HOW I GOT LEH’

While roaming around in the Leh marketplace, I was amused at the embroidered T-shirts displaying the words “How I got Leh’d” along with a bike. I came back from my trip to Ladakh and settled back to routine. A lot of pending work had to be completed and unpacking in itself was a daunting task. I kept moving on but something was amiss. It was on the third day in Mumbai that I suddenly realized the meaning of those words and how I missed Leh.

We drove across Kashmir from Jammu to Leh and explored Ladakh for several days. The journey was demanding and so was settling in with the altitude but each day brought us new surprises. The sky was a deep crayon blue and really blue, and mountains on the way were pink, red, purple, blue, yellow, green and all possible shades of brown. We travelled though snowfall on the highest motorable road in the world at Khardung-La (18360ft) at minus 12 degrees and sand storms in the Hundar desert at plus 30 degrees, just a couple of hours apart. Spending the night in a tent on the banks of the fabulous Pangong Lake made famous by 3 Idiots, at an altitude of 14000ft, with nothing to separate us and nature except a few layers of cloth was an awe-inspiring experience.

The insanely harsh climate of Ladakh blends amazingly with the peace and calm reflected in the people who seem to be purified with endurance, to create an environment that uplifts the spirit to another level altogether. Little wonder that my 13-year old daughter said what she didn’t for Dubai or Singapore: I want to come back to Leh every year.

Handling Hyperactive Children

Parenting amidst today’s scenario is difficult. Problems like hyperactivity and aggression in children are on rise and are not uncommon any more. The reasons are multiple. The dilemma for the parents... Is my child Hyperactive or just Overactive? Research indicates that increase in aggression on Television, electronic media, computer games could be the cause for the same. Some common yet serious conditions like ADHD or Autism require special consideration in reference to hyperactive children.

Hyperactivity or Attention DeficitHyperactivity Disorder (ADHD) is a common disorder.  There is much discussion about ADHD and also some common misconceptions. ADHD is a Neurobehavioral condition and is seen in 7-8% of school going children and about 60-80% of children may continue to have features of ADHD even in adolescence and early childhood as per American Academy of Pediatrics. Indian studies also show similar prevalence of 8-10% of ADHD in school going children.    The children may be inattentive or hyperactive or a combination of these symptoms. Most of these children with hyperactivity require help or medication during the initial years but usually settle by early adulthood. Diet modification in the form of reduction in chocolates, junk food helps. Medications are safe, effective and are easily available.

Autism or Autism Spectrum Disorder is a Neurodevelopmental condition seen in children. Most of the children with this condition may appear hyperactive or weird or aloof.Most of the children with autism usually have poor eye contact, avoid social interaction and may have certain odd behaviours. They have difficulty in learning new skills and understanding instructions.However the children with milder problems do well with support and early conventional therapies but severe cases may be difficult to manage and require medications.

Dr Thadhani adds that hyperactivity in children could be a purely attention seeking behaviour also. Parenting and environment at home plays a major role in cases associated with temper tantrums.  Such cases are easy to handle and can be dealt effectively with parental counselling and simple behaviour modification techniques at home.

ADHD and Dyslexia are also related with a significant overlap of 15 – 20% of cases. In such conditions poor school performance and inattention may coexist.It is very important for the child to undergo proper evaluation before we start treating Hyperactivity in children.

A child with hyperactivity needs you to understand his behaviour so that appropriate help and support can be extended him. Most of these children do very well if timely intervention is done.

Dyslexia

What is Dyslexia?

Learning disability or commonly known as Dyslexia is a well-established neurodevelopmental disorder and is present in a child since birth.

How commonly do you see Dyslexia?

Dyslexia is estimated to be present in 10% of all school-going children. It is seen in boys as well as girls.

What causes Dyslexia?

It may manifest at any time depending on various factors such as academic exposure, environmental stimulation, potential of the child etc. It is known to run in families and a genetic basis has been suspected as one of the causes. No clear cause is identified but any minor insult to the growing brain during pregnancy, birth or even later may lead to learning problems later on.

What are the types of Learning Disability?

Learning Disability consists of three distinct types, Dysgraphia (difficulty in writing), Dyscalculia (difficulty in arithmetic) and Dyslexia (difficulty in reading).

How does Dyslexia present?

