Childhood Disorders Short
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Transcript of Childhood Disorders Short
Common Difficulties
Learning Disorder
• Difficulty in reading, writing, arithmetic
Behavioral Disorder
• Disorder of attention
• Disorder of conduct
Emotional Disorder
• Anxiety• Depressio
n
Learning Disability: Symptoms
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Difficulty learning phonetics Poor grades Poor memory Poor comprehension- not able to
understand written text Discrepancy between oral and written
language Avoidance/reluctance to study
Causes of Learning Disabilities
Heredity Problems during pregnancy and
birth: An illness or injury during or before birth
Incidents after birth: Serious illness, head injuries, poor nutrition and exposure to toxins such as lead can contribute to LD
This difficulty in not due to
Low IQ “Slow learners” (IQ 71 to 80) Mental retardation (IQ ≤ 70)
Language barrier Visual handicap (>60% disability) Hearing handicap (> 60% disability) Physical handicap (e.g. cerebral palsy) Psychiatric disorder Poor motivation/attitude difficulties
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Reading
“Late starter” compared with others of his/her age
Puts sounds in wrong order or reverses words; e.g., was/saw; slit/silt; skates/sticks
Difficulty in following line, uses finger Reads slowly, word by word, ignores full stops Confuses words which look similar; e.g.,
look/took May not recognise “easy” words
he learned long ago Leaves words out; also puts extra words in Difficulty in breaking words into syllables
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Spelling
Confuses letters that look alike, especially b/d Confuses letters that sound alike, e.g., n, m, ng Puts letters in the wrong order;
e.g., gril, frist, bersa, saduh Spelling can be bizarre, with no relation to
real wordse.g., Htit, Brail, spirn, sighnt, niegteet, xqatk, tesbogjapApe (The last example is supposed to be “This dog jumped up!”)
Mirror writing; e.g., tac, tnew. (may also reverse letters)
Writing
Holds pencil awkardly; words often don’t sit on lines
Forgets letter shapes, relative heights, positions on line
Difficulty copying from the board Punctuation - omits capitals and full-stops Difficulty getting sentences and stories
down on paper Writing “stories” is generally a slow,
painful procedure
Number Confuses signs (+, -) and
symbols (6,9 8,3)
Reverses digits,
e.g., 12 and 21
(In English) Confuses number names
which sound alike,
e.g., fifty/fifteen
Impact on affected child
Boredom and carelessness; Disinterest in school & studies Withdrawal in class; Disorganization, inattention; Sloppy or poorly done work Slow to respond to questions Learned helplessness Aggressive behavior/behavior
problems
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Impact on teacher & parents
Confusion due to lack of awareness
Lack of acceptance in parents Feel that the child can do; but
“does not want to do” Feel the child is “dumb” Blame the child Blame teachers/parents Undue pressure on child
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Identifying LD in Classrooms
Learning Disability Checklist Informal measure Meant for screening only Not enough for diagnosis While rating keep in mind if
behavior to be rated in both inappropriate to age and interfering in performance
No checklist should be regarded as a 100% reliable “measure” of dyslexia
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Indian Scenario & Educational Policies
Prevalence rate of dyslexia in India- 9.87% among Indian School Children
Since early 1990’s, National Educational Boards (ICSE & CBSE), State Governments of Maharashtra, Tamil Nadu and Karnataka provide accommodations from standard I to XII
Children identified with dyslexia and receiving exam provisions show 22% improvement in scores.
Roadmap for helping child with
LD Screen children failing in 3 or more subjects in two consecutive tests
Look for signs of SLD- apply
checklist
If child meets criteria- refer for
evaluation
If child is diagnosed to have
SLD
CBSE ExemptionsClassroom Management
Special Education
CBSE Exemptions
Exemptions from third language Extra time during examinations Option of studying one compulsory language
as against two Besides one language any four of the
following subjects can be offered: Mathematics, Science, Social Science, another language, Music, Painting, and Home Science.
Classroom Management Strategies
Make the child sit away from doors / windows and close to the teacher.
Don’t criticize or reprimand the child in front of others.
