Let the action begin!!*

Dr.S.Subramanian

Autism has been recognized as a neurological condition characterized by difficulty in social skills of those afflicted. Autistic people do have emotions and empathy. They are not a class to be condemned. Many have good intelligence. 

Autism as a condition has gained global attention in the recent past. With evolving research and ideologies focusing on causes, prevention and therapies the need of the hour is for us the general society to understand the context and concepts behind it. As with any evolving field, there are going to be new theories postulated and certain old thoughts thwarted. We have to be mature and dynamic enough to accept the ones with solid scientific base and reject the flawed ones. 

More than lack of understanding, a major dissuader in autism awareness is the set of myths associated with it. It takes a very short time span for the myths to spread while it takes a painstaking effort to remove those. One of the popular misconceptions was linking childhood vaccines to be a trigger. This notion is still in the minds of many while it has been scientificallyproved and accepted by the medical fraternity that vaccinations do not contribute to autism.Another misconception was that parenting style is a contributor to autism, with autistic kids lacking the maternal warmth in their upbringing. 

“Vasudaiva kutumbakam”, is a popular quote by many. It means the world is a family. Is it not time we extend this into action? If one among the family is different, we do our best toaccommodate their interests, we try to understand them. Same goes to our autistic brethren. While they take their strides towards progress, we the more mature and supposedly better endowed with social skills need to be accommodating them as part of our society.  We need to facilitate the social life of autistic people. Try to be empathetic, teach young ones to accommodate such people in peer groups. Be it school or workplace or a public forum, let us welcome them. Please remember they do not need our sympathy, we need to understand and accommodate them.  

While science strives to help the cause of autism, I strongly believe the society is the biggest contributor in empowering the autistic. 

As a pediatrician, it is heartwarming to see many children cruise out of illness. But I do not want to stop at that. I want to see what we can do as a society to help the not too lucky among us. Chennaiites are known for their activism for a cause. Be it flood relief or jallikattu protest. I want the youth to use their power of viral uprising to understand, facilitate and fight for the cause of a dignified life for the autistic. Are you with me?

*This article is reproduced from the Autism awareness booklet by Nishta Neurodevelopment Centre 

FLAT FEET

Here are a few facts about FLAT FEET, shared by our physiotherapist Mr.Lokesh Kumar.

What are flat feet?

 Most adult feet have an arch along the inside edge of the foot. Flat foot is when this arch is apparently absent or reduced in standing. The arches may ‘appear’ when your child is sitting, when the big toe is bent backwards or if your child stands on tiptoe. Before the age of 3 all children have flat feet, as the arch on the inside of the foot does not begin to develop until after this age.

What causes flat feet?

 The many bones in the feet are held together by stretchy bands called ligaments. Flat feet are usually due to loose or soft ligaments and baby fat between the foot bones. This causes the arch to fall when your child stands up which is why flat feet are sometimes called “fallen arches”. The typical flat foot is flexible and most children have no symptoms. Flat feet can occasionally be caused by tight muscles, which is more likely to cause pain. There are different terms that are used to describe flat feet but essentially they all mean the same thing.

 They are: · Pes planus · Pes valgus · Pronated feet · Fallen arches

Will my child need treatment?

 If your child does not have any associated problems with their flat feet then they are unlikely to need treating. Many people have a long -standing belief that flat feet are abnormal and require treatment with special shoes, insoles or even splints or braces. We now know that the majority of children between 1-5 years of age have flat feet. This is part of normal development of their feet and over 95 percent of children grow out of their flat feet and develop a normal arch. The other 5 percent continue to have flat feet, but only a small number will ever have a problem. Most children with a persistent flat foot participate in physical activities, including competitive sports, and experience no pain or other symptoms. It is less important how your foot looks as to how it functions. However, if your child complains of foot, ankle or knee pain, or has poor balance, or poor stamina in walking, then a referral to see a physiotherapist may be necessary. They can then assess the problem and treat appropriately if required.

 What would be the treatment?

 Treatment for a more severe or painful flat foot can consist of exercises and/or stretches for your child to do. It can also include your physiotherapist referring your child to an orthotist or podiatrist who specialise in providing corrective devices such as arch supports (insoles) to put in your child’s shoes. Most children with painless flexible flat feet do not need any treatment. Insoles will not change the shape of the foot and are therefore not a ‘cure’; they simply hold the foot in a better position so that it can work more effectively and may help reduce some of the symptoms.

