NBDs are biological brain disorders that interfere with normal brain chemistry. Children often have multiple conditions. Each disorder manifests with overlapping symptoms of various presentations and severity (see diagram).
This diagram illustrates the complexity of the relationships between the various diagnoses for NBD. Symptoms such as inattention and lack of concentration are common to several diagnoses such as anxiety disorder, depression, OCD, bipolar disorder, ADHD/ADD, and other serious psychiatric illnesses. All of these disorders can coexist with a primary learning disability. The only way to accurately diagnose an NBD is through a comprehensive assessment. YOU CANNOT DIAGNOSE WITH A CHECKLIST.
They are not the result of poor parenting, poverty, or other interactions (Dr. D.J. Jaffe). They are all caused by various biological changes in the chemistry of the brain. The biological nature of these disorders has been well researched and medically recognized. Genetic factors may create a predisposition in some people and life events may trigger the onset of symptoms.
It is very important for parents and educational staff to recognize and accept the fact that, while the symptoms of these disorders may be behavioural, the causes are biological.
Treatment and management of NBDs has been compared to the treatment of diabetes; both are medical conditions. Treatment with medication rectifies the biological imbalance. No one would deny a diabetic their insulin but there is huge resistance to giving a child medication that will restore the balance of neurotransmitters.
These children will maximize their potential with specific and comprehensive treatment/management plan along with the coordination and support at home and in school.
Different biological disorders require different treatments and management approaches. Getting the correct diagnosis is absolutely critical.
Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent with emotional or behavioural problems.
A developmental bio-psycho-social approach to clinical assessment of children and adolescents is what families should seek while working with our mental health system.
What gets in the way?
The inconsistency of the child's functioning often confuses concerned adults.
It is the nature of these disorders that:
For more information on Diagnosis, please read this.
The isolation, anxiety and sometimes demoralization of ordinary parents who are managing their best with challenging children is a heavy burden. A lack of knowledge of medical issues and unnecessary guilt can play havoc with parents' sense of well being and self-esteem. No one deserves such a burden: since disorders create invisible limitations, overt support and understanding is often not available to either children or their families (Pat Kirchner).
In order for the family to remain intact and well, support must be made available immediately to deal with the emotional stresses that come from day to day living with these children/adolescents as well as the added burden of stigma that is imposed by an ill informed society.
Use the sources of support available in the community:
Children who have this disorder will do better when they have support and commitment from their parents and family:
What does this mean?
In the confrontation between the stream and the rock, the stream always wins… not through strength, but through persistence. -- H. Jackson Brown
Reviewed by M. Kodsi, M.D., Child and Family Psychiatrist.