Use a lot of praise. Studies show that it takes ten positive comments to counteract one negative one
Seat the student with good role models Use peer tutors when appropriate
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Avoid making the child read in front of the class
Avoid criticisms for sloppiness or illegibility
Have students complete writing activities in small steps
Give the child extra time to complete his/her work
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Attention Deficit Hyperactivity
Disorder (ADHD) Brain dysfunction disorder Onset before 7 years More frequent in boys than girls Affects 4-6 percent of school-age children Has a genetic component Life-long; can be managed, not cured
Defining ADHD: Symptoms
Easily distracted Fidgeting and squirming in seat Talking out of turn Leaving seat in the classroom Shifting rapidly from one task to another without
completing first one Unable to play quietly Talking excessively Interrupting or intruding others Disorganized: loses books, notebooks, pencils Unaware of consequences and engages in potentially
dangerous behavior Associated problems: speech delay, problems in
sleeping
Diagnosis
IQ must be within normal / average range
Onset of symptoms must be before 6 years of age
Symptoms must be present at least in 2 settings
Causes of ADHD
Neurotransmittor dysfunction Pre-frontal cortex deficits
Not due to… Poor parenting Family problems Bad teachers / ineffective schools Too much television
Neurotransmittor dysfuntion
ADHD is thought to be caused by a neurotransmitter malfunction
Dopamine is a neurotransmitter that plays a large role in learning, memory and focus
Impact on child
Behavioral problems (not listening, answering back, disruptive behavior)
Low self-esteem Poor motivation Academic decline (50%
comorbidity of LD)
Management
Medication Behavioral Therapy Parent Management Training Combining behavior therapy, parent
management training and behavior management in school is most effective as per research
Behavioral Treatment
Psycho-education about ADHD Structure/routines Clear rules/expectations Attending/rewards Planned ignoring Effective commands Time out/loss of privileges Point/token systems Daily school-home report card Intensive summer treatment programs
Classroom Management
Use clear communication, and give one direction at a time with eye contact
Give ample warning before you expect the child to change activities
Using novelty helps Offer love and support as the child
tries to meet expectations
Oppositional Defiant Disorder
(ODD)Recurrent pattern of behavior that is:
Negativistic Defiant Disobedient Hostile behavior toward authority figures Externalizing blame, Vindictive Temper tantrums Arguing
Conduct Disorder
Aggression against people or animals
Frequent bullying or threatening Often starts fights Used a weapon that could cause
serious injury Physical cruelty to people Physical cruelty to animals
Associations with ODD and CD
Intelligence and underachievement in school
Lack of emotional intelligence Personality factors: impulsive, callous,
unemotional Multiple problems in relationships: peers,
family, teachers, authority figures. Co-occurring Disorders: ADHD, anxiety,
depression, substance abuse.
Management
Medication for aggressive behavior
Parent management training Cognitive behavior therapy Behavior modification Learning support Management of co-morbid
conditions
Emotional disorders
Children with these disorders internalize their pangs and pains which then manifest as Anxiety or Depression. Most Emotional Disorders are stress related.
Somatization, stuttering, stammering, also fall in this category
Case Study - I
Name: Aashi Age: 6 year /FChief complaints Inability to study or sit in class. Cannot recognize alphabets Writes with mirror images Restless Doe not listen Defying instructions Hitting and throwing things at others No effect of scolding or hitting by parents
Analysis
Diagnosis: ADHD Assessment:
IQ (104) ADHD Ratings- Criteria met for
inattention & hyperactivity Pre-Academic Skills- poor verbal &
performance skills
Recommendations
Presenting Complaints
Aggressive behavior Defiant Answering back Avoids studies Can not concentrate Gets up frequently while
studying Careless about belongings
presenting complaints, contd.
Does not get along with children of his age
Avoids writing Slow handwriting Not able to complete class work Forgets easily Silly mistakes Study-related lying
Assessment
• Intellectual Assessment• Full scale IQ = 94• Verbal Quotient =
104• Performance
Quotient = 82• ADHD
Assessment• No ADHD features
Attention: Impaired Perceptual-Motor
Abilities: Impaired Memory
Visual: Impaired Auditory: Impaired
Language Reading : Grade 3,
read word by word Writing: Slow, poor
spatial relations, missed letters
Comprehension : Grade 2
Spellings: Grade 3 Arithmetic: Adequate