Sensory processing disorder

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses like biting a sandwich or riding a bicycle. Sensory Processing Disorder (SPD), exists when sensory signals are either not detected or don't get organized into appropriate responses.

A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks.

Sensory processing disorder may affect one sense, like hearing, touch, or taste. Or it may affect multiple senses. And people can be over- or under-responsive to the things they have difficulties with.

Signs of over-responsivity

Dislike of textures (such as those found in fabrics, foods, grooming products or other materials found in daily living)

Discomfort, sickness or threat induced by normal sounds, lights, movements, smells, tastes, or even inner sensations such as heartbeat.

Signs of under-responsivity,

Sluggishness and lack of responsiveness

Sensory cravings (fidgeting, impulsiveness, and/or seeking or making loud, disturbing noises)

Sensorimotor-based problems, (slow and uncoordinated movements, bump into things and poor handwriting)

Sensory discrimination problems, that might manifest themselves in behaviors such as things constantly dropped.

Sensory processing problems are usually identified in children. But they can also affect adults. Many children with SPD start out as fussy babies who become anxious, as they grow older. These kids often don't handle change well. They may frequently throw tantrums or have meltdowns.

Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children, adolescents, and adults with SPD, these difficulties are chronic, and they can significantly disrupt everyday life.

There is a lot of research going on to know the causes of SPD. Some preliminary research suggests that SPD is often inherited while there are others, which suggests that it has an environmental origin. The exact cause of sensory processing problems has still not been identified.

It is not easy to be a parent of child with SPD. It is important at this time to understand and believe in your child. Treatments like Sensory Integration therapy depends on a child's individual needs. But in general, it involves helping children do better at activities they're normally not good at and helping them get used to things they can't tolerate. Along with the therapies, you can help them at home in different ways:

Trying your best to understand sensory processing disorder is beneficial for both the parent and child. This might include talking with a professional, reading a book or looking up information online. Understanding your child’s sensory needs will help you to plan your day with him/her.

Teach your child how to interact with his world through play, fun games, crafts and activities. Focusing on fun makes it less ‘therapeutic’ and, therefore, less ‘scary’.

Making time each day for activities to help fulfill your child’s sensory needs can make a big difference in your childs life.

Make a visual schedule for your child. By visual schedule, we mean is to put each day’s events into writing and make them visible for your child to follow during the day.

SPD is only a small part of who your child is. Help him to accept that part, but also to see the other amazing things inside of him.

This depends on the severity of the child’s diagnosis. Each and every child’s ability is varied from mild, moderate and severe condition.

With mild condition, nearing age appropriate and minimum behaviour tantrums (no hitting, biting, throwing things, able to follow basic instruction) your child will be able to attend mainstream school provided the school provides your child will adaptive strategies while learning, consessions during exams and test.

With moderate condition and moderate behaviour tantrums

SLC has launched a campaign called ‘Jakarta Inclusive’. This campaign focuses on empowering different individuals in the community through various awareness actions. Awareness program is an essential factor when creating an inclusive community. Awareness program through different talks, seminars, workshops towards different organizations, parents, professionals and others in the society, will bring us all together as one whole community enabling an inclusive community with differently abled individual in Jakarta.

ADHD

ADHD stands for Attention Deficit Hyperactivity Disorder. It is a medical condition. A person with ADHD has differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. ADHD can affect a child at school, at home, and in friendships.

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood, although a combination of factors is thought to be responsible.

Genetics:

ADHD tends to run in families and, in most cases, it's thought the genes you inherit from your parents are a significant factor in developing the condition.

Research shows that parents and siblings of a child with ADHD are more likely to have ADHD themselves. However, the way ADHD is inherited is likely to be complex and is not thought to be related to a single genetic fault.

Brain function and structure:

Research has identified a number of possible differences in the brains of people with ADHD from those without the condition, although the exact significance of these is not clear. For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) states that all cases of attention deficit are diagnosed as ADHD, with one of three different types: Primarily Hyperactive-Impulsive, Primarily Inattentive, or Combined.

1. ADHD, Primarily Hyperactive-Impulsive type:

People with hyperactive ADHD feel the need for constant movement. They often fidget, squirm, and struggle to stay seated. They appear to act as if “driven by a motor” and often talk and/or run around excessively. They interrupt others, blurt out answers, and struggle with self-control. This is more common in children and men.

