Emotional Disabilities: Are They Innate Or Nurture-Based?

Emotional disabilities can be present from birth, and are known as congenital disorders. These are defined as structural or functional anomalies that occur during intrauterine life and can be identified prenatally, at birth, or later in infancy. Congenital disorders can be inherited or caused by environmental factors. They can result in long-term disabilities that impact individuals, families, healthcare systems, and societies. Examples of congenital disorders include Down syndrome, congenital heart defects, and neural tube defects.

Congenital disorders

Some common congenital disorders include:

• Intellectual disability
• Down syndrome (Trisomy 21)
• Cerebral palsy
• Fragile X syndrome
• Blood and metabolism disorders

These disorders can have a lifelong impact on physical and mental health, and children with congenital disorders may experience challenges with inclusion in the community and skill development. They may require long-term support, including physical therapy, speech therapy, and occupational therapy.

While some congenital disorders cannot be prevented, there are preventive public health measures that can decrease their frequency. These include:

• Ensuring adolescent girls and mothers have a healthy diet and maintain a healthy weight
• Ensuring adequate dietary intake of vitamins and minerals, particularly folic acid
• Avoiding harmful substances, such as alcohol and tobacco
• Reducing environmental exposure to hazardous substances during pregnancy
• Controlling diabetes prior to and during pregnancy
• Ensuring any exposure of pregnant women to medications or medical radiation is justified and based on careful health risk-benefit analysis
• Vaccination, especially against the rubella virus

Additionally, screening and early diagnosis are important steps in reducing mortality and morbidity from congenital disorders. Newborn screening can help detect disorders that may not have immediately visible effects, and early referral and treatment can improve outcomes.

Genetic abnormalities

• Fragile X syndrome is the most common inherited cause of intellectual disability and is associated with physical, behavioural, and emotional difficulties.
• Huntington's disease affects the nervous system and causes cognitive and emotional changes over time.
• Autism Spectrum Disorder (ASD) is characterised by persistent deficits in social communication and interaction, as well as restricted and repetitive patterns of behaviour. While ASD has a strong genetic component, the exact causes are still being investigated.
• Down syndrome is caused by trisomy 21 and leads to learning difficulties and health problems. While not all people with Down syndrome experience emotional disabilities, they may be at a higher risk due to associated cognitive impairments.
• Prader-Willi syndrome is a rare genetic condition that can cause an insatiable appetite, which may impact emotional well-being.
• Williams syndrome can cause developmental, learning, and medical problems. While children with this syndrome often have well-developed language and music skills, they may also experience emotional difficulties.

It is important to note that the presence of a genetic abnormality does not always lead to the development of an emotional disability. The interaction between genetic factors and environmental influences is complex and multifaceted. Additionally, early intervention and support can play a significant role in managing and improving emotional disabilities.

Environmental factors

• In-utero exposure to harmful substances: Exposure to certain substances in the womb can increase the risk of emotional and behavioural disorders. For example, maternal smoking, alcohol consumption, and drug use during pregnancy are associated with an increased risk of behavioural problems in children.
• Maternal health and well-being: The mother's health and mental well-being during pregnancy can influence the child's development. Maternal depression, anxiety, substance use, and psychological distress can impact the child's emotional and behavioural development.
• Socio-economic factors: Poverty and low socio-economic status are risk factors for emotional and behavioural disorders. This may be due to factors such as homelessness, social isolation, exposure to toxins, and limited access to nutritious foods and health care.
• Household dynamics: Poor parent-child relationships, parental conflict, neglect, and abuse can contribute to the development of emotional and behavioural disorders.
• Early childhood environment: The quality of a child's early learning and social environment can impact their emotional and behavioural development. Limited opportunities for choice, social interaction, and meaningful activities can increase the risk of challenging behaviours.
• Infection and illness during pregnancy: Maternal infections, such as syphilis, rubella, and cytomegalovirus, can affect fetal development and increase the risk of emotional and behavioural disorders in children.
• Maternal nutrition: Inadequate maternal nutrition, such as iodine and folate deficiency, can have negative consequences on the child's neurodevelopment and increase the risk of emotional and behavioural disorders.
• Maternal diabetes: Uncontrolled diabetes during pregnancy can impact fetal development and increase the risk of emotional and behavioural disorders in children.
• Environmental toxins and pollutants: Exposure to heavy metals, pesticides, and other environmental toxins during pregnancy can contribute to emotional and behavioural disorders in children.
• Stress and trauma: Children who experience significant stress or trauma, such as physical or emotional abuse, are at an increased risk of developing emotional and behavioural disorders.
• Access to health care and interventions: Limited access to health care and early intervention services can impact the identification and management of emotional and behavioural disorders.

These environmental factors can interact with genetic factors to influence the development of emotional and behavioural disorders in children. It is important to address these factors and provide support to promote healthy fetal development and reduce the risk of emotional and behavioural disorders.

Physical symptoms

In addition, physical symptoms of emotional disability can include panic attacks, persistent and irrational fears of particular objects or situations, and intense fears or irrational thoughts related to separation from parents.

The physical symptoms of emotional disability can also be linked to psychological factors or conflict, and the person experiencing them may not be conscious of producing them.

Furthermore, physical symptoms of emotional disability can be considered culturally sanctioned responses, particular symptoms and social responses influenced by cultural factors and often demonstrated within specific cultural settings or environments.

Finally, physical symptoms of emotional disability can include somatic symptoms such as increased heart rate, shortness of breath, sweating, trembling, shaking, chest pain, abdominal discomfort and nausea.

Emotional disability criteria

• Inability to learn that cannot be explained by intellectual, sensory, or health factors.
• Inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
• Inappropriate types of behavior or feelings under normal circumstances.
• A general pervasive mood of unhappiness or depression.
• A tendency to develop physical symptoms or fears associated with personal or school problems.

These criteria are used to determine eligibility for special education services and interventions. The presence of one or more of these characteristics is required, along with the adverse effect on educational performance, chronicity, and severity. The behavior and emotions exhibited must be more intense or frequent than typically expected for an individual's age, gender, and cultural group.

The emotional disability criteria are also used to distinguish emotional disability from social maladjustment. While there may be overlap between the two, the qualifying conditions of long duration, marked degree, and adverse effect on educational performance must be met for a student to be identified as having an emotional disability.

In addition, the presence of a serious psychiatric disorder, such as schizophrenia, can be considered supportive of an emotional disability but is not sufficient for a diagnosis. A comprehensive assessment is necessary to determine eligibility for special education services.

When evaluating a student for emotional disability, it is essential to consider the student's developmental stage, cultural, and linguistic factors. The impact of racial and cultural biases must also be carefully examined to avoid misidentification and disproportionate representation of certain groups.

Frequently asked questions