The presentation of children with dyslexia is varied. Children may have various combinations of academic and behavioral problems that make each child with dyslexia unique. Since it is a hidden handicap it may go undetected. A child who is otherwise bright and is able to perform well in other spheres of life does badly in school. The child shows very salient but definitive social adjustment problems if not helped earlier. Most of the children exhibit academic problems by the fourth and fifth standard or even earlier.

What are the pointers of Dyslexia?

The child shows reading problems whereby he may hate reading aloud or may not read at all or reads with finger tracing. Usually, his oral performance is much better than the written work. The child may show a lot of spelling errors and slow and inadequate written output. Most of the children just dislike writing. There may be significant problems in mathematics including understanding basic concepts, learning of tables and sequencing.

If my child does not study, what do I do?

An eye checkup and audiogram is required to check the vision and hearing of the child. A detailed evaluation of the child including the Intelligence Quotient (IQ) along with educational assessment helps to understand the child better. In the city of Mumbai this kind of help is available for evaluation of learning problems in various guidance and counseling centers.

HOW TO BE A PERFECT MOM

Perfection is the price we pay for evolution.  We are all constantly striving to improvise in the diverse roles we play. The secret desire to be a perfect wife, homemaker is at the bottom of all. The role of a mother has changed with time. Our grandmothers were the homely lot who could cook a great sumptuous meal and solved our day to day problems. They were always available to hear us out.  The next generation seemed more empowered but still the focus was essentially the HOME. They did go out to work and made their mark but also stayed back when needed. The mom today is truly the ‘super mom’.  The family dynamics and the demands on the mother are astronomical now.

The challenge today is to carve responsible and compassionate individuals out of our little cute ones. The prime responsibility of raising and disciplining the children stays largely with mother. To get the point across with children requires effective and skilful interaction.  Moms desperately want to build rapport with their children, while children are lost in their friends or gadgets and are happy with minimal need based communication. So the first thing the mom has to do is to get tacky and techno savvy. Talk the same language, more likely you would get along. Believe me these gadgets are not as scary as they appear and if you spend some time with them you get the hang of it. Another possibility is discovering some common interests with your child like sports, fashion etc.  Also doing things together with the child gets you in their good books. It could be cooking a special dish, helping in their craft work or typing their school assignments for them.  Gradually the conversation will drift from brief question and answer sessions to a friendly chat. The depth of the conversation can be navigated accordingly.  If you share your little childhood secrets, the child may also do the same.

Availability is an important factor in getting closer and an important constraint in case of working mothers. The child should be told about your work schedule and in which manner the child can contact you if needed. This helps in building trust and confidence. The child will usually wait to share with you. Deadlines with respect to your children need to be observed strictly. The key to being a perfect mom lies in setting the priorities right.

Discipline still is needed. If you get too friendly the children tend to take the advice lightly. If you nag anyways they show defiance. The trick here is correct balance.  Be firm and communicate your expectations regarding issues like use of mobile at night, appropriate clothing, and internet access.  Avoid too many ‘NO’s in day to day handling of children. But stick to your rules once they are laid.   In younger children it is easier to set limits and gently cajole them into following them. But as they get older, it gets difficult. 

Arguments and constant comparisons with peers may make you lose the edge.  Remember the moment you get angry you have lost all you gained with numerous rapport building exercises. The mantra is to bargain and set the rules with mutual consent.  Be flexible sometimes and set a grey zone to lower your own stress levels.

Also it is imperative that you stay in control. You cannot afford sudden outbursts even if you are furious.  Usually it scares a child and if this behaviour is too often the children learn to ignore this unpleasant occurrence. Best is to take time out before the situation gets out of control.  Remember the children are like little monkeys and all they do is to ‘APE’  our behaviour. We need to be better behaved if we want our kids to do the same.

It is important to notice and try to change the unacceptable behaviour early. Discuss with your spouse, family or friends and make sure that every adult is more or less communicating the same message regarding acceptable and unacceptable behaviours.  Also we need to keep in mind that behavioural problems could be secondary to an underlying condition like hyperactivity, autism, learning problems etc. So the sooner we accept the more likely we will respond to the needs and cause of the behaviour. Observe for a while and seek professional help with a counsellor if needed. Counselling is usually centred around understanding the child and environment responsible for behavioural concerns.

Happy parenting … all the best!!!

