Pediatric Disorders of Regulation in Affect and Behavior

Pediatric Disorders of Regulation in Affect and Behavior

A Therapist's Guide to Assessment and Treatment

2nd Edition - January 12, 2017
This is the Latest Edition
  • Author: Georgia DeGangi
  • eBook ISBN: 9780128098776

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Pediatric Disorders of Regulation in Affect and Behavior, second edition is a skills-based book for mental health professionals working with children experiencing disorders of self-regulation. These children are highly sensitive to stimulation from the environment, emotionally reactive, and have difficulty maintaining an organized and calm state of being. Children with these struggles often have difficulty adapting to changing demands at home and school. The child may additionally struggle with bipolar or mood disorder, anxiety, depression, obsessive–compulsive disorder, Asperger’s syndrome, eating or sleep disorders, and/or attention-deficit disorder. This book will help professionals integrate treatment strategies that address the individual’s regulatory, sensory integration, and mental health problems. The book is organized with each chapter discussing a different form of dysregulation in eating, sleep, mood regulation, anxiety, attention, and behavioral control. Chapters begin with developmental and neurobiological underpinnings of the problem, include clinical observations, and close with diagnosis and treatment strategies. Recommended treatments integrate aspects of dialectical behavioral therapy, mind–body therapies and sensory integration techniques, and interpersonal therapy. Checklists for diagnosis and treatment planning are included at the conclusion of each chapter with an appendix of 20 skill sheets for use in treatment.

Key Features

  • Practical skill-based treatment book for mental health and occupational therapists
  • Addresses eating, sleep, mood, attention, and behavioral control
  • Presents integrated treatment using sensory integration, DBT, interpersonal therapy, and more
  • Includes checklists and skill sheets for use in treatment


Clinical practitioners dealing with children; occupational therapists

Table of Contents

  • Chapter 1: Problems of Self-Regulation in Children and Adolescents

    • Abstract
    • 1. The concept of self-regulation and its development
    • What is a regulatory disorder?
    • 3. Clinical significance of regulatory problems in children
    • 4. Outcomes of regulatory disordered infants
    • 5. Early symptoms and their relationship to later diagnostic outcomes
    • 6. Impact of early symptoms on later developmental outcome
    • 7. Types of regulatory problems
    • 8. Case illustrations of the different subtypes of regulatory disorders
    • 9. Identifying problems of self-regulation in infants and children
    • 10. Summary

    Chapter 2: Treatment of Irritability and Other Mood Regulation Problems

    • Abstract
    • 1. What is an emotion?
    • 2. Cognitive appraisal
    • 3. Physiological aspects of emotion
    • 4. Expression of emotion
    • 5. The socialization of emotions
    • 6. Modulation of emotion and mood states
    • 7. A developmental–structuralist approach to organizing sensory and affective experiences
    • 8. Application of developmental–structuralist model
    • 9.  of a child with difficulties in various emotional stages
    • 10. Identifying causes of mood dysregulation
    • 11. Treatment approaches
    • 12. Case examples
    • 13. Summary

    Chapter 3: Anxiety Disorders: How to Calm the Anxiety Cycle and Build Self-Confidence

    • Abstract
    • 1. Symptoms of anxiety
    • 2. Neurobiological mechanisms underlying anxiety
    • 3. Types of anxiety disorders in children
    • 4. Posttraumatic stress disorder
    • 5. Strategies to alleviate anxiety
    • 6. Summary

    Chapter 4: Dealing with Depression

    • Abstract
    • 1. Types of depression
    • 2. What causes depression?
    • 3. Neurobiological bases for depression
    • 4. Four portraits of depression
    • 5. Effective treatments for children suffering from depression
    • 6. Summary

    Chapter 5: Eating Disorders

    • Abstract
    • 1. The many facets of eating?
    • 2. What can go wrong?
    • 3. The developmental stages of eating
    • 4. The assessment process
    • 5. Treatment intervention
    • 6. Case example 1: it’s a family affair
    • 7. Case example 2: the impact of early deprivation and an attachment disorder on feeding
    • 8. Case example 3: food aversions and behavioral resistance at mealtime
    • 9. Summary

    Chapter 6: Sleep Problems

    • Abstract
    • 1. Sleep problems in children
    • 2. Impact of sleep problems on development
    • 3. Development of sleep–wake cycles
    • 4. Stages of sleep
    • 5. Self-soothing and the process of sleep
    • 6. The sleep environment, cultural beliefs about sleep, and family sleep patterns
    • 7. Sleep problems in children with dysregulation
    • 8. Evaluating sleep problems in the child
    • 9. Management of sleep problems
    • 10. Summary

    Chapter 7: Obsessive–Compulsive Disorder: How to Build Flexibility and Budge Compulsive Thinking