3. ADHD, Combined type

People with combined-type ADHD demonstrate six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity.

2. ADHD, Primarily Inattentive type

People with inattentive ADHD make careless mistakes because they have difficulty sustaining attention, following detailed instructions, and organizing tasks and activities. They are forgetful, easily distracted by external stimuli, and often lose things. This is more common in adults and girls, and was formerly known as ADD.

Some symptoms to look at for children with ADHD are:

Symptoms of Inattention:

Make careless mistakes in schoolwork or at work

Problems sustaining attention in tasks, play or conversations

Have problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines

Avoid or dislike tasks that require sustained mental effort, such as schoolwork

Lose things necessary for tasks or activities

Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

Symptoms of Hyperactivity-impulsivity:

Fidget and squirm in their seats

Leave their seats in situations when staying seated is expected

Run or dash around or climb in situations where it is inappropriate

Be unable to play or engage in hobbies quietly

Be constantly in motion or “on the go,” or act as if “driven by a motor”

Talk nonstop

Blurt out an answer before a question has been completed, finish other people’s sentences, or speak without waiting for a turn in conversation

Interrupt or intrude on others, for example in conversations, games, or activities

While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

Psychotherapy

Behavioural therapy is a type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. This therapy also teaches them to monitor their own behaviour, give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting.

Medication

For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination. Sometimes several different medications or dosages must be tried before finding the right one that works for a particular person. Their prescribing doctor must monitor anyone taking medications closely and carefully. It should be noted that medicine is not the only solution for ADHD. It should be combined with Psychotherapy for effective results.

Parents and teachers can help kids with ADHD stay organized and follow directions with tools such as:

Keeping a routine and a schedule.

. Keep the same routine every day, from wake-up time to bedtime. Include times for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible.

Organizing everyday items.

Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.

Using homework and notebook organizers.

Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books.

Being clear and consistent.

Children with ADHD need consistent rules they can understand and follow.

Giving praise or rewards when rules are followed.

Children with ADHD often receive and expect criticism. Look for good behaviour, and praise it.

Autism

Autism Spectrum Disorder (ASD) is a developmental disorder that affects communication and behavior. Although autism can be diagnosed at any age, it is said to be a “developmental disorder” because symptoms generally appear in the first two years of life.

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience. Therefore, no two people with ASD have the same symptoms.

In 2013, the American Psychiatric Association merged four distinct autism diagnoses (autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome) into one umbrella diagnosis of Autism Spectrum Disorder (ASD).

The exact cause of ASD is not known but research suggests that a combination of genetic and environmental factors influence the development of autism. Although scientists are still trying to understand why some people develop ASD and others don’t, some risk factors include:

Having a siblings or other people in the family with ASD

Having certain genetic conditions—people with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have ASD

Exposure to drugs during pregnancy

Having older parents

Premature birth or very low birth weight

Autism is often accompanied by medical issues such as:

Gastrointestinal (GI) disorders

Seizures

Sleep disturbances

Signs of Autism usually appear by age 2 to 3. Often, it can be diagnosed as early as 18 months. Some associated development delays can appear even earlier.

The timing and severity of autism’s early signs vary widely. Some infants show hints in their first months. In others, symptoms become obvious as late as age 2 or 3.

Not all children with autism show all the signs. Many children who don’t have autism show a few. That’s why professional evaluation is crucial.

The following "red flags" may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician or a psychologist for an evaluation:

By 6 months

Few or no big smiles or other warm, joyful and engaging expressions.

Limited or no eye contact

By 12 months

Little or no babbling

Little or no back-and-forth gestures such as pointing, showing, reaching or waving

By 9 months

Little or no back-and-forth sharing of sounds, smiles or other facial expressions

By 16 months

Very few or no words. (no imitation or response)

Little or no response to name

Autism is characterized by marked difficulties in behavior, social interaction, communication and sensory sensitivities.

People on the spectrum may exhibit unusual behavior due to the difficulties they have in responding to their environment. Their behavior is generally an attempt by them to communicate their feelings or to cope with a situation. Behavior problems may occur as the result of their heightened sensitivity to a sound or something they may have seen or felt.