 Will anything make it worse?

 No, you do not need to restrict your child’s activities. Walking barefoot, running, doing foot exercises or jumping will not make flat feet better or worse. Supportive footwear is always recommended for your child’s feet.

 

MATHLOGIC OR MATHEMAGIC?

Is Math Magic or Logic?

Too often, we are puzzled with the topic in question – Is math a magic or logic? Let’s unfold the logic behind the magic.

Math is based on pattern, language, symbol, and visuo-spatial aspects.  If we can appreciate the importance of these aspects, math can be a cakewalk. The first step toward decoding the logic is to understand the various operators, symbols and remember them. Then the logic behind each one of them can be revealed and as it unfolds, one can work magic with it.

Based on language and symbol math is a logic. For example let’s take the word “Volume”. Volume of a cone is different from volume of a radio or voluminous meaning volume of a book.

When we take a symbol at the elementary level, the four main operations are plus, minus, multiply and division. When we take the operation of division the symbols that are introduced for the same concept are first L  then ) followed by) ---- (   and of course /.  

In the above concept, the visuo spatial aspect is concerned and the visuo spatial is connected to pictures with magic and the space it occupies is logic.

Let’s see the magic. For example 4.1.2018 can be written as 2 ².1 ². 4² + 4 4 ²+2. Isn’t this pattern a magic?

So from 0 to 9 the numbers with their vibrant patterns, language, symbol and visuospatial profile make Math Magic and Logic too!! You can work magic if you can first understand the logic. It is indeed fun!!

Mrs.Sujatha Sriram

Department Head of Special Education

Nistha Center

 

                                                                

 The role of routine in your child's life!!

Routines help children do better with everyday tasks, boosts confidence to handle life and can be used to help the child meet developmental milestones through early intervention.

Three types of routines are vital

Transition routines
They help your child switch from one task to other with ease.  For instance if it is lunch time after a reading session, plan a reading activity on food at the end which would remind the child of food and what to expect next. Plan transitions for every activity right from therapy sessions to fun time. This will help the kid internalize changes in activity.

Intervention routines

You might be taking your kid for therapy sessions where they will be taught new skills as part of interventions. Combining those interventions with the child's daily routine can make it far more effective compared to therapies that occur only during the therapy sessions. For instance, for a child with delayed language development, you  could say the same phrase every time the child takes a bath so that the child learns to associate those words with the activity.

Play routines

Routines can be especially effective during playtime because the child is more likely to be fully engaged in the activity. For instance, a child being taught to button a shirt can be engaged in a dressing up game for a toy and this can be repeated every day so that the child picks up the ability. Later the game could be modified by playing the game with self- buttoning.

The above are few instances where routines help a child have a grip over daily activities.

MULTIPLE INTELLIGENCE

Multiple Intelligence- a Pediatrician's perspective

 

Dr.S.Subramanian

 

 The variety and dynamism that I see in the children that come to me, enthuses me.  Alas! I find that most of the time, their potential is not brought out.  I keep pondering if there could be a means to tap the apt means to bring out the best in every child.  Multiple Intelligence could be one way to do so.

 

Dr Howard Gardner, Prof of education in Harvard University developed this theory of Multiple Intelligence. This has helped educators, psychologist and parenting experts understand how children process and learn information.

This is a theory that directly challenged the traditional understanding of intelligence and its evaluation.

According to this theory every child has seven different intelligence. Once we understand this, it becomes easy to present a given information in a pattern that may best suit a given child.

The domains are (as seen in the picture)

Linguistic, logical- mathematical, spatial, bodily-kinaesthetic, musical, interpersonal, intrapersonal, natural and existential.

How are we to use this theory best? Though there are multiple ways in which this theory an be successfully applied in a daily life or class room setting, like any other idea, there has been an array of offshoots and methodologies that claim to have originated from MI theory. Dr Gardner, himself has suggested three possible ways in which this theory can be applied in day to day setting.

