Mixed Disorder - CYSHN

Mixed Disorder of Emotional Expressiveness

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This fact sheet was developed by our partners at the Minnesota Department of Human Services, Children´s Mental Health Division, for use in determining eligibility for early intervention services only.

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Condition Description
Mixed Disorder of Emotional Expressiveness is a formal mental health diagnosis given to an infant or toddler by a licensed mental health professional using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R). Children who qualify for a Mixed Disorder of Emotional Expressiveness diagnosis are unable to express a developmentally appropriate range and a developmentally appropriate intensity of emotions for at least two weeks. The difficulty with emotional expression is demonstrated across many types of emotions and represents a change from the child's previous functioning 1

Impact on Learning and Development
If untreated, young children with Mixed Disorder of Emotional Expressiveness may experience delays in development and demonstrate difficulties in their relationships with others. They may also demonstrate difficulties in later school achievement and develop behaviors that require juvenile corrections interventions.2,3

Treatment Options
While the research surrounding effective treatment options to address this disorder is minimal, experts in the field recommend a combination of psychotherapy and parent education. 4 Additionally, as with all interventions targeted toward young children, consistent and frequent communication across all of the systems working with the child (the child's primary care givers, child care providers, primary health care providers, mental health providers, etc.), is essential for optimal success in treatment. 5

1 Zero to Three (2005). Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition. Washington: ZERO TO THREE Press.
2 Zigler, E., Taussig, C., & Black, K. (1992). Early childhood intervention: A promising preventative for juvenile delinquency. American Psychologist, 47(8), 997-1006.
3 President's New Freedom Commission on Mental Health. (2003). Goal 4: Early mental health screening, assessment and referral to services are common practice. Achieving the Promise: Transforming Mental Health Care in America. 57-66.
4 Levy, S., Frankel, K., and Harmon, R. (1997). Disorders of affect: Mixed disorder of emotional expressiveness. In A. Lieberman, S. Wieder & E. Fenichel (Eds.), DC: 0-3 Case Book (pp.129-143). Washington, D. C.: ZERO TO THREE.
5 Parlakian, P. and Seibel, N.L. (2002). Building Strong Foundations, Practical Guidance for Promoting the Social-Emotional Development of Infants and Toddlers.

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