Some behaviors may include:

Unusual intense or focused interests

Repetitive body movements such as hand flapping and spinning

Repetitive use of objects such as repeatedly switching lights on and off or lining up toys

Sticking to routines such travelling the same route home each day and doing things in exactly the same order every time

Unusual sensory interests such as sniffing objects or staring intently at moving objects

Sensory sensitivities including avoidance of everyday sounds and textures such as hair dryers, vacuum cleaners and sand

People with autism often have communication difficulties in one form or another. There are some people with autism who speak fluently, others who are speech impaired to varying degrees and others still, who are unable to speak at all. Of those who can speak, they will often use language in a very limited or unusual way.

Response to many of the non-verbal forms of communication like facial expressions, physical gestures and eye contact is also very difficult for a person with autism. They are often unable to understand and express their needs just as they are unable to interpret and understand the needs of others. This impairs their ability to share interests and activities with other people. For this reason they may appear distant and aloof. Because they are often delayed in their speech and struggle to make sense of other non-verbal forms of communication, they may withdraw into repetitive play and behavior and avoid interaction.

Other difficulties with social interaction and communication are:

Limited use and understanding of non-verbal communication such as eye gaze, facial expression and gesture

Difficulties initiating and sustaining conversations

Lack of seeking to share enjoyment, interests and activities with other people

Repetitive use of language such as repeating phrases from television

There is no cure for autism, but early intervention using skills-training and behavior modification can yield excellent results. This type of educational and behavioral treatment tackles autism symptoms -- impaired social interaction, communication problems, and repetitive behaviors. It can also boost the chances of a child with autism being able to go to school and participate in typical activities

Educate yourself:

The first step to caring for a child with Autism is to find out everything related to Autism. Understanding about Autism will make you get more knowledge and it will be easier for you to know the child's needs and his abilities.

Start Early:

Early diagnosis and intervention is very essential for all children with disabilities.

Focus on the positive

Just like anyone else, children with autism spectrum disorder often respond well to positive reinforcement.

Always give love to your child:

Family affection especially parents love is the key to his/her optimum growth and development. ASD is a condition that will be experienced for life, but with the affection of the family, especially parents can make the child live longer, healthier and happier.

Recognize children's talents and focus children to develop their talents

The way to care for a child with Autism is to recognize the child's talents and focus the child to develop their talents. Even though these children have social communication and behavioral challenges, but if cared for properly and given appropriate therapy, education and training, children with Autism can also achieve.

Find schools that are suitable for children:

Children with ASD can go through schooling and can get jobs, which suits their strengths. A school should be able to provide services appropriate and suitable for your child. They should also provide an IEP which, meets your child’s needs enhances his abilities.

Stay consistent and on schedule:

People on the spectrum like routines and consistency. Talk to their teachers and therapists and try to work on a consistent set of techniques and methods of interaction in school and at home.

Give it time

You’ll likely try a lot of different techniques, treatments, and approaches as you figure out what’s best for your child. Stay positive and try not to get discouraged if they don’t respond well to a particular method immediately but instead give it time.

Involve your child for everyday activities.

If your child’s behavior is unpredictable, you may feel like it’s easier not to expose them to certain situations. But when you take them on everyday errands like or a post office run, it may help them get them used to the world around them so involve them in your everyday activities.

Get support:

Whether online or face-to-face, support from other families, professionals, and friends can be a big help. Support groups can be a good way to share advice and information and to meet other parents dealing with similar challenges. Think about what might make your life a little easier, and ask for help.

Cerebral Palsy

Cerebral palsy, or CP affects balance, movement, and muscle tone. “Cerebral” means the disorder is related to the brain, and “palsy” refers to weakness or a muscle problem.

Most people with cerebral palsy are born with it. That’s called “congenital” CP. But it can also start after birth, in which case it’s called “acquired” CP.

CP affects the area of the brain that controls the ability to move muscles. Cerebral Palsy can happen when that part of the brain doesn’t develop as it should, or when it is damaged right around the time of birth or very early in life.

People with cerebral palsy can have mild issues with muscle control, or it could be so severe that they can’t walk. Some people with CP have difficulty speaking. Others have intellectual disabilities, while many have normal intelligence.

Cerebral Palsy is caused by brain injury or brain malformation that occurs before, during, or immediately after birth while the infant’s brain is under development. But how a brain injury affects a child’s motor functioning and intellectual abilities is highly dependent on the nature of a brain injury, where the damage occurs, and how severe it is.

The brain damage usually occurs before birth, but it can also happen during birth or the first years of life.