1.       Multiple approaches to a concept, subject matter or discipline- creating variety of ways in which a single item can learnt. The more the number of approaches more likely that more children are understanding the concept better. This can be especially be done to make children understand and explore and get hands- on with respect to certain important concepts.

2.       Personalisation of education: understanding a child's strength and understanding that essentially all of us are different in the way we approach a learning. MI theory takes this concept seriously. As a corollary, when the aim is to help a child understand a key concept or help a child understand a specific field of learning it needs to be individualised to the child's strength based on MI.

3.       Cultivation of desired capabilities: schools should plan to cultivate skills and capabilities that are highly valued in a given society. For eg if in a community performance of musical instrument is considered important, then it is important and of high value for schools to cultivate intelligence related to that domain.

Yes, multiple Intelligence does explain to us why a given child takes to a specific domain like music or public relation easily. But it also gives us approach or pathways to reach, teach and inculcate concepts that are considered important for a child to be part of the community as a whole.

 

Positive impact of Yoga based interventions in Autism

Mrs.Nrithya Jagannathan – Senior Consultant
Krishnamacharya Yoga Mandiram

Interventions that integrate the various tools of yoga can have a significant positive impact on children and adults in the autism spectrum.

 As is already known, at a purely physical and physiological level, yoga contributes to an overall improvement in metabolism, energy, stamina and immunity. Further, early yoga intervention can also contribute to enhancement of gross and fine motor skills, which may be delayed in some children.  Thus, the regular practice of yoga under competent guidance can improve quality of life of autistic children and adults

While children in the autism spectrum are often intelligent and very capable of comprehending and following instructions and even practicing independently, many have difficulties in relating to people and changing environments. The most important aspect of such applied yoga interventions is the development of a bond between the teacher and student. In creating a neutral and non-judgmental environment a good yoga therapist is able to help children with autism cope with social anxiety. Yoga, with its onus on stimulating the parasympathetic nervous response offers a very simple and yet powerful means to help these children manage their anxiety and also function with ease and confidence.

 Another aspect to the efficacy of yoga interventions specifically for autism is the creation and establishment of a routine practice, which is another area that these children may struggle with. Here again, the relationship with the teacher plays a key role.

 Depending on where a child is in the autism spectrum, it is possible to introduce simple chants, technique of breath regulation and also visualization. Some interventions can be applied in a group setting, while other children, especially those on the far end of the spectrum may require individualized attention.

Often a therapist may also integrate tools of yoga with other techniques such as singing, counting, coloring etc. for better effect.

All things considered, in the present times, the appropriate application of yoga based techniques under the guidance of a qualified care provider can go a long way in helping children in the autism spectrum at multiple levels - physically, physiologically, cognitively and emotionally.

MULTILINGUALISM - AN OUTLOOK

MULTILINGUALISM - AN OUTLOOK

Ms. Devi Jessie Mary

Speech and Language Pathologist

To better understand the topic of conversation, let’s first understand what exactly the term ‘LANGUAGE’ means.

LANGUAGE is a form of human communication
                        is formed by symbols
                        is constructively and systematically structured
                        is in both oral and or text form
                        is used in a conventional manner
                     

Looks complex, doesn’t it? Imagine this language learnt, in two different forms. Complexity goes up a notch. Individuals who speak two languages are called “Bilingual” and those who speak more than two are called “Multilingual”. This is the idea we are going to be looking into.

Now, to dive head-first: The general question that is frequently asked, “Will my child being exposed to two languages, cause speech delay?” or on the other end of the spectrum, “Is the reason for my child’s speech delay because we speak two languages at home? –

This article looks into the frequent myths and facts often discussed in our scientific forum. For your eyes, let’s blast a few popular myths with scientifically proved beliefs:

1

Myth: Newborn babies cannot recognize language distinction when exposed to the same.

Fact: Infants can recognize the language they are most exposed to and turn their heads towards the familiar language more than any other language. The exposed language and its spoken forms with the intonation patterns, rhythm and pitch are already in familiarity with the child. Infants hearing and interacting with adults in two languages know from the beginning that there are more than one system in use and can distinguish between them easily.

2

Myth: Bilingual at minimal is alright but more than two languages is a definite no-no !!

Fact: As long as, the child receives constant interactive exposure to the language, there should be no trouble learning two or three or more languages.