    • Abstract
    • 1. What is obsessive–compulsive disorder?
    • 2. Is there a difference between healthy rituals and obsessive–compulsive behavior?
    • 3. What causes obsessive–compulsive spectrum disorders?
    • 4. How can this disorder be treated?
    • 5. Steps to overcome obsessive–compulsive disorder
    • 6. Common pitfalls: things to avoid
    • 7. Case example 1: facing a germy world
    • 8. Case example 2: stuck in endless repetitions
    • 9. Case example 3: compulsive checking
    • 10. Summary

    Chapter 8: Treatment of Attentional Problems

    • Abstract
    • 1. Types of attentional problems
    • 2. The processes that underlie attention
    • 3. What is attention? Some historical perspectives
    • 4. Arousal, alerting, and sensory registration
    • 5. Sustained attention: attention getting and attention holding
    • 6. The role of effort in attentional tasks
    • 7. Selective attention: screening and selection
    • 8. Motivation, persistence, and self-control
    • 9. Treatment applications
    • 10. Case example of child with attentional problems
    • 11. The assessment
    • 12. Case example: the plight of the procrastinator
    • 13. Case example: when a whole family struggles with ADHD
    • 14. Summary

    Chapter 9: The Sensory Defensive Child: When the World is Too Bright, Noisy, and Too Close for Comfort

    • Abstract
    • 1. What is sensory integration?
    • 2. Sensory integrative dysfunction
    • 3. The concepts of sensory defensiveness and sensory dormancy
    • 4. Clinical assessment of sensory integrative dysfunction
    • 5. The tactile system
    • 6. The vestibular and proprioceptive systems
    • 7. Sound sensitivities
    • 8. Motor planning disorders
    • 9. Case description: the gravitationally insecure child with developmental dyspraxia
    • 10. Case example of treatment approach with child with pervasive developmental disorder
    • 11. Case example of a child with severe sensory defensiveness: therapy spanning from infancy to adulthood
    • 12. Summary

    Chapter 10: Addressing Attachment and Problems of Intimacy: How to Build Healthy Emotional Connections

    • Abstract
    • 1. Overall philosophy of treatment
    • 2. Attachment patterns of children with dysregulation
    • 3. Assessment
    • 4. Treatment approaches
    • 5. Case example of CCA with a dyad with a disorganized attachment disorder
    • 6. Reparenting the client to provide nurturing and safety in the therapeutic relationship
    • 7. Case example
    • 8. Conclusions

    Appendix: All Skill Sets

    • 1 Self-Soothing
    • 2 Activities for Problems of Touch
    • 3 Moving for Mood Regulation and Sleep
    • 4 Improving Attention Span
    • 5 Distractions for Emotional Regulation
    • 6 Positive Self-Talk
    • 7 Mindfulness: Stilling the Mind
    • 8 Systematic Relaxation: Stilling the Body
    • 9 Validation
    • 10 Finding Pleasure and Making Connections
    • 11 Creating Positive Life Experiences
    • 12 Thinking With a Clear Mind
    • 13 Increasing Personal Effectiveness
    • 14 Observing Limits
    • 15 Taking Control of Behavior
    • 16 Keeping Track of Positive Behaviors
    • 17 Eating Habits and Nutrition
    • 18 Strategies for Improving Sleep
    • 19 Installing Structure and Organization
    • 20 Communicating Effectively With Others

Product details

  • No. of pages: 548
  • Language: English
  • Copyright: © Academic Press 2017
  • Published: January 12, 2017
  • Imprint: Academic Press
  • eBook ISBN: 9780128098776
  • About the Author

    Georgia DeGangi

    Georgia DeGangi, Ph.D., OTR, FAOTA, is a clinical psychologist and an occupational therapist. She currently works in private practice at ITS (Integrated Therapy Services) for Children and Families, Inc., in Kensington, Maryland, and has worked at the Reginald S. Lourie Center for Infants and Children in Rockville, Maryland, as the Director of Research for the past ten years. She has over 25 years' experience working with infants, children and their families. She has extensive experience with diagnosis and treatment of a range of developmental, sensory, behavioral, and emotional problems. Dr. DeGangi has conducted research for many years to examine the most effective ways of treating children as well as examining how problems in infancy related to self-regulation, sensory processing, attention, and social interactions develop as children grow older. Among her publications are the Test of Sensory Functions in Infants, the Infant/Toddler Symptom Checklist, and the Test of Attention in Infants. Dr. DeGangi is internationally recognized as a leading expert in the assessment and treatment of sensory processing, attention, and interactional problems in infants and children. She was the 1992 recipient of the A. Jean Ayres award from the American Occupational Therapy Foundation and has been distinguished in the roster of fellows of the American Occupational Therapy Association. She serves on the faculty at the Infant/Child Mental Health program of the Washington School of Psychiatry and is associate editor of the Journal of Learning and Developmental Disorders.

    Affiliations and Expertise

    Reginald S. Lourie Center for Infants and Young Children, Rockville, Maryland, USA