Deliberate self-harm (DSH) is a common though often hidden condition in children and adolescents that may result in suicide. This discussion covers several aspects of DSH including its prevalence, etiology, and management. The relationships of DSH to body dissatisfaction and suicide are specifically considered. Even though most cases of DSH do not end in overt suicide, DSH reflects that potential underlying psychological pathophysiology, and likelihood of eventual death from self-murder, cannot always be predicted or prevented. It is important to take all acts of DSH as serious, and to offer comprehensive management to prevent future acts of DSH and potential suicide.
Autism, first described in 1943 by Leo Kanner, was at that time thought to be a rare disorder (1). In the past two decades, the prevalence of Autism has seen a consistent and dramatic increase with the diagnostic criteria changing to encompass a broader perspective of symptom manifestations, now called autism spectrum disorders (ASD), which has led to increased knowledge and push for earlier screening and recognition of the disorder. In the past, the ASD were historically made up of multiple distinct disorders (i.e., autistic disorder, pervasive developmental disorder-not otherwise specified and Asperger disorder). In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), these disorders were combined into one term Autism Spectrum Disorder. The most recent estimate from the Centers for Disease Control and Prevention (CDC) is that 1 in 68 children has a diagnosis of ASD (2). In 2016, The American Academy of Pediatrics recommended all children be screened for ASD at ages 18 and 24 months and for all children who fail routine developmental surveillance. Many studies have been published on emerging theories for the pathophysiology and etiology of ASD, most concluding the cause is multi-factorial with a complex interplay of several mechanisms, genetics, epigenetics, and environmental
Increased visibility of adverse encounters between individuals with autism spectrum disorder (ASD) and law enforcement (LE) has stimulated a dialog among providers. There are a variety of contributing factors to the increase, including the recognized lack of training of LE professionals on the needs of individuals with ASD and the paucity of awareness of resources by the families of these individuals. The aim of this article is to provide insight into developmental-behavioral pediatric professionals, to enhance safety and reduce adverse outcomes for individuals with ASD in schools and the community.
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