• The main occupation of childhood is play
• Purpose of play- explore the environment, learn about reality and develop rules
• Important neurological connections are made in greatest numbers during the play years
• Play practices social behaviors
• Play helps develop a sense of personal causation
• During childhood, the child transitions from no work at all, to some work with school and chores
• Habits, routines and responsibilities are established

 A stable, secure, and predictable environment is one of the most important factors in helping the child at any age to develop trust in self, other people, and the world in general.

•It is unusual for mental health problems to be diagnosed in infancy unless it is severe; believed to have biological causes.

•ADD: Attention Deficit Disorder-shortened attention span and lack of focus.

•ADHD: Attention Deficit Hyperactive Disorder- shortened attention span, lack of focus, and hyperactivity.

•PDD: Pervasive Developmental Disorder- impairing the ability to develop in many areas (e.g. infantile autism).

•ODD: Oppositional Defiant Disorder- resentful, argumentative, and lack of respect for authority.

•Reactive Attachment Disorder- child stops responding to other people because he or she has been neglected or ignored. This may lead to failure to thrive.

•Children are seldom treated as inpatients because it’s important for the family to be a part of the child’s development.

•Goals of treatment: Developing trust & social interactions, increasing gross & fine motor coordination, improving sensory processing sills, and facilitating spontaneous play.

•Sensorimotor, sensory integrative, play therapy, and expressive art activities help children develop and express fantasies.

•In addition to emotional and social deficits, it seems that children with mental health problems are more likely than other children to have developmental motor delays.

MENTAL HEALTH FACTORS IN MIDDLE CHILDHOOD

• Develops awareness of social norms and expectations of others.
• Develop ability to cope with delayed gratification.
• Physically more coordinated.
• Vast amount of knowledge required through school work and relationships.
• Family and peer groups have a great impact.
• Diagnosis at this stage: conduct disorder, ODD, substance use, ADHD, and learning disabilities.
• OT treatment is in school, outpatient, day treatment or after school programs.
• Only hospitalized if harmful to self and others.

GOALS:

• Increasing trust and readiness.
• Developing cooperation.
• Improving self-esteem and self-awareness.
• Develop body awareness and sensorimotor skills.
• Improving coordination.
• Improving perceptual skills.
• Improving cognitive skills.

• OT assessment and intervention addresses the occupational role of the child.
• Family/child adjust the environment to be successful in chores and homework.
• OTA would benefit from additional training and supervision.

Most Important Tasks of Adolescence

• Develop an identity seperate from ones parents
• Social and sexual identity that will support an independent life
• Center areound peer groups of other adolescents
• The adolescent explores values and interests to develop social skills

It is not unusual for an adolescent to experience:

• Insecurity
• Mood swings
• loneliness
• depression
• anxiety

Major psychiatric disorders:

• Schizophrenia
• Mood disorders (mania and depression) that can lead to sucide
• Substance-related disorders (drugs and alcohol accepted by peers)
• Gender identity disorders (sexual experimentation) by personal preference or acting out
• Eating disorders (anorexia nervosa or bulimia) more common in girls

Treatment

• Adolescents may be treated in outpatient or community settings
• Adolescent Role Assessment
• Adolescent Leisure Interest Profile

Goals of Treatment

• Gain self-esteem
• Gain self-identity
• Development of occupational choice
• Training in daily life skills
• Development of sensorimotor skills (body image)
• Acquisition of prevocational and leisure behaviors
• Coping Skills
• Create strategies and interventions to work toward these goals in which they continually are involved in evaluating if the plan is working and determining future goals.

OT or OTA working with adolescents who have mental illness will focus on "occupations and interests of choice rather than disorders"

MENTAL HEALTH FACTORS IN MIDLIFE

FerolMenks “The point in the life cycle when the individual realizes that time is limited and the he or she cannot accomplish everything hoped and planned for”

Erikson’s crisis generality versus stagnation focuses on the concern of establishing and guiding the next generation.

Midlife Challenges:The decline in physical abilities, cosmetic deterioration, women /menopause, men/decline of sexual potency, raising teens, caring for aging parents, and children leaving home.

THE MENTAL HEALTH FACTORS FOR MIDLIFE ARE SEPARATED INTO 3 GROUPS

1)The first group consists of people who have had mental health issues for years. The problems have continued and worsened as they aged.

•Every day is a challenge

•Burned out on life

•Low energy and drive for investing in treatment/ intervention/life

•Will go along with treatments and not invest in making progress

•If not burned out they are career patients that see themselves in the patient role for life. They use the mental health system to help them meet their needs for physical safety, food, shelter, and economic assistance.

•Occupational therapy intervention will focus on improving/maintaining ADL’s, providing the opportunity for work, and the ability to function independently.

2)The second group consists of people who have developed adjustment disorders that result in maladaptive behaviors.

•Lack the ability to adapt and resolve crisis

•Μaladaptive behaviors can develop like drug abuse, alcohol abuse, over eating, or withdrawal.

•Crisis intervention will identify the problem and present a plan for managing the problem.

• Occupational therapy intervention is based off of Menks conflict resolution model , a five step process that begins with identifying the problem and ends in implementing a plan of action.

3)The third group consist of people who have developed dementia and Alzheimer’s.

•The first signs of Alzheimer’s can show as early as age 40 and increase slowly over time.

•Memory impairment that will increase over time

•Change in social behavior (less social and inappropriate social behaviors)

•Important to assess areas of difficulty

•Occupational therapy interventions can help patients remain alert, perform daily functions, and provide memory training.

• - Work Decreases
• - Open time is filled with leisure time
• - Loss of work role, parental role, or homemaker role
• - Set goals for occupation that increase self-worth
• - Leisure activities include lifelong interests
• - Individual living requires client-centered support through their own growth and development.

Psychosocial tasks of late adulthood-