The DSM-V Diagnoses of Toddlerhood

I was TRYING to read an interesting paper on psychiatric comorbidities but our toddler had other ideas. We considered just letting him be, but we do eventually want to get our bond back.

Parents the world over are united in their description of toddler behaviour… “Nut job, lunatic, crazy person, psycho, delusional, insane…”

It turns out that “toddlerhood” is unique in that it encompasses almost the entire range of DSM conditions, and mostly all at the same time.

Disclaimer: it should be obvious, but in no way do I mean for this post to be disrespectful to persons with mental illness. If you have trouble understanding the humour then you are potentially (1) Psychotic, or (2) Sociopathic. If you don’t think you’re either of these, then you (3) Lack insight.

As an example of how you need disclaimers for EVERYTHING these days, check out this sign outside a strip club:

What kind of sad, litigious world do we live in?

Anyway, back to the toddlers, and their DSM-V diagnoses:

1. NEURODEVELOPMENTAL DISORDERS

Repetitive speech
“Get your socks please. ” I want strawberries.
“Can you please go get your socks and shoes.” I want strawberries.
“Is your bag ready?” I want strawberries.
“OK. I’ll get you some. Can you PLEASE get your shoes!” I want strawberries.
“YOU’RE KILLING ME… FINE! I’ll get you strawberries!” (Offer strawberries) NO! I WANT STRAWBERRIES!
Sigh.

Inattentive & Hyperactive
Sorry I can’t listen to you because I’m too busy being a kangaroo on the sofa.

Separation Anxiety

separationanxiety

2. NEUROCOGNITIVE DISORDERS

Delirium “reduced clarity of awareness of the environment with an inability to focus, sustain or shift attention.”
Too much iPad / sugar / Wiggles / all of the above.

Amnesia “inability to recall important information.”
“Where is your jacket?”
(Super posh British accent from who-knows-where) “I can’t find it anywhere.”
Cute until he uses this phrase to answer all of your questions. Refer back to “Repetitive Speech”.

3. SUBSTANCE USE DISORDER

Recurrent use of strawberries associated with impairment (inability to function without them), health problems (strawberry-tainted diarrhoea), failure to meet responsibilities at home (“Please help Mum unpack the dishwasher.” “No. I want strawberries.”), constant preoccupation, pharmacological criteria (they haven’t established safe upper limits of plasma strawberry, but if they did, would be several thousand times the safe upper limit).

We are trying to wean but sadly there is no methadone equivalent for strawberries. No other fruit will do.

4. SCHIZOPHRENIA SPECTRUM & OTHER PSYCHOTIC DISORDERS

Oh yeah, this is a big one for toddlers.

Delusions “an idiosyncratic belief or impression maintained despite being contradicted by reality or rational argument.”
“I want to jump!” (from that 2 metre-high statue).  Part of me wants to let him. But another part of me worries about child services (and fractured tib, fib, calcanei). The latter worry wins.
“It’s mine!” (toddler clutching object that clearly belongs to someone else). The most fixed and permanent of all toddler delusions.

Hallucinations essentially “an experience involving the apparent perception of something not present.”
Could be ANYTHING. Usually strawberries. Or airplanes. Yeah, anything.

Disorganised speech. All the time.

Disorganised behaviour. ALL. THE. TIME.

Negative symptoms “social withdrawal, apathy, poverty of speech (brief replies), deficits in attention control”.
Especially when the TV is on. Friends with older children warn this is particularly prevalent in teenagers.

5. OBSESSIVE COMPULSIVE & RELATED DISORDERS

Another biggie for toddlers.

“I wanna touch button!” (for the 52nd time) (“No”… Cue tantrum.)
“I wanna get it!” (boiling hot cup of tea, 14th attempt) (“No”… Cue tantrum.)
“I wanna wash hands!” (despite having just washed already clean hands seven times) (“No”… Cue tantrum.)

“I wanna count!” (“OK, count then…”)
“One, two, three, four, five, six, eight, nine, ten.”
“Seven. You missed seven.”
“One, two, three, four, five, six, SEVEN, twelve, sixteen, fifteen, SEVENTEEEEEEEEEEEN!”
Whatever dude.

“I wanna, I wanna, wanna, I wanna…!” (no fricken idea what he wanna but what the hell… Cue tantrum.)

Toddlers even fulfil the criteria for a “new” DSM-V diagnosis in this category:

Hoarding Disorder “characterized by the persistent difficulty discarding or parting with possessions, regardless of the value others may attribute to these possessions… They accumulate a large number of possessions that often fill up or clutter active living areas of the home to the extent that their intended use is no longer possible. Historically, compulsive hoarding has been a difficult behavior to treat successfully (threats of no iPad and bribery with strawberries both proving to be unsuccessful.)

For examples of this disorder, drop by to any house that has toddlers, unannounced, before the parents have had a chance to frantically clean up and lie, I mean pretend, that this is how tidy their house usually is.

6. EATING DISORDERS

Probably the two diagnoses that toddlers would meet are:

Binge Eating Disorder “recurrent episodes of binge eating, where binge eating is eating in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. Associated with a lack of control over eating during the episode, eating until uncomfortably full, eating when not physically hungry…”

Strawberries, I’m not sure what’s the most he’s ever had… punnets that is…

Pica “eating of non-nutritive substances, the eating behaviour is not part of a culturally supported or socially normative practice.”

As evidenced by his poos, I’m guessing sand. It makes nappy change time like a fricken holiday at the seaside.

7. SLEEP DISORDERS

Let’s face it, mostly for the parents… But for anyone who has ever co-slept, even for 5 minutes, have you experienced…

Rapid Eye Movement Behaviour Disorder, characterised by repeated episodes during sleep associated with vocalisation (“Stop it give me toy, MINE!”) and/or complex motor behaviours (thrashing of arms, legs) which may be sufficient to result in injury (usually to the parent). Rarely occurs during daytime naps. Upon awakening, the individual is completely awake, alert, and not confused or disoriented. (And not at all apologetic.)

Yes… YES!

8. IMPULSE CONTROL DISORDERS

Encompasses all of toddlerhood. Specific examples not required.

Please share your experiences with DSM-diagnosable toddler behaviour. Make me feel better as a parent. 🙂

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