Functional Symptoms in Children Who Have Developmental or Behavioral Differences

Abstract

Children and adolescents who have developmental or behavioral differences (DBD) may present with the same range of nonorganic functional symptoms as otherwise typical young people. Paradoxically, DBD may itself be a nonorganic functional symptom. The presence of DBD may introduce potential pitfalls in the assessment and management of functional symptoms, leading to incomplete or erroneous conclusions and inappropriate interventions. Some specific nonorganic functional symptoms are more likely to present in children with developmental differences (DD) compared to typically developing children. Children who have behavioral differences (BD), particularly autism spectrum disorder, are more likely to present with functional symptoms than their neurotypical peers. Failure to take DBD into account often leads to hasty and incomplete evaluation of symptoms and consequent failure to address key underlying problems. An approach to diagnosis and treatment which takes DBD into account is likely to lead to the best outcome for the affected child and family. Included in this discussion are several symptoms which are, strictly speaking, not functional symptoms but which occur more often in association with DBD than in typical people. These symptoms may be ameliorated with effective management of the underlying DBD.