Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviours (may act without thinking about what the result will be), or be overly active. It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviours. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might: daydream a lot, forget or lose things a lot, squirm or fidget, talk too much, make careless mistakes or take unnecessary risks, have a hard time resisting temptation, have trouble taking turns, have difficulty getting along with others. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms.

In most cases, ADHD is best treated with a combination of behaviour therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behaviour therapy, particularly training for parents, is recommended as the first line of treatment. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist or developmental paediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

Hearing Impairment And Impact of Hearing impairment

Hearing Impairment

Any deviation from the limits of normal hearing is defined as hearing impairment. Hearing sensitivity of each ear is measured separately and the degree of hearing impairment/ hearing loss is generally classified in five categories and additional category-slight hearing loss is added between the normal hearing and mild hearing loss especially when assessing the hearing sensitivity of the young children. Table 1 shows the classification of severity of hearing impairment.

              

                 Classification                                                                        PTA range in dBHL

Normal Hearing                                                                   -10 to 15

Slight Hearing Loss                                                               16 to 25

Mild Hearing Loss                                                                26 to 45

Moderate Hearing Loss                                                      46 to 55

Moderately – Severe Hearing Loss                                   56 to 70

Severe Hearing Loss                                                            71 to 90

Profound Hearing Loss                                                       91 and more

     

Table 1. Classification of hearing impairment severity

Impact of hearing impairment

                   

Consequences of hearing impairment will depend on the ears involved, degree of hearing loss, type of hearing loss and age at onset of hearing impairment. Usually, it is assumed that if hearing impairment is only in one ear, person may not have any serious problems in terms of listening. However, research has indicated difficulty to localize, reduced speech discrimination and lower speech and language development leading to significant effect on educational, linguistic and auditory perceptual development of children.

Degree of hearing impairment is of major factor leading to the negative impact on the social, educational and economical development of the individual. Mild hearing impairment may not place persons in disadvantageous position to hear and communicate but the higher degree of hearing impairment can put the person daily living in a very difficult position as he/she will need some assistance. Generally, people speak while involved in conversation at 65dBSPL. If a person has hearing impairment of 60dBHL or more he/she will find problems in verbal communication. This level of hearing impairment has been equated as 40% hearing impairment as in persons with disability(Full participation, equal opportunity and protection of rights) act 1995. Thus the definition of hearing disabled as stipulated in the PWD Act 1995 is a person who has minimum of 60dBHL of hearing impairment in the better ear in speech conversation frequencies.

…… Reference is taken from "Sfuran"

Govt. of West Bengal

Understanding Hearing Impairment

Hearing is one of the vital sense organs, which facilitates the social and economic development of the individual. Two ears provide the binaural advantage of hearing so that one can able to localize the source of the sound and judge the distance of the source of the sound. Because of the complex structure of the inner ear, one can able to distinguish minor differences in intensity, frequency and duration of sounds, which is importantly used for discrimination of speech sounds. Thus hearing plays an important role in learning the verbal language. Physiologically ear respond to sounds having the frequency between the 20Hz to 20000Hz when the air pressure equal to or more than 0.0002 dynes per sq. cm is created by any vibrating object. It is also found that binaural hearing thresholds are better than monaural hearing thresholds providing the advantage of ease of listening. Adults with no history of ear problem have a pure tone threshold average for the frequency of 500Hz, 1000Hz, and 2000Hz within 25dBHL. In children, the normal hearing limit shall be 15dBH, as the lower level for normal hearing norms was considered keeping in view of the importance of hearing during the language and speech learning period at an early age.

…… To be continued 

Reference from Sfuran

          Govt. of West Bengal

The Magnitude of the Hearing Impairment

As on 1^st March 2001, Indian population stands at 1,027,015,247 and projected population in 2016 will be 1, 263,543,000. (Census of India, 2001). With the present set of a concept of hearing disability, the Census of India, 2001 counted 1,261,722 people in whom hearing disability exists (Males 53.4% and Females 46.59%). Majority of persons with hearing disability reside in rural India (81.06%) except in the Union territory of Chandigarh. Delhi, and Daman and Diu.

NSS 58^th Round of Survey estimated persons with disability to be 18.49 million (1.8% of the total population). 10% of the persons with disability are likely to have the hearing disability of moderate to profound degree. This number is likely to go high if we have to add hearing disability of lower degree.

