pleasure he feels when he plays with his genital area. The child can do this alone in his room, or in crowded environments, having difficulty in self-control.

In some cases, the child spends so much energy that he sweats, blushes, and may even make noises. Again, in extreme cases, the child’s genital area may become irritated. Masturbation usually goes away on its own after a while. However, masturbation can be seen as a way of attracting attention, relaxation, and escape when the family is over-interested or when the child’s emotional difficulties are beyond their capacity.
             How to Behave?

When this behavior of the child is noticed, it should not be reacted harshly to this issue, the child should not be frightened, when it is noticed that he masturbates, he should be told to do this in his own room, after a short time he should go to him and end the work, his attention should be directed to another subject and a game should be played with him.

           Hair plucking:

It is more common in 1-2 year old girls. It is a movement that the child does to overcome his stress. The biggest reason for this behavior is the lack of emotional bond between the mother and the child. Hair pulling behavior is more common in girls who have difficulty in expressing their feelings and who grow up under prohibition and pressure.

How to Behave?

When the child takes his hand to his hair, he should not be warned, his attention should be diverted. Gathering hair and wearing hairpins can provide short-term solutions. If the child pulls his hair by looking at your face when he is angry, you should not react to this behavior. However, if the behavior is thought to be of emotional origin, specialist support should be sought.

          Do not lie:

In the lies that children tell, it is possible that the child cannot evaluate the truth well, makes up what he sees and hears, or tells things that did not happen as if they happened. It is often the contradictory attitudes of adults towards the truth that push children to lie. Even if the child lies, he is very sensitive to the lies of his parents.

The child acquires a habit of profiting from lies by the fact that the mother and father share the child with the lie and as a result promise the child rewards for keeping silent. Some children may express a longing or take the opposite attitude while lying. If the child has difficulty in meeting the expectations of his parents or if he is afraid of punishment, he resorts to lies.

            How to Behave?

Self-confidence should be instilled. Contradictory situations in parental attitudes should be avoided. Models suitable for the child should be presented. Reinforcers should be used to encourage the child to tell the truth. Instead of directly judging the lie told by the child, the reasons that encourage the child to lie should be investigated. Healthy communication and interaction should be established with the child. Ways of coping with the reactions of the child in the face of negative behaviors should be taught and lying should be avoided.

           Stealing:

The sense of ownership is not fully developed in the preschool period. Children in this period have difficulty understanding that it is bad behavior to take someone else’s belongings without permission. For this reason, in order for the stealing behavior to be considered as an adjustment and behavioral disorder, the child must have reached primary school age.

The reasons underlying the stealing behavior are excessive disciplined attitude, comparator attitude, parents’ excessive fondness for money or stinginess, giving financial punishments, not meeting the needs, reinforcing the previous stealing behavior, feeling of worthlessness and loss of self-confidence, feelings of jealousy and competition, and lack of love and indifference. can be specified.

How to Behave?

First of all, the child should be told that it is not right to take something that does not belong to him, and he should be made to think about how he will feel when something belonging to him is taken without permission. From the age of 4-5, children begin to understand the effect their behavior will have on the other person. At this point, dramatization games can come in handy. He should be taught that he should apologize to the person from whom he bought his belongings, and he must be given to the owner. You should be calm and determined. Do not act blaming, critical or angry.

            Stubbornness:

The stubborn child is the result of the tense mother-child relationship and its onset goes back to infancy. The mother’s being too strict and insistent about toilet training or food leads the child to passive resistance. A mother who dwells too much on details that are too involved and too talked about easily pushes her child into such a defensive path. Discrimination between siblings can also be a situation that triggers stubbornness. Developmentally stubborn behavior is observed in children at the age of 2-3 years. This is because children are trying to prove that they are independent individuals and that they can make their own choices. Inappropriate parental attitudes in this period cause the child to turn this into a habit and to show these behaviors in the future.

            How to Behave?

First of all, it should not be turned into a power struggle. Without being stubborn, either the child wins and after that he tries to get everything he wants, or the parents can resort to violence as a solution. Trying to stay calm is very important. The tension of the parents increases the stubbornness of the child. Whatever he wants can be used as a reward. It can be said that after doing a desired behavior, you will get what you want. Using simple language when explaining why what he wants cannot be done, and expressing that you are sorry for not being able to fulfill his request, and sharing your feelings will comfort him. Care must be taken to act decisively and consistently.

