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Developmental Blocks

Tuesday, June 16, 2015

There are a host of neurological conditions that can affect children, ranging from learning disabilities to schizophrenia. Anindra Siqueira & Dev Goswami tell you more about them

Last week we told you about behavioural disorders that manifest in childhood and how you should deal with them. In the second of our two-part series on children’s disorders, we’re telling you about neurological or psychological conditions, what you can do, and how drugs are used in connection with them. We’re also bringing you a case study to help you understand the issue better. 

“When parents want to understand the level of their child’s development, they focus on motor skills, vision, hearing, speech and other evident parameters. But, they frequently neglect aspects of imaginative ability, socialising and communication skills, a deficit of which lead to problems such as being unable to understand the world and pervasive development disorders. Dyslexia, or learning disabilities, also represent a specific deficit in written, read or spoken language,” psychiatrist, counsellor, author and founder of MINDFRAMES, Dr. Shefali Batra, explains.

Worrying Signs
There are several neurological conditions that affect your child’s behaviour — it takes some parents years to even begin to see the patterns. Dr. Shefali tells us about the signs you should watch out for.

  • Schizophrenia While schizophrenia is an expansive disorder — consult any library and you will find volumes of subject matter, more than you will be able to take in. However, all you need to know is that it involves losing touch with reality. Dr. Shefali says, “There may be delusions, where children believe in things that aren’t true, as well as hallucinations, where they see, hear or feel things that aren’t actually present.
     
  • Learning disabilities (LDs) Learning disabilities, or learning disorders (LD), are a group of conditions that include dyslexia and problems that make it difficult to read, write or do mathematics. Dr. Shefali says, “The LDs include a series of deficits that interfere with the child’s learning. Children with LD process what is taught to them in a manner that’s different from the conventional pattern. The information in their brain is processed differently and the techniques these children use to understand things is unusual.” Some parents don’t realise when their children suffer from learning disabilities, because they seem fine in other areas of schoolwork. When parents dismiss their children as naughty and playful, or subconsciously deny their inability to learn math, it can aggravate the problem. We don’t know why learning disabilities occur, but they are believed to be a result of ill-established neural connections.
     
  • Autism Autism is not a single disorder, but a spectrum of disorders. It can be spotted at an early age — in most cases, before children are 3-years-old. Children with autism have difficulty using words to communicate their emotions. Dr. Shefali says, “Such children do not display regular interests, and prefer inanimate objects over animate ones. They require a sense of ‘sameness’ in their routine and get upset when their surroundings change. They also engage in repeated rocking movements to stimulate themselves.” The most common behaviour that children with autism exhibit is that they don’t maintain eye contact. Sometimes, even moving furniture around the room can affect their behaviour drastically and they will try to restore what they think of as order.
     
  • Asperger’s syndrome A type of high-functioning autism, people who suffer from Asperger’s generally have above average intelligence and also have a problem with social interactions. Dr. Shefali, explains, “Asperger’s gets diagnosed when children are slightly older, because language and communication matures at a later age, and it is often overlooked, as these children are misunderstood by their parents and peers, who think they are odd or asocial. They require understanding and you need to build up trust before they can be helped to learn socially appropriate behaviour.”
     
  • Tic disorders and Tourette’s syndrome This condition is characterised by involuntary movements. People who suffer from it also blurt out random, mostly obscene, words. Dr. Shefali says, “These are known as ‘tics’ and could be motor tics (movement) or verbal tics (words). The presenting symptom is frequent blinking. This may progress to facial and body movements including kicking, jumping or thrusting motions. Verbal tics vary from a simple throat clearing sound to grunting, barking or uttering obscene words.” Children who have tic disorders are impulsive and display hyperactive behaviour.
     
  • Eating disorders These include bulimia, anorexia and even binge-eating. However, they are less common amongst children and usually occur during adolescence. They are serious conditions and shouldn’t be ignored. Some can even be life-threatening. Dr. Shefali says that children become so preoccupied with food and body weight that they cannot focus on anything else.