Before Birth causes include:

Maternal exposure to toxic substances, such alcohol or drugs while pregnant

Maternal Infection such as German Measles and herpes simplex during pregnancy.

During Birth causes include:

Lack of oxygen to the brain during prolonged labour

Breech birth which occurs when your baby’s buttocks or feet come out first

Rh incompatibility which occurs when a mother’s blood Rh type is incompatible with her baby’s blood Rh type

Post birth causes include:

Jaundice in infants

Brain infections like meningitis

Head injuries or bleeding into the brain

The symptoms of CP vary from person-to-person and range from mild to severe. Some people with CP may have difficulty walking and sitting. Other people with CP can have trouble grasping objects.

The symptoms can become more severe or less severe over time. They also vary depending on the part of the brain that was affected.

Some of the more common signs include:

Delays in reaching motor skill milestones, such as rolling over, sitting up alone or crawling

Variations in muscle tone, such as being too floppy or too stiff

Delays in speech development and difficulty in speaking

Spasticity or stiff muscles and exaggerated reflexes

Lack of muscle coordination

Involuntary movements

Excessive drooling and problems with swallowing

Difficulty walking

favoring one side of the body, such as reaching with one hand

neurological problems, such as sezieures or intellectual disabilities.

The different types of CP are:

Spastic Cerebral Palsy

Spastic CP is the most common type of CP. It causes stiff muscles and exaggerated reflexes, making it difficult to walk.

Many people with spastic CP have walking abnormalities, such as crossing their knees or making scissor like movements with their legs while walking. Muscle weakness and paralysis may also be present.

The symptoms can affect the entire body or just one side of the body.

Dyskinetic cerebral palsy

People with dyskinetic CP have trouble controlling their body movements. The disorder causes involuntary, abnormal movements in the arms, legs and hands.

In some cases, the face and tongue are also affected. The movements can be slow or rapid and jerky. They can make it difficult for the affected person to walk, sit, swallow, or talk.

Diplegia

Both legs are affected. The arms may be affected to a lesser extent.

Mixed cerebral palsy

Some people have a combination of symptoms from the different types of CP. This is called mixed CP. In most cases of mixed CP, people experience a mix of spastic and dyskinetic CP.

Cerebral Palsy can also be categorized by the part of the body it affects.

Hypotonic cerebral palsy

Hypotonic CP causes very poor muscle tone and overly relaxed muscles. The arms and legs move very easily and appear floppy, like a rag doll.

Babies with this type of CP have little control over their head and may have trouble breathing. As they grow older, they may struggle to sit up straight as a result of their weakened muscles. They can also have difficulty speaking, poor reflexes, and walking abnormalities.

Ataxic cerebral palsy

Ataxic CP is the least common type of CP. Ataxic CP is characterized by voluntary muscle movements that often appear disorganized, clumsy, or jerky.

People with this form of CP usually have problems with balance and coordination. They may have difficulty walking and performing fine motor functions, such as grasping objects and writing.

Quadriplegia

Both arms and legs are affected. The muscles of the trunk, face and mouth are often also affected.

Hemiplegia

One side of the body (one arm and one leg) is affected.

A cerebral palsy diagnosis usually takes place anywhere between 18 months and 5 years of age. Parents and caregivers are usually the first to notice delays in a child’s development, which is one of the first signs of cerebral palsy. However, every child develops at his or her own pace, so doctors often hesitate to make an immediate diagnosis until further symptoms can be observed. A doctor will diagnose CP by taking a complete medical history, performing a physical exam that includes a detailed neurological exam, and evaluating the symptoms. Additional testing like EEG, CT scan or an MRI can

Early treatment for children with cerebral palsy is important because there are more opportunities to correct or improve some of the child’s mobility limitations during this time. The goal of treatment for CP is to improve limitations and prevent complications.

Treatment isn’t focused on curing or fully correcting a child’s CP. Rather, it’s about nurturing a child’s development so they can live as independently as possible. Many children with cerebral palsy are completely self-sufficient and have satisfying, meaningful lives. Actively treating the symptoms that coincide with CP is the best way to ensure the highest quality of life for a child as they transition into adulthood.

Treatment may include prescribing assistive aids, medications, and surgery. Parents should seek out a multidisciplinary team of specialists to effectively treat their child’s condition.

How to help my child with CP?

