Section 12about 6 min · no rush

A gentle note before you read: symptom lists make almost everyone recognise themselves somewhere. That is a normal effect of reading, not a diagnosis. If something here sits on your mind, a conversation with a professional helps more than re-reading.

12

Child mental illness & neurodevelopmental disorders

The curriculum's fifth item ("Be familiar with child's mental illness"). Separation anxiety is covered on the Anxiety disorders page; here are the four the CTEVT curriculum and the Mental Health-3 class notes name: intellectual disability, ADHD, autism, and the behaviour disorders.

Intellectual Disability (Intellectual Developmental Disorder)

CTEVT PSC curriculum319 · F70–F79
DSM-5 Criteria: all three required
  1. Deficits in intellectual functions: reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, learning from experience: confirmed by clinical assessment and standardised testing (IQ roughly ≤ 70).
  2. Deficits in adaptive functioning across three domains: conceptual (language, literacy, number, memory), social (empathy, social judgment, friendships, gullibility), practical (self-care, money, safety, work, transport).
  3. Onset during the developmental period (childhood or adolescence; the class notes and CTEVT say "before age 18").

Severity, mild / moderate / severe / profound, is graded by adaptive functioning and support needed, not IQ alone. Causes: genetic, prenatal, perinatal, and postnatal.

ID is a permanent developmental state, not an episodic illness. The counselor's work is family psychoeducation, skill-building with caregivers, disability-card and special-education advocacy, and caregiver support.

AspectIntellectual disabilityMental illness
NatureDevelopmental limitation in intelligence & adaptive skillsDisturbance of mood, thinking, or behaviour
OnsetDuring the developmental periodAny point in life
CoursePermanent state; skills can grow with supportEpisodes that can remit, relapse, be treated
Main responseSkill training, environmental support, inclusionTherapy, medication, recovery-oriented care

ADHD · Autism · ODD · Conduct Disorder

CTEVT PSC curriculum
ADHD: 314.0x · F90.x
  1. ≥6 inattention symptoms, and/or ≥6 hyperactivity-impulsivity symptoms, for ≥6 months (≥5 from age 17):
    • Inattention: careless mistakes · can't sustain attention · doesn't seem to listen · fails to finish · disorganised · avoids sustained mental effort · loses things · distractible · forgetful
    • Hyperactivity-impulsivity: fidgets · leaves seat · runs/climbs · can't play quietly · "driven by a motor" · talks excessively · blurts answers · can't wait turn · interrupts
  2. Several symptoms present before age 12.
  3. Present in 2 or more settings (home and school).
  4. Clear interference with functioning; and
  5. Not better explained by another disorder.
Autism Spectrum Disorder: 299.00 · F84.0
  1. Persistent deficits in social communication and interaction: all 3: social-emotional reciprocity · nonverbal communication · developing and understanding relationships.
  2. Restricted, repetitive behaviour: ≥2 of 4: stereotyped movements/speech (lining up toys, echolalia) · insistence on sameness and routines · highly restricted, intense interests · sensory hyper- or hypo-reactivity.
  3. Present in the early developmental period.
  4. Clinically significant impairment.
  5. Not better explained by intellectual disability alone.

Oppositional Defiant Disorder (313.81/F91.3): ≥6 months of angry or irritable mood, argumentative-defiant behaviour toward authority, or vindictiveness; ≥4 symptoms, with someone other than a sibling.

Conduct Disorder (312.8x/F91.x): a more severe pattern violating others' basic rights or major norms; ≥3 of 15 behaviours in 12 months across four groups: aggression to people and animals, destruction of property, deceitfulness or theft, and serious rule violations. ODD can precede CD; CD with callous-unemotional traits carries the highest risk.

Nepal

In Nepali classrooms the ADHD child is "badmash", the autistic child "lato", the child with ID "kamjor": moral labels where clinical ones belong; childhood depression hides behind stomachaches and irritability. School screening and teacher psychoeducation are high-leverage counselor tasks. Disability identity cards (four classes: red, blue, yellow, white) unlock allowances and school support: helping a family obtain one is a concrete counseling outcome. No national figure exists for childhood disorders specifically; the National Mental Health Survey 2020 measured adolescents and found 5.2% had a mental disorder at some point. See Nepal in numbers.

A worked example: A 9-year-old named Kiran fidgets constantly, blurts answers, and cannot finish assignments. His teacher calls him "badmash," but a counselor identifies six inattention and six hyperactivity symptoms present before age 12, in both home and school, confirming the diagnosis. The intervention focuses on task breakdown and positive reinforcement rather than moral correction.

ADHD attention and activity inattentive, restless, impulsive; 6 months; before 12 Autism spectrum social communication and repetition from early development; restricted interests, routines ODD defiance toward authority angry, argumentative, vindictive; 6 months Conduct disorder violating others' rights aggression, destruction, deceit, rule-breaking; 12 months neurodevelopmental (how the brain grew) behavioural (learned pattern) ID sits across all four: limits in thinking and daily skills from early development
Four disorders, one map. Top row is how the brain developed; bottom row is a learned pattern that can escalate, ODD sometimes preceding conduct disorder. In a Nepali classroom all four arrive with a moral label first.
A skill to try · two minutes

Co-regulation: lend your calm. A distressed child borrows an adult's nervous system. Get low to their level, slow your own breathing so they can hear it, and name the feeling: "you are angry, the tower fell". A named feeling shrinks; a lectured feeling grows.

A coping skill, not a treatment: it supports care, it does not replace it.

Key points
  1. Intellectual disability is a lifelong developmental state, graded by the support a person needs, not by IQ alone.
  2. ADHD, autism, ODD and conduct disorder each have a distinct pattern; moral labels ('badmash', 'lato') hide clinical ones.
  3. Children show depression as stomachaches and irritability; school screening and helping families get disability cards are high-impact work.
Quick check

Three friendly questions to settle what you just read. This is reassurance, not a test: a wrong tap is part of learning, and you can try again.

Intellectual disability requires:

ADHD symptoms must appear:

ID differs from mental illness because ID:

Learn more

Pick one, not all: these are chosen to be light, not exhaustive.

ChannelHow to ADHD (Jessica McCabe): Short, kind, practical videos: good for parents too.
Video · 6 minHow autism freed me to be myself (Rosie King, TED): Autism from the inside, by a 16-year-old.
Book chapterWhere There Is No Psychiatrist: child sections: Assessment and family guidance for low-resource settings.

Slow is fine. This curriculum took years to write; nobody expects it in one evening.