What you need to know
A few types of muscular dystrophy may present with a psychological complication. It is important to discuss the child’s individual issues with the team and treat the child according to the plan developed.
- Fatigue and pain may make psychological problems worse.
	- Fear of pain and joint instability may lead to avoidance behavior.
		- This may make the dysfunction and disability worse.
 
- Psychological distress may increase pain.
 
- Fear of pain and joint instability may lead to avoidance behavior.
		
- Children may be self-conscious of physical differences.
- Depression is often associated with chronic pain and disabilities.
	- Individuals may feel misunderstood and/or alone.
 
- Other possible psychological problems:
	- Anxiety
- Low self-confidence
- Negative thinking
- Hopelessness
- Desperation
 
- Other considerations:
	- Misconceptions of abilities can cause insecurity and anxiety in social situations.
- Physical limitations may cause frustration or embarrassment.
- Medications may have side effects that impact behavior and/or school work.
 
- Increased incidence of:
	- Impulsivity
- ADD
- Autism
- Oppositional/defiant behaviors
- Aggression
- Obsessive like features
		- Difficulty with mental flexibility
 
- Depression, and anxiety
		- Physical signs
			- Headaches
- Stomachache
- Sensitive
- Changes in appetite
 
- May be due to awareness that this is a fatal disease
 
- Physical signs
			
 
- Other considerations:
	- Difficult concentrating, and controlling emotions
- Poor coping skills
- Rigid and lack flexibility in thinking
		- Can lead to non compliance or arguing
 
- Difficulty with transition
- Emotional moodiness
- Social problems due to:
		- Physical limitations
- Cognitive delays
- Social deficit
- Difficulty identifying and interpreting facial features
- Lack of practice with social skills
 
- May be on steroids
		- May make boys more emotional and more active than normal
 
 
What you can do
- Counseling and support for pain
- Behavioral supports
- Meditation and yoga
- Antidepressants
- Help with adaptation and acceptance of issues and potential limitations
	- Be supportive
- Understanding
- Consistent
 
- Some individuals need support for social skills development
- Make eye contact to help ensure attention
- Be clear and concise
- Provide routine and structure
- Clear boundaries
- Transitions
	- Provide advanced warning of change
- Visual cues