Parental Recourse
Dr. Shefali says, “Parents are disheartened when they find out that their child has a pervasive developmental disorder. In my experience, I have seen an array of reactions ranging from a complete breakdown, self-blame, to a more mature, problem-solving approach, where they accept the truth and make an effort to help thier child. These children are creative and imaginative. With adequate support and a specialised treatment plan, you can improve their communicability and behaviour.”

Many of the conditions that we’ve listed can be treated with a combination of drugs and cognitive behaviour therapy. When children have autism, and more specifically Asperger’s, parents need to build trust before their children can be taught socially appropriate behaviour. Tourette’s syndrome can be treated with behaviour therapy, where children are taught to unlearn an unhealthy habit and relearn a healthy one. Dr. Shefali says that with learning disabilities, management is essential. The earlier these disabilities are dealt with, the better the chances of keeping up with other children and school curriculums. She tells us that parents and teachers can also be given special teaching methods to facilitate the learning process.

More about learning disorders
Learning disabilities are becoming increasingly common, especially since schools have begun to follow a system where students are accepted into higher standards whether they pass or fail  at least to the eighth standard. This makes it difficult for children with learning disabilities to get the attention that they need. Dr. Shefali says that learning disabilities (LD) are not the same as mental retardation. She tells us, “Intelligence is an overall description of ability in different dimensions. We usually determine intelligence through words and performance. Children with LD may have good performance abilities. However, they may lack the verbal component of intelligence, which includes words, vocabulary and mathematics. These children are well aware of their environment and may be street smart. However, their intellectual performance in school may be lacking. With advancing age, the ability to retain information becomes increasingly deficient, and the child loses the potential he/she is capable of.”

Dyslexia in real life
From all the neurological disorders that exist, dyslexia is one that is perhaps the most widely-known, partly because it has been showcased in several films. We’re telling you about a real-life case of Jeevan, a 9-year-old boy, who came from a well-off family and whose school referred him to Dr. Shefali because his teachers thought he was a slow learner. Jeevan’s case illustrates how possessing the correct knowledge about psychological disorders can help a child — instead of being labelled as slow, or challenged, both Jeevan’s school and his parents saw to it that he was given the appropriate care. Dr. Shefali tells us that after a series of tests, which assessed his learning abilities, he was diagnosed with dyslexia. He was then put on a remedial education programme with special educators and tutors. His behaviour was modified using the token reward system and reinforcement strategies, which were explained to his mother as well. His confidence was built using cognitive restructuring. Today, he has developed an affinity for reading and writing, both of which were once phobias for him. He is well-adjusted in school and has several friends. He also gets along with his brother and while his performance is average, Dr. Shefali tells us that it’s highly commendable.

Can drugs help?
No one likes the idea of young children being subjected to long-term doses of medication. However, it is important to realise that when it comes to managing neurological disorders — or even behavioural disorders, for that matter — drugs work in conjunction with therapy. Drugs can help subside the physical symptoms of neurological disorders, which helps pave the way for quicker, more effective therapy. Dr. Shefali tells us that medication can help with conditions such as ADHD, rash and destructive behaviours, extreme depression, schizophrenia and bipolar disorder. However, she does tell us that it isn’t ethical for a doctor to prescribe unnecessary medication, especially to a child. She adds, “Some medicines require blood tests, ECG and CT scans before they can be prescribed. Medicines should always be given under supervision to ensure that the child is really taking them and also to make sure that there is absolutely no risk of overdose.” She does agree that some of these drugs can have major side-effects. The drugs that are used to treat ADHD, for example, have been connected to stunted growth, while those for schizophrenia can cause tremors, weight gain and metabolic abnormalities. But, Dr. Shefali says, “I’d say there is no medicine that doesn’t have side effects. Simple medication that we take for fever and headache as well as stronger drugs taken during cancer treatments all have tremendous side effects, but the benefits outweigh the risks; that is why we take them.” 

The effects of abuse
Abuse — whether its parental or familial — can have nasty consequences; that is quite obvious. But, childhood abuse is not the only reason for mental health disorders. Dr. Shefali tells us that there is no definitive cause of mental disorders; it’s a complex interplay of biological, psychological and social factors. However, abuse is one of the foremost social factors that can increase the likelihood of a child suffering from a mental disorder.

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