Cerebral palsy (CP) affects each person in a different way, so no two families have the exact same experience when they become involved in their child’s care. Whether your little one has mild or severe CP, there are a number of ways that you can help him do his best.

Stay on Top of His Care

As your child will visit a number of health care providers, its wise for you to stay informed about your child’s health. You’ll help make health decisions, learn which treatments and therapies work, and see when a treatment is a success or has setbacks.

Be Your Child’s at-Home Therapist

Therapy time doesn’t have to end when your time slot is over. If you learn the proper ways to help your child at home, you can help him stretch his muscles, build balance and reduce pain.

Help Him Be Active

Your child may not be able to play sports at the same level as his peers, but it’s important to get him moving to the best of his ability. Help him walk (if he can), play, and move as much as possible.

Teach him new skills, and he may use his muscles in new ways. Being active may strengthen his muscles, and it may help lead to fewer muscle spasms. People who are active have fewer health problems than people who never move around.

Help Him Expand His Mind

Help your child broaden his world:

Go to museums.

Work on art projects.

Listen to all types of music.

Play games together -- or create your own games.

Give your child a chance to take on an active role when you try new things. This type of experience may help him learn new skills, think about a problem from another angle, and have more self-esteem.

Focus on Diet

It’s wise to serve healthy food that can help strengthen bones and muscles. Some children with cerebral palsy may have weak bones. This is more likely among children who aren’t able to walk. Your child’s doctor may prescribe medicine, but -rich foods may help bone strength, too.

Keep a Bright Outlook

A child with cerebral palsy won’t be able to do all of the things that his siblings or peers can do, but he shouldn’t be upset by this or focus on his limits. Instead, help him realize all of the things that he’s able to do on his own or with help. If you always keep a positive attitude, your child should stay positive, too.

Get to Know Other Parents

You’re likely to meet other moms and dads in the doctor’s office or a physical therapist’s waiting room. It can help to build friendships with parents who are dealing with the same issues.

Down Syndrome

Down syndrome is one of the most common chromosome abnormalities in humans. Down syndrome (DS or DNS), also known as Trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is named after John Langdon Down, a British doctor who fully described the syndrome in 1866.

It is typically associated with physical growth delays, characteristic facial features, and mild to moderate intellectual disability. The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an 8 or 9-year-old child, but this can vary widely from person to person.

Down syndrome is caused by a random error in cell division that results in the presence of an extra copy of chromosome 21.

The type of error is called nondisjunction. Usually when one cell divides in two, pairs of chromosomes are split so that one of the pair goes to one cell, and the other from the pair goes to the other cell. In nondisjunction, something goes wrong and both chromosomes from one pair go into one cell and no chromosomes for that pair go into the other cell.

Most of the time, the error occurs at random during the formation of an egg or sperm. To date, no behavioral activity of the parents or environmental factor is known to cause Down syndrome.

Therefore, Down syndrome is not a hereditary disease but a genetic disorder that occurs when the baby is conceived as having an additional chromosome 21.

A person with Down Syndrome will show the following features:

Decreased or poor muscle tone

Short neck, with excess skin at the back of the neck

Flattened facial profile and nose

Small head, ears, and mouth

Upward slanting eyes, often with a skin fold that comes out from the upper eyelid and covers the inner corner of the eye

White spots on the colored part of the eye (called Brushfield spots)

Wide, short hands with short fingers

A single, deep, crease across the palm of the hand

A deep groove between the first and second toes

In addition, physical development in children with Down syndrome is often slower than development of children without Down syndrome. For example, because of poor muscle tone, a child with Down syndrome may be slow to learn to turn over, sit, stand, and walk. Despite these delays, children with Down syndrome can learn to participate in physical exercise activities like other children. It may take children with Down syndrome longer than other children to reach developmental milestones, but they will eventually meet many of these milestones.

Educate your self:

The first step to caring for a child with Downs Syndrome is to find out everything related to Down Syndrome (DS). Understanding about DS will make you get more knowledge and it will be easier for you to know the child's needs and his abilities.

Start Early:

Early diagnosis and intervention is very essential for all children with disabilities.

Recognize children's talents and focus children to develop their talents

The way to care for a child with Down syndrome is to recognize the child's talents and focus the child to develop their talents. Even though these children have mental and physical challenges, but if cared for properly and given appropriate therapy, education and training, children with Down syndrome can also achieve

Visiting doctors regularly

Most children with Down Syndrome have associated health problems. Some children have congenital heart disease, muscular disorders, hearing problems, sightings and cancer of white blood cells (leukemia). Visiting a doctor on a regular basis can help overcome the disease suffered by children.

