ADHD – LD6

 

While I personally find autism the most challenging and confusing disorder to deal with (perhaps because it is not “one” disorder?), Attention Deficit Disorder-ADD or Attention Deficit Hyperactivity Disorder-ADHD is certainly the most common of all childhood developmental disorders and also has generated the greatest amount of controversy as far as standards of diagnosis, treatment and parenting are concerned.

Undoubtedly, something that affects up to 5-10% of all children will call for a great deal of attention. ADD or ADHD (I generally prefer the second term but there are some kids who are attention deficit but not markedly hyperactive), should be detected as early as possible. What is often considered naughtiness is most often ADHD. In severe instances, the child will be thought of as “uncontrollable”, “terribly disobedient”, and perhaps also “unmanageable”. Hearing any of these terms (or their many cognates) should indicate the need for a professional evaluation.

In older children, once in school teachers will notice the short attention span and perhaps also the fidgetiness that goes with it and may call for an evaluation. Children with ADHD are often as intelligent as their peers or more so but will lag behind in the developmental testing due to the cumulative effecs of the short attention span. It is not uncommon to find dyslexia and or dyspraxia also showing up in a detailed evaluation but more commonly ADHD occurs alone. ADHD is now thought to be a catch-all designation that includes at least 5 or 6 different types of disorders, but you can find out more about that in your own research.

Common signs that we look for include:

• Consistently not completeing tasks.
• Not listening or paying attention.
• Keeps losing things.
• Swithches from one activity (or play) to another, more frequently than his/her peers.
• Easlly distractable.
• Refuses to do things considered “boring” (including homework).
• Acts without thinking, very impulsive.
• Needs constant supervision.
• Seems to have “too much” energy.
• Climbs, jumps, runs, more often than peers.
• May be short tempered.
• Seems to fidget a lot, has difficulty sitting still.
• Child can be inflexible, argumentative, and stubborn.

The professionals of course will have a much more detailed list and lots of questions to ask about stuff like developmental milestones, but if any of the above seem to apply to your child, do have a child psychologist do a complete evaluation.

So, if you do have a child with ADHD what’s next? depending on the age and the actual developmental level as well as the child’s own personality and what types of symptoms are present, the professionals will give you detailed instrucions. It is also very important that you do get into a support group with those who are also having to learn how to effectively deal with ADHD.

Controversies are many, so here I’m just going to tell you what I think and leave you to research the various issues and decide for yourself.

In my experience medications are almost always avoidable, but here the proviso is what sort of a parent or caregiver you are. If you are the type who finds all this difficult to accept and would rather not be bothered, then perhaps you should ask the psychaitrists to help both you and your child with some pills. Mostly a type of stimulant is used that strangely seems to calm ADHD kids down. But, I do believe that with a little care and the right support, your child probably can avoid needing to be medicated.

You need to start a journal. Note down behaviors, good and bad as they occur as well as stuff like sleep timings, diet – quantity as well as type, and how the child is coping with studies, feedback from teachers, achievements and especially the developmental milestones.

ADHD is treatable. 

Stay in close tough with the counselors, teachers and other professionals who are going to be dealing with your child’s ADHD, share ideas, ask questions and make suggestions. Find a team/school that both you and your child are comfortable with and work together to sort things out. We have found that in addition to counseling, occupational therapy, sensory integration and yoga have all proved helpful. Treatment is usually successful when done with a will to succeed. Your child may always have the tendencies, but will slowly learn how to keep them under control, how to concentrate better, and how to be better organised about life and the various tasks that go into making one more successful.

We pay a lot of attention to diet, but there are many who feel that it’s not that big of a deal. Generally, in our experience, cutting carbs and increasing mixed fats and proteins usually helps almost immediately to modulate hyperactivity and more slowly also has an effect on increasing attention spans. But, this may be anecdotal… We have also found that some children are “set-off” by particular foods or spices. If you do your journal properly, you will find your child’s pattern – if there is one!

We have found that identifying each child’s interests is an important first step. It’s much easier to work on the attention span using the child’s own interests as a springboard. Boredom is one of the biggest enemies, so trying a ‘standard formula’ rarely works across the board.

Keep plugging away. Both you and your child should realise that having ADHD does not make one less valuable as a person. The real point is that each and every child should have the best possible shot at realising their own unique potential – and that’s the Challenge!

P.S. There’s lots of half-baked stuff out there. Use your common sense, resarch thoroughly, discuss issues threadbare before jumping on to the latest bandwagon. A little thoughtful hesitation never hurts!

LD4 – Autism

Autism, despite its name, is not just one type of disorder. The better term is Autism Spectrum Disorder (ASD henceforth) and that includes a number of distinct developmental deficits and perhaps also from a variety of etiologies (causes) too. DSM IV does distinguis between ‘classical’ autism and PDD NOS (pervasive developmental disorders – not otherwise specified) which does include most of what I’m here calling the autism spectrum.

ASD actually results in a failure to relate. The affected child may not make good eye contact, may find close physical contact disturbing, and will not easily speak even to express basic needs. In other words, the ASD child may not even recognise “the other” as similar to but distinct from “the self”.