AUTISM AND MYTHS --- Part 2

Myth: Autism can get cured completely with medicines.

Autism is a neurodevelopmental condition and hence does not go away but the various therapies and medications help the individuals with autism led a near normal life.

Myth: Autism is an emotional or mental health disorder.

While physical or social behaviors of individuals with autism may suggest that they have a psychological disorder, autism is actually a biological illness, that affects the brain's growth and development.

Myth: There is an autism epidemic at present.The word "epidemic" often implies a sudden increase in the number of individuals within a fixed time who have, in this case, autism. Yes, the number of cases have increased due to more social and media awareness about autism and more and more cases are getting diagnosed.

Myth: Autism is more common in America.This is a common belief that autism is a western disease but this is not true as we do see a lot of autism in India since last decade and earlier these children were misdiagnosed as having mental impairment or other psychiatric conditions.

Myth: Autistic children never learn in regular schools.Autism spectrum is a condition where the children vary greatly in their clinical presentation and the children with mild to moderate symptoms do cope up with conventional teaching methods. Also it is important to give them a chance as many improve as they grow.

                                                                                           

AUTISM AND MYTHS ---- Part 1

Aman, a 4 yr old male child usually spins around himself and around the furniture. When on bed he rocks himself to sleep. His interaction with his parents is less for his age.  He is unable to follow simple commands at home and at play school.  He occasionally gets aggressive with peers and screams without any clear reason.  To an outsider, Aman looks like a typical overactive child full of energy.

Simran is 6 years old and is a very quiet child. Her mother says that she is a very shy child and still hides behind her mother if an outsider comes to her house. At school she follows instructions and is doing well. She does not participate in group activity at school and has no friends. During her visit to the doctor she had poor eye contact and demonstrated minimal interaction.

Raj is extremely hyperactive and difficult to control. His mother is unable to cope up with his motor-like activity and feels completely frustrated.  He was put in a play group and after one month the school politely refused to let him continue as he was disruptive for the entire class.

Most of these children have behaviour which is extreme and affects their learning and play as well. These children belong to the autism spectrum disorder which is not so uncommon anymore.

Autism is a neurodevelopmental condition which mainly affects areas of social interaction and communication.  These children also may have some motor movements like hand flapping, rocking which are repeated over and over again. The manner in these children behave is quite different and represent a spectrum of symptoms from mild ones which are considered as shy to the real aggressive ones.

The younger children with autism are referred to me with complains of speech delay or hyperactivity while older children lag behind in studies at an early stage because of inability to follow classroom instructions.

The parents notice the soft subtle signs of autism like poor eye contact of the child while talking, most of the children were late to start talking and have inadequate speech.  Usually stay in a world of their own, these children are happy alone and find it difficult to play and interact with other children. Inability to focus and hyperactivity with unpredictable aggression also is noted in the children.

Doctors, school teachers and parents have become increasing aware of this condition in the last decade. The awareness has been greatly increased by media with main stream movies like ‘My name is Khan ‘and ‘Barfi’ depicting main characters with autism spectrum disorder.  Many Hollywood movies like Dear John, Mercury Rising and Rain Man showed autistic characters and popular serials like the Big Bang theory have depicted the main character as suffering from Asperger’s syndrome.

The statistics across the world are mind boggling with the latest reported prevalence  of autism being 1 in 50 school going children reported to have autism in United States recently.

It is difficult to estimate the numbers in our country as there is no mandatory reporting of Autism in India as for diseases like Malaria, Tuberculosis.  However there is an alarming increase in the number of cases of autism seen in past few years.

Children with autism have difficulty at an early stage but come for treatment late. Most of the mothers report noticing something wrong with the way child behaves much before they come for help but find it difficult to point out.

It is important for parents not to ignore atypical behaviour in the child. I feel that early detection of this condition with proper treatment can go a long way in normalizing the behaviour.  Closing your eyes is not going to take the problem away but you lose on the benefits of early treatment.

Also Read: http://www.medindia.net/news/Interviews/expert-tips-to-parents-for-children-with-autism-qa-with-child-specialist-116672-1.htm

http://healthmeup.com/photogallery-healthy-living/mental-health-autism-in-children-and-myths/20522

http://m.timesofindia.com/life-style/health-fitness/health/Autism-in-children-and-myths/articleshow/19357541.cms