…… Reference from Sfuran

Govt. of West Bengal

How to Cope up with Stress?

How to Cope up with Stress?

“Stress” is a condition which we experience when we cannot meet up with the expectations of self or the Environment. The biggest myth is that only adults experience stress but out of my experience I have learned that an infant also suffers from stress which is unexpressed.  For example, a child has set a goal for himself/herself to achieve and supposedly he/she fails to accomplish at that moment this child might undergo stress. On the daily basis every individual at some time experience this condition. But the symptoms and stressors vary person to person.

If we discuss about children there are very many stressors in their life like: they have to look “cool” among their peers, they have to maintain their academic performance, and they also have to maintain a good “virtual image”. So, somehow while managing all these children loose the equilibrium and undergo stress which sometimes leads to Depression.

Symptoms of stress:

• Becoming easily restless, irritated, and temperamental
• Having difficulty calming and quieting your mind
• Feeling bad about yourself (low self-esteem), lonely, worthless, and depressed
• Avoiding others
• Lack of  energy
• Headaches
• Upset stomach, including diarrhea, constipation, and nausea
• Aches, pains, and stressed muscles
• Chest pain and rapid heartbeat
• Insomnia
• Recurrent colds and infections
• Nervousness and trembling,  cold or sweaty hands and feet
• Continuous worrying
• Racing thoughts
• Inability to focus
• Changes in appetite -- either not eating or eating too much
• Exhibiting more nervous behaviours, such as nail biting, fidgeting, and pacing

Ways to cope up with stress:

• -          Exercise daily
• -          Reduce your Caffeine intake
• -          Reduce junk food
• -          Increase intake of green vegetables and fruits
• -          Sleep well
• -          Write and discuss the problem
• -          Make a to-do list
• -          Be assertive
• -          Stop procrastination
• -          Deep breathing
• -          Listen to music
• -          Read positive literature
• -          Discuss the problem
• -          Focus on the solution
• -          Talk to professional

These are the few ways to deal with stress. If we can opt and implement even few of them it may become easier to cope up with such situations. A person with stress can also approach to professional like a counselor or psychotherapist who can connect them to the environment and themselves by individual and group therapy sessions.

Written by

Archana Sharma

Counselling Psychologist

Challenging Dejection By Parents of Special Need Children

  Challenging Dejection By Parents of Special Need Children

......taken from Sfuran (Commissioner Disability)

The nature and content of parental depression vary according to the specific personal and interpersonal situations and temperament of the parents: some blame themselves, some blame others, some have intense anxiety along with depression, some have crying spells, some resign early to fate and some become abusive. Also, parental depression occurs in different phases and takes different forms accordingly. For example, the anxiety and attribution of blame in the pre-diagnostic stage of uncertainty is very different from the post-diagnostic feeling of subsequent fatigue of prolonged caring. Again, the age of the child and the parent is a significant factor. The parental stress increases when the child reaches adolescence and also when the parents reach middle age. The relative share of depression and anxiety depends on socio-economic condition, the extent of socially embarrassing or disruptive symptoms of the child and social support.

Autism Basics

Autism Basics

(Last Part)

---- taken from an article of K. S. Adhikaree, Ex Asstt. Commissioner

In determining the degree of abnormality peculiarity, frequency, intensity, duration, of behaviour are also to be considered along with child’s chronological age.

Management – As it is not a disease no question of treatment may arise. Therapies, intervention, properly designed to remedy specific symptoms – educational, behavioural and medical are to be developed to bring substantial development. A very small proportion of those with childhood autism can lead independent adult life. There is rather a better prospect for a child with Asperger syndrome. The autistic children with mental retardation, epilepsy or other associated ailments will have restricted lifestyle in adulthood. Out of many interventions, educational and psychological are most effective. Before designing intervention a multidisciplinary team consisting of Psychologist, Psychotherapists, Speech Therapist, behaviour therapists, special educator, doctor and rehabilitation professionals and others should be formed comprehensive need assessment. ECE in Anganwadi Centres may yield a good result for the children with autism as they may learn language from other children. Every task of intervention should be developed step by step. Parental choice is always an effective guide for overall development but parents should not be over expectant or opposite. The doctor should be more cautious to declare a child AUTISTIC.