Find schools that are suitable for children

Children with Down syndrome also have the same rights as normal children to get an education. A school should be able to provide services appropriate for a DS child. They should also provide an IEP which, caters to your child’s needs enhancing his abilities.

Always give love to children

Family affection especially parents love is the key to his/her optimum growth and development. Down syndrome is a condition that will be experienced for life, but with the affection of the family, especially parents can make children with Down syndrome live longer, healthier and happier.

Intellectual Disability

Intellectual disability is an umbrella term that describes problems with how a person thinks and understands things. A child with Intellectual disability might have difficulty communicating, remembering, learning, paying attention or thinking clearly. Some people with intellectual disability will also have trouble learning and functioning in everyday life, they will find it hard to carry out daily, common tasks or to recognise people or objects. For example, this person could be 10 years old, but might not talk or write as well as a typical 10-year-old. He or she also is usually slower to learn other skills, like how to get dressed or how to act around other people.

Intellectual disability is a cognitive impairment and can be more common in conditions such as:

Down syndrome

Autism

Fragile X syndrome

Cerebral Palsy

The causes for Intellectual Disability can be varied. These causes can be grouped into categories:

A. Medical conditions that lead to intellectual disabilities fall into three groups.

1) prenatal exposure to alcohol and other drugs;

2) exposure to certain toxins; and

3) some types of infections during pregnancy

4) Difficulty during labour

5) Infections or health conditions (such as menengities) of the infant.

B. Brain injury or stroke is another cause of intellectual disability. This can be caused due to accidents at any age.

C. Genetic causes of intellectual disability. The two most common chromosomal abnormalities are Down syndrome and fragile X syndrome.

Individuals with Intellectual Disability show symptoms by having delay in their developmental milestones. The deficits then manifest itself at various levels:

Conceptual Domain

Slow language development (children learn to talk later, if at all)

Slow development of pre-academic skills

Difficulties in academic learning (reading, writing, mathematics)

Difficulty understanding concepts of time and money

Problems with abstract thinking (concrete approach to problem solving)

Problems with short-term memory

Difficulties with functional use of academic skills such as money management and time management

Practical Domain

Requiring different levels of support for daily life activities such as

Personal care

Complex tasks (e.g., shopping, transportation, care organization, meals, money management)

Health care and legal decisions

Household tasks

Recreational skills

Social Domain

Limitations in language and communication skills

More concrete and less complex spoken language (if used), compared with peers

Limited vocabulary and grammatical skills

Receptive language that may be limited to comprehension of simple speech and gestures

Communication that may occur through nonspoken means only—such as gestures, signs, facial expressions, and other forms of augmentative and alternative communication (AAC)

Social Skills

Immature social judgment and decision making

Difficulty understanding peer social cues and social rules

Intellectual disability is diagnosed through the use of standardized tests of intelligence (testing a person’s I.Q.) and adaptive behavior (the ability of a person to function and perform everyday life activities). The clinical psychologists are eligible for conducting these tests and diagnosing your child.

It is important to do a variety of tests like hearing and vision tests to rule out other diagnosis. In case of a genetic or medical condition, doctors may event suggest blood tests or brain scans to get more evidence and a detailed analysis.

Steps to help your intellectually disabled child include:

Educate yourself

Learn everything you can about intellectual disabilities. The more you know, the better advocate you can be for your child.

Do not give up

Encourage your child’s independence! Let your child try new things and encourage your child to do things by himself or herself. Provide guidance when it’s needed and give positive feedback when your child does something well or masters something new.

Find the appropriate school

Find a school that will provide and fulfil the needs of your child and believe in your child’s abilities.

Encourage social activities

Get your child involved in-group activities. Taking an art class or participating in school group activities will help your child build social skills.

Stay involved

By keeping in touch with your child’s teachers, you’ll be able to follow his or her progress and reinforce what your child is learning at school through practice at home.

Learning Disability

A learning disability is a neurological disorder. In simple terms, a learning disability results from a difference in the way a person's brain is "wired."

