Makiko Okuyama
Department of Psychosocial Medicine, National Center for Child Health and Development
Neurodevelopmental Disorders, such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), are the risk factor for child abuse. The parents who do not know the characteristic trends of their own child often get frustration because they cannot discipline their child in the way they want. Therefore, pediatricians should diagnose ASD and ADHD as early as possible, and should provide parent training to the parents of ASD and ADHD. In addition, the parent of ASD and ADHD often has the trend of ASD or ADHD and they themselves have difficulties to raise children. In our study, the mother who had ASD trends showed highest risk for abusive child raring because of their cognitive problems. Those who are ASD trends parents should be trained concrete methods of child raring.
On the other hand the children who have attachment problems caused by child abuse including neglect, showed the similar symptoms of ASD and ADHD. The major differential diagnosis for Reactive Attachment Disorder is ASD and for Disinhibited Social Engagement Disorder the major differential diagnosis is ADHD. When we see the child who has been abused and show ASD or ADHD symptoms, it has to be careful to diagnose because it sometimes very difficult to differentiated. For those children, they have to be put in the secure environment and good relationship with their care taker. I would discuss broad problems with ASD, ADHD and child abuse.
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