It is important not to say “yes” after insisting on something you said “no” at first. Giving the child a choice will relax both him and you. Offering choices sends the message that the child can make his own decisions and allows him to stop being stubborn. Thus, you will feel more comfortable because of choosing one of your own wishes. The small number of options makes it easier for the child to decide.

            Do not hurt:

Aggression is a human instinct. This impulse is not destroyed or completely suppressed, but changes form. There are different types of aggression: verbal, physical, passive and active. Anger reactions such as crying and hitting are seen in infancy. While physical aggression is more common between the ages of 1-4, verbal aggression increases at the age of 4-5. In middle childhood, children’s aggression is more purposeful.

This behavior can occur when the child is brought up with very strict or loose discipline. Insecure children may display aggressive behavior. Aggression can occur with the inhibition of the child. Aggression can also be seen in the form of harming oneself and others. Causes such as problems in the family, communication disorder, lack of love, behaviors that encourage the child to delinquency, traumatization, and inability to prevent one’s own impulses cause aggression to emerge.

How to Behave?

Unbalanced and negative relationships within the family should be avoided. As confidence develops, the child learns to wait and restrain his reaction. Therefore, the child should be instilled with confidence. Aggressive behavior decreases when he sees that being docile instead of rebellious results in his own benefit. In order to discharge the aggressive impulse, the child should be directed to various activities such as sports. In the school environment, it is important to make programs suitable for the child’s interest, needs and developmental level, to prepare physical environments and to choose materials.

Active games or activities that will enable the aggressive child to be active should be prepared. It is helpful to create stories for the child to criticize and empathize with his own behavior and to read these stories to the child. Any form of behavior that may reinforce aggressive behavior should be avoided.

             Fear and phobia:

Fear is a normal reaction to environmental danger. In infancy, loud noise, sudden movements, fear of unfamiliar people and animals; In the preschool period, fear of traffic accidents, fire, punishment, imaginary creatures and nightmares is seen. In late childhood, fears such as bodily harm, being influenced by movies on TV, and failure in school are observed. Separation from parents upsets the child, undermines his confidence and fears that the parents will abandon him.

The rate of fear is higher in the children of families who raise their children with fear or who are overprotective. Fear is also seen intensely in children who encounter various fights, illness, surgery, natural disasters such as earthquakes, fires, and floods that the child witnesses at home.

             How to behave?

Situations that he fears should not be used to discipline the child. 2-3 year old children really need protection. Therefore, it is necessary to supervise children’s games and take precautions against various dangers. Being overprotective does not improve the child’s ability to cope with situations and makes the child timid. Strong reactions should be avoided in the face of the child’s fears. Shame, embarrassment, ridicule and confronting the child should be avoided because of their fears.

If the child is deprived of play and friends, the opportunity should be created. The child’s fears should be recognized, not suppressed, and one fear should not be overcome with another fear. The child should be supported in overcoming their fears, starting with small steps. For example, a small water pool can be built on the beach to make the child who is afraid of the sea reconcile with only the water.

             Anxiety:

Fear and anxiety are very close but different concepts. Fear consists of a certain object or situation, whereas in anxiety, more of the object is ambiguous. An anxious child is tense, anxious, and emotional. Anxious child is overexcited in new situations. This causes him to show some physical behaviors such as nail biting and playing with his hair. Anxious child takes care to follow the rules. Sensitive to anger or criticism. In addition, anxiety in the child may occur as a result of a physiological disorder.

In their own developmental relevance, children can experience many anxieties. However, if it has already exceeded the eligibility age, then it may have become non-temporary. In case of high level of anxiety, difficulties such as being isolated from social environments and not developing good relationships can be seen in children. This situation can make the child aggressive, as well as introverted, obedient and timid.

             How to Behave?

Environments that cause anxiety for the child should be avoided. It is necessary to seek medical help to determine whether the anxiety is the result of a disorder of organic origin. Children should be encouraged to engage in activities that increase their self-confidence. It should not be forgotten that family problems increase the anxiety of the child. It would be appropriate to investigate the causes of the anxiety and explain to the child in a language that they can understand that these concerns are not important.