Learning disabilities affect how a person learns to read, write, speak, and do math. They are caused by differences in the brain, most often in how it functions but also sometimes in its structure. These differences affect the way the brain processes information

Learning disabilities are often discovered once a child is in school and has learning difficulties that do not improve over time. A person can have more than one learning disability. Learning disabilities can last a person’s entire life, but he or she can still be successful with the right educational supports.

Some of the most common learning disabilities are the following:

Dyslexia.

People with dyslexia have problems with reading words accurately and with ease (sometimes called “fluency”) and may have a hard time spelling, understanding sentences, and recognizing words they already know.

Dysgraphia.

People with dysgraphia have problems with their handwriting. They may have trouble forming letters, writing within a defined space, and writing down their thoughts.

Dyscalculia.

People with this math learning disability may have difficulty understanding arithmetic concepts and doing addition, multiplication, and measuring.

Apraxia of speech.

This disorder involves problems with speaking. People with this disorder have trouble saying what they want to say. It is sometimes called verbal apraxia.

Central auditory processing disorder.

People with this condition have trouble understanding and remembering language-related tasks. They have difficulty explaining things, understanding jokes, and following directions. They confuse words and are easily distracted.

Nonverbal learning disorders.

People with these conditions have strong verbal skills but difficulty understanding facial expression and body language. They are clumsy and have trouble generalizing and following multistep directions.

There is no single, specific cause for learning disabilities. However, there are some factors that could cause a learning disability:

Heredity

A child, whose parents have had a learning disability, is likely to develop the same disorder.

Illness during and after birth

An illness or injury during or after birth may cause learning disabilities. Other possible factors could be drug or alcohol consumption during pregnancy, physical trauma, poor growth in the uterus, low birth weight, and premature or prolonged labor.

Stress during infancy

A stressful incident after birth such as high fever, head injury, or poor nutrition.

Environment

Increased exposure to toxins such as lead (in paint, ceramics, toys, etc.)

Learning disabilities are not caused due to physical or mental illness, economic condition, or cultural background; neither do they indicate that the child is weak or lazy.

In normal development, the child is expected to acquire a certain set of basic cognition and motor skills. Any significant delay or gap in this development could be a sign of learning disability.

The signs of LD may vary slightly during each stage of childhood. The following table shows the delay and difficulties at different levels.

Preschool

Delay in speech, Pronouncing simple words, Recognizing letters and words, Learning numbers, rhymes or songs, concentrating on tasks, Following rules and directions

Middle & High School

Spelling similar words (sea/see, week/weak)

Reading aloud, writing assignments, solving word problems in maths (the child may avoid doing tasks involving these skills)

Primary school

Connecting letters and sounds, Differentiating between similar sounding words or rhyming words, Reading, spelling, or writing accurately

Distinguishing right from left, for example, confusing 25 with 52, “b” with “d,” “on” with “no,” “s” with “5”Recognizing letters of the alphabet

Using correct mathematical symbols for doing maths problems

Remembering numbers or facts Slow in learning new skills Understanding the concept of time Hand-to-eye coordination, being unable to gauge the distance or speed, thus leading to accidents Tasks involving fine motor skills: holding pencil, tying shoe lace, buttoning shirt and so on Keeping track of own possessions like stationery items

Handwriting (child may grip the pencil tightly)

Memorizing or recalling facts

Understanding body language and facial expressions

Spelling words accurately (the child may write the same word with different spellings in a single writing assignment)

Difficulty in reading and writing tasks

Poor memory

Adjusting to new surroundings

Understanding abstract concepts

Focusing consistently: the child may lack concentration on some tasks, while focusing excessively on others

Children with learning disabilities have difficulties in some areas of learning, they also have great aptitude, skill and talent in other areas of their interest.

Identifying a learning disability is a complex process.

The first step is to rule out vision, hearing, and developmental issues that can overshadow the underlying learning disability. Once these tests are completed, a learning disability is identified using psychoeducational assessment, which includes academic achievement testing along with a measure of intellectual capability. This test helps determine if there is any significant difference between a child's potential and performance capability (IQ) and the child's academic achievement (school performance), which indicates Learning Disability.

A learning disability cannot be cured. However with timely intervention and support, children with learning disabilities can be successful in school. Parents and teachers are the first persons to notice that the child is finding it difficult to read, write or learn. If you think that your child may have a learning disability, seek help from a psychologist or other trained specialists for the required intervention program or therapy.

Note: Early detection can help the child benefit from treatment or therapy. Neglecting the condition may affect the child's ability to cope with the condition.