3

Myth: Multilingual children exhibit delay in development compared to monolingual peers.

Fact: Research suggests differently. Children exposed to two or more languages, develop in the same manner as children exposed to a single language, i.e. they meet their developmental milestones appropriately, in the absence of any developmental disorders.

4

Myth: Children when exposed to a language, just pick it up!!

Fact: A prevailing idea is that it is very easy for children to learn a new language and there is minimal effort involved. It is not so. Language is very complex, it takes a life-time to learn the nuances of the language and to become a master of the same. Language development in the earlier stages of development consists of vocabulary knowledge, which progresses into sentence formulation and advances into conversations as well as advanced language functions. The more the child is exposed to the language, the more he/she will learn and will become a confident user of the language.

5

Myth: Learning two languages or more confuses the child and impairs his/her cognitive ability (i.e. their ability to think and learn).

Fact: Most often, this advice is provided under the misconception that the child’s brain can pick up only one language. Not true!! As a matter of fact, the child’s brain development and cognitive ability is highly enhanced during the developing period. Contrary to the myth, there is scientific evidence that well-developed (multiple) language actually enhances an individuals’ cognitive flexibility – that is bilingual speakers, especially children are better able to see things from two or more perspectives and to understand how other people think. They also have better auditory language skills (i.e.) they can discriminate the sounds of the language better and they mature earlier in terms of ability to think and talk about language.

6

Myth: The child’s brain cannot handle more than one language at a time, let alone proficiency.

Fact: Children under two years old are particularly proficient at learning two languages at once because the human brain has its highest receptivity for language at this time. It has been found that children can acquire more than one language spontaneously up to approximately eight years of age, although they need to be exposed to a variety of spoken and written forms to develop full competence. Therefore, to use a language proficiently during the early years of development requires a certain amount of problem solving and more so when a young child is learning second or third language which is different from the community of speakers.

7

Myth: Children exposed to two or more languages will be slow thinkers.

Fact: Until the 1960s, research suggested that bilingual children acquired language more slowly than monolingual children and achieved smaller vocabularies. But recent studies have pointed fingers in the opposite direction. It is suggested that children who speak more than one language constantly use superior executive function of the brain as they develop and mature, compared to their monolingual peers. What is this executive function of the brain?? It is an umbrella term for the management (regulation, control) of cognitive processes including working memory, reasoning, flexibility and problem solving as well as planning and execution.

Now, you tell me: “Is multilingualism a danger for childhood development?” Collective expert opinion: No!! Rather, the benefits of multilingual speech towards better cognitive development and critical thinking is supported by numerous researchers.

Then, why are you advised against the same? Please understand that the recommendation is not a general one. It is specifically given for parents who express concern towards the child’s language development, when the child exhibits a significant delay or the child is diagnosed to have developmental disorders. It is easier for the chid to pick up one language input and gain proficiency, amidst the pressure of the child to reach to his/her milestones battling other developmental problems as well. But ultimately, in our environment, we use two languages in our everyday life. It is inevitable – where one is our native and our nouns are all in English!!

It is generally advised best that the parent speaks to their child in the language they are most comfortable with, in terms of fluency. This could be the native language or a language the parents speak very well. Sometimes, wishing to provide more exposure to English due to school requirements, the parent might start using the language suddenly, wherein the child was already exposed to their native language. This might actually have the undesired effect of delaying the child’s language development. In fact, it has been shown in educational settings that building on a child’s skills in a first language help the acquisition of a second one.

It is recommended to avoid abrupt stopping of a familiar language or sudden introduction of a new language replacing the exposed language. Why? Because language is strongly linked to emotion, affect and identity. It has been recorded to cause emotional and psychological difficulties for both the child and the parents.

Remember, Language is THE FORM OF HUMAN COMMUNICATION. Learning the same, with ease and comfortably nurtures the child’ cognitive, emotional and social development. We are after all, social creatures with innate desire to have and maintain relationships within our communities. Language is the bridge, which should be constructed systematically, in order to continue humanity’s progress – not scrutinized. Multilingual children develop as their monolingual peers do; there is no difference and nor does it cause language delay. Take caution and ask your speech-language pathologist, before you make a decision pertaining to the child’s language learning.