            Excessive shyness/introversion:

Children whose feelings and justified reactions are suppressed with punishment and who are met with condemnation and accusation lose their self-confidence over time, they prefer to remain silent and withdraw in order not to do anything wrong.

How to Behave?

The child should be given the right to speak frequently, he should be allowed to express his feelings in every matter, he should be asked frequently what he feels and think, the child should be valued, the child should be listened to when he speaks, and the child should not be too intrusive.

             Tic:

They are involuntary intermittent contractions of the body muscles. For example; such as blinking, head or shoulder movement, eyebrow raising. Tics can occur as a result of events that cause extreme excitement and fear. Children with tiki are often agitated, anxious, and nervous. Tics usually occur to get rid of anxious situations. Tics, like stuttering, increase with attention. Facial tics are mostly due to psychological causes. However, there may be a bodily cause in tics in the form of large movements that spread to the whole body. Tics are often temporary. They fade before puberty.

             How to Behave?

When talking to a child with tic, reminding the child not to do the tic behavior often increases the frequency of this behavior. Because tics create tension in the child, it is appropriate to find the source of this situation and make corrective changes. Events, environments, situations, people and objects that frighten the child should be identified and avoided. In communication with the child, too much attention should not be drawn to the child’s tic. The tic behavior of the child should not be allowed to be a mockery. In order to prevent tic behavior, the child should be given self-confidence.

Stuttering:

It usually occurs in preschool age. If it is not due to any organic disorder, it is of psychological origin. Natural disasters, traffic accidents, illnesses and surgeries, traumatic experiences such as witnessing a fight, fear of animals, being frightened by sound, family problems, divorce and death, and faulty parental attitudes can cause stuttering. Some of the psychological origin stuttering is temporary, most of them continue until adolescence, some of them decrease after the age of 20, but reappear from time to time.

Stuttering that continues after childhood may increase from time to time due to stress, anxiety and excitement. In children, too, stuttering may not be permanent; It may increase from time to time with anxiety and excitement, and sometimes it may disappear completely, even for short periods. The psychological origin of stuttering seen in children can be strengthened and reinforced by the wrong attitudes of the people around the child.

Even if the parents are careful about this, the child’s stuttering may increase due to the mistakes made by other family members, schoolmates, teachers and neighbors with whom the child interacts, or other problems may arise due to stuttering.

            How to Behave?

While the child is talking, his speech should not be corrected. While listening to his speech, he should not behave impatiently and nervously, and should not be interested in other things. His speech should not be mocked, the child should not be belittled. Their speech should not be imitated, and imitation of others should be prevented.

He should be prevented from paying attention to his speech; Behaviors such as making people talk frequently and trying to teach them to speak well increase stuttering as they will underline the speech problem. In order to prevent the loss of self-confidence, the positive things he does in other areas should be praised and his actions should be approved by giving small responsibilities. As parents, excessive oppressive and protective attitudes should be avoided. The child should not be compared with siblings or other children. The child should not be criticized or scolded frequently. When he is excited, try to calm him down. Others should not be told that he stutters in front of him.

            Eating disorder:

Behaviors such as choosing food and refusing food for psychological reasons are frequently encountered. Forces such as parents’ insistence on feeding, rewarding and punishment negatively affect the child’s eating habits.

             How to Behave?

The amount the child eats should not be compared with other children. The important thing is not how much the child eats, but how he is fed. Especially in children with low appetite, foods with high nutritional quality should be tried to be given, and they should not be forced for the amount.

*Finally…

  • It is necessary to be conscious and knowledgeable in order to determine at what age the problems faced by the child are normal, short-term and temporary.

  • Behavior should not be considered conscious.

  • The problem should not be ignored.

  • In order to solve the problem, inappropriate attitudes such as criticizing or belittling the child should not be shown.

  • The problem should not be expected to go away on its own.

  • Professional help should be sought. Even conscious families who read a lot about child development and education have difficulty in recognizing such problems. For this reason, it is beneficial for all parents to consult a specialist in the 0-6 age period, which is very important in personality development, to have their children’s development checked, to find out if there is a problem that the parents are not aware of, and to take precautions against possible adaptation and behavioral disorders.

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