If your child has a learning disability, you can:

Give encouragement

All children need love, encouragement, and support, and for kids with learning disabilities, such positive reinforcement can help ensure that they emerge with a strong sense of self-worth, confidence, and the determination to keep going even when things are tough.

Therapy

Depending on the learning disorder, some children might benefit from therapy. For example, speech therapy can help children who have language disabilities. Occupational therapy might help improve the motor skills of a child who has writing problems.

Be an advocate for your child

You may have to speak up time and time again to get special help for your child at school and at home. Embrace your role as a proactive parent and work on your communication skills. It may be frustrating at times, but by remaining calm and reasonable, yet firm, you can make a huge difference for your child.

Extra help

Give your child extra professional help. A trained professional can teach your child techniques to improve his or her academic skills. You can also teach children organizational and study skills.

Individualized Education Program (IEP):

Your child's school or a special educator should develop an IEP that will describe how a child can best learn in school. They should also state the accommodations that your child will require in school and for exams.

Focus on strengths

Your child is not defined by his or her learning disability. A learning disability represents one area of weakness, but there are many more areas of strengths. Focus on your child’s gifts and talents and nurture them.

Speech or Language Delays

Speech Delay, refers to a delay in the development or use of the mechanisms that produce speech. Speech is different from language. Speech is the actual process of making sounds, using such organs and structures as the lungs, vocal cords, mouth, tongue, teeth, etc. While, language delay refers to a delay in the development or use of the knowledge of language. It's understanding and being understood through communication — verbal, nonverbal, and written.

Language and speech are two independent stages and they may be individually delayed. For example, a child may be delayed in speech (i.e., unable to produce intelligible speech sounds), but not delayed in language. In this case, the child would be attempting to produce an age appropriate amount of language, but that language would be difficult or impossible to understand. Conversely, since a child with a language delay typically has not yet had the opportunity to produce speech sounds, it is likely to have a delay in speech as well.

A baby who doesn't respond to sound or who isn't vocalizing should be seen by a doctor right away. But often, it's hard for parents to know if their child is just taking a little longer to reach a speech or language milestone, or if there's a problem that needs medical attention.

Here are some things to watch for. Call your doctor if your child:

by 12 months

isn’t making different kinds of sounds to express feelings

isn't using gestures, such as pointing or waving bye-bye

by 18 months

prefers gestures over vocalizations to communicate

has trouble understanding simple verbal requests

by 2 years

can only imitate speech or actions and doesn't produce words or phrases spontaneously

says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs

Can't follow simple directions

Has an unusual tone of voice (such as raspy or nasal sounding) which is more difficult to understand than expected for his or her age

3-4 years

Parents and regular caregivers should understand about half of a child's speech

A speech delay in a child can be due to a number of reasons. For a normally developing child, it might be due to an oral impairment, like problems with the tongue or palate (the roof of the mouth). A short frenulum (the fold beneath the tongue) can also limit tongue movement for speech production.

Sometimes speech delays may happen due to oral-motor problems. These are caused because some areas in the brain responsible for speech is unable to coordinate with the part of the body responsible for the production of speech sounds like the lips, tongue, and jaw. These kids may also face other oral-motor problems, such as feeding difficulties.

Hearing problems are also commonly related to delayed speech. That's why an audiologist should test a child's hearing whenever there's a speech concern. Kids who have trouble hearing may have trouble articulating as well as understanding, imitating, and using language.

If you think that your child might have a problem, it's important to get an early evaluation by a speech-language pathologist.

The speech-language pathologist will evaluate your child's speech and language skills within the context of total development. The pathologist will do standardized tests and look for milestones in speech and language development.

The speech pathologist may also refer your child for a hearing test. Based on the test results, the speech-language pathologist might recommend speech therapy for your child.

Parental involvement is an important part of helping kids who have a speech or language problem. Here are a few ways to encourage speech development at home:

Spend a lot of time communicating with your child. Even during infancy — talk, sing, and encourage imitation of sounds and gestures.

Read to your child. Start reading when your child is a baby. Look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.

Use everyday situations to reinforce your child's speech and language, talk your way through the day. For example, name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear. Ask questions and acknowledge your child's responses.

Keep things simple, but avoid "baby talk."

Recognizing and treating speech and language delays early on is the best approach. With proper therapy and time, your child will be better able to communicate with you and the rest of the world.