Observant care givers will be able to identify the more severe forms of ASD quite early as the deficits in achieving developmental milestones and interaction may be discernible even from the 9th month onwards, but sometimes it takes much longer to detect.

Common signs include:

• not turning when the parent says the baby’s name;
• not turning to look when the parent points and says, “Look at…” and not pointing themselves to show parents an interesting object or event,
• lack of responsiveness.
• repetitive motion, rocking back and forth.
• failure to speak, babbling.
• lack of ‘pretend’ play.
• repetitive, mechanical, play.
• smiling late; and
• failure to make eye contact with people.

(The above signs may not all occur together and may not all be discoverable at the same ages)

The lack of interaction can have a devastating psychological effect on the parents. While all developmental deficits are challenging to parents, the parents of kids with ASD perhaps have the hardest time. But, if the challenge is taken up, even severely affected kids will show improvement and sometimes the improvements will be remarkable.

The challenge is really not ever to give up. The parent (or caregiver) must insist on a relational response and then must insist on the right response. It can be a lifelong struggle, but ultimately very rewarding.

Once ASD is suspected, the child psychologist or paediatrician will be able to confirm the diagnosis. Therapy involves intensive one-on-one occupational therapy, with sensory integration, and directed play involving the child. Behavioral approaches as well as cognitive ones have proved to be helpful but it is most important that the parents learn what they have to achieve at home and work to effectively reinforce whatever the therapists are doing. Some parents actually take the lead in providing therapy and we have seen this approach produce excellent results. The more the parental involvement, (in my experience) the better the child responds!

In our experience even severely affected children can show remarkable improvement, so don’t get discouraged and don’t give up hope.

While all the parents of children with developmental deficits will be under some extra pressure, especially the parents of autistic kids can find the pressure and tension very taxing. So, it is particularly important that they get support for themselves and being a part of a group with the parents of other ASD affected children can be a great help.

Asperger’s Syndrome is somewhat related to ASD and sometimes even considered to be a part of the ASD spectrum. In Asperger’s, the language deficits may not be present. These kids will have normal or even good language skills but will still be lacking relationally.

All ASDs are treatable. Sometimes, remarkable improvement is seen. With dedication and will, a lot can be done! Get help, and then stick to the task at hand. Take it one day at a time, be patient, set yourselves tough but achievable goals, and you may be surprised at what you and your child can achieve together.

Insight into your child’s personality, what he (ASD is about five times commoner in males) likes and dislikes, getting your lives into a routine, and keeping a detailed journal that covers nutrition, moods, therapies, and anything else that comes to mind – will all prove to be very valuable aids to doing the best that you can for your child.

The American Association of Pediatricians has just published two papers on Autism. For further information, this is an excellent place to start.
AND Please, please, PLEASE look at all the wonderful and up-to-date information contained in the “Yale’s Autism Seminar“!!!!

Developmentally Challenged Children – Tips for Parents

Upon discovering that a child of ours is having a developmental disorder, be it autism, ADHD, dyslexia or whatever, parents face a number of difficulties. Often the first question asked is “who’s fault is this?”. Rest assured, developmental disorders are not the result of poor parenting!

The process of discovery may be painful but it is very important for both parents to accept the reality and deal with it. In many cases the disorder will be treatable even when discovered late. More importantly, the negative effects on a child with a developmental disorder can be devastating unless they are counteracted by parents and friends who are determined to let their child know that an inabity to perform on par with peers does not result in rejection or less love.

Start keeping a detailed journal for your child. Note down things like diet, moods, new therapies, hours of sleep, illnesses, medications, and physical data such as height, weight, head circumference, bmi and whatever else seems of importance. Make sure that you make relevant entries daily. This can be an invaluable help as time goes on. Ask your therapist to give you an appropriate developmental checklist and note down your child’s progress.

Finding the best therapy for your child is of great importance and perhaps even more important is to evaluate exactly what the individual child’s problems are.

A good therapy centre for developmental disorders will have at least the following facilities: Personnel; an occupational therapist, a child psychologist and a special educationist. Then Facilities; comprehensive licensed tests, a developmental playground, sensory integration toys and tools and good nutritional support. They will also maintain a therapy schedule with plenty of one-on-one sessions and so have a high therapist to client ratio. Finally, good therapy centers will include the parents in the therapy process. In our experience, when parents and therapists effectively cooperate, children do much, much better.

Parents then need to find out all they can about the particular problems that their child faces. The internet has plenty of information, but not all of it is good! Be sure to discuss what you learn with the professionals who are helping you! Join a support group with other parents who are sailing in similar waters. A good support group can be invaluable for sharing burdens and for finding solutions. You will be surprised to discover how common developmental problems are!

Finally, start including your extended family and your friends in your experiences. Don’t try to keep your child’s difficulties a secret.  This can be hard to do but it is very necessary.  Not all will be understanding but most people will appreciate your confidence and will try to be practically helpful.

Educating a developmentally challenged child can be difficult but many schools recognise the problems and are starting to practice inclusive education. Search out such forward thinking schools and spend time talking to your child’s teachers about what additional therapy is ongoing and areas where your child needs extra help.

Always know that you and your child will grow together. Some developmental problems can be completely cured, others can be so well compensated for that no deficit will be detectable and in all cases improvement will be seen!

So, never give up…