Speech Langauge Disorder- Apraxia

When we got wind of Ivan's challenges, I became frantically, looking for answers. Or rather, would I honestly, admit that I was looking for a cure. I just could not wrap my head around the idea that he had something we could not fix. The normalcy as we knew it in our lives, had been wrecked forever.

I tried to establish a routine for Ivan, and soon it became a night ritual for me. Peter had started to take overseas job projects, leaving me and the two boys alone. So, I would settle the boys both in the same room. First we would have Oreos and Milk, then we would go to bed, followed by soft instrumental music playing in the background. I say a night time prayer and tuck the boys in. El had always been rather independent and didn't like the mushy good nights. But Ivan would want me to sit by his side. I would sit in and watch him drift off to sleep. Once they were down for the night, my routine continues, as I broke down in tears and poured out my pain and anger. After a good cry, I would take a deep breathe and go over to my room and start reading and researching. The routine grew on me, and I would say that I found it healthy to let it out on a regular basis. One night, I stumbled on this article on Apraxia. I saw many symptoms that I related with, I figured that Ivan had this condition.

I came to know that autism was a landlord that had many other co-occupants too. And one of them in Ivan's case was Apraxia. Here are some info, that could help you know what it is.

"Apraxia - a neurological disorder that occurs when a child is unable to execute speech movements- the specific sequence of movements that results in proper speech- because of problems with coordination and motor planning. Apraxia does not involve muscle weakness. The child's brain is unable to plan and order motor activities so that the mouth can form the correct shapes to form words. The apraxic child knows what he wants to say, but his mouth isn't getting the correct messages to be physically able to say the desired words or sentences."

Within apraxia itself, there are two kinds, oral apraxia and verbal apraxia.

"Oral apraxia affects the child's ability to move his or her mouth muscles for intent other than speech, e.g., coughing or blowing out birthday candles."

"Verbal apraxia is identified when the child's ability to sequence speech sounds is impaired, again, not resulting from muscle weakness."

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Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

A Mother's Story

Look at this picture, the mama protects her little ones. Likewise, so do we. Mothers of children with special needs are like her. Tender and loving to our little ones, but we can tear you into pieces too. Here is a story of a loving mother, she shares her experience in her own words.

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My son has Aspergers.

Such a simple statement but it has impacted our lives so much. I have avoided writing this, pushing it all the way to the end of my TO-DO list for the last month because truly, sometimes even thinking about it can hurt. It is like opening a can of worms. I fell into a deep dark hole when we first found out about him and it took me a very long time to crawl out of it and just live again. So I was not too keen to revisit those “dark hole” years.

In this short entry, I will write about the early years after discovering my son’s condition – the struggle and the reactions from those around us and also the strategies we used to help him - and ourselves.

When I use the term ‘us’, I am referring to my husband and I. When we found out we were pregnant shortly after the wedding more than a decade ago, I was overwhelmed. I was fresh out of university, just started my first job and just married a stranger (mine was an arranged marriage haha!). So when my precious little one was born, amidst the flurry of managing a new job, new marriage, new house, new set of family members and new everything, I did not really pay much attention as to whether he was developing according to a neurotypical’s developmental milestones. 

When he did not seem to like my cuddles, I thought maybe I was not touching him right. When he still did not talk at 18 months, my in-laws said boys develop speech later, so – OK. However, when he was still walking on tiptoes at 30 months and he had huge tantrums over something as minor (to me, at least) as the weather or food texture, I hit the jam break. I have heard of the ‘Terrible Two’, but I could sense that something was not really right. And true enough, I soon got a call from the day care centre which I have enrolled him in just a couple of months earlier. Apparently, he had been displaying ‘certain odd behaviours’ in class, e.g. walking around the classroom, disinterested in lessons, rolling and pressing himself against the floor, licking the chalkboard and refusing the food offered during breaks – escalating into screaming fits if the food contained chopped fruits and vegetables. They thought he just needed adjusting but it had been three months and they said the staff could not handle him. So they told me to withdraw him.

I think that was the turning point for me. I began really observing him and reading up on a neurotypical’s developmental milestones, and that was when it dawned on that my little darling was not ‘normal’. As if coping with that was not difficult enough, the comments from others started coming in – ‘Why does he walk like that?’, ‘Why does he behave like that? You should teach your son to behave, you know.’ To cut a long story short, I did not know what to do with my adorable little gem. I became depressive, quit my job and cut off all contacts except with my mother. I could remember one very low point during that period when I was alone at home with him, trying to manage a tantrum. I was so frustrated with him that I just packed my little monster into a carton box in a bid to contain him. Yes, I was crazy and desperate. And yes, I tore up the box and took him out the very next minute.

Anyway, after the initial drama, thank goodness my mum and the never-say-die part of me eventually took charge. We consulted a pediatrician who worked with us to manage my little sweetheart. At that point, no specific diagnosis was made but the doctor identified issues that he was having, primarily sensory and social ones. (The diagnosis was only made when my son was six, as we were debating whether he should be in mainstream or a special school. Anyway, the final diagnosis was mild Aspergers so he is now in mainstream.) He was aversive to many textures, especially furry, hairy and woolly ones. And he had vestibular issues. He got cranky and started getting nausea when in moving vehicles or when taking rides. And yes, he basically lives in a world of his own. At about three years old, he could already talk but he still pulled at my hand to get my attention. And he showed no inclination to interact with his peers of the same age.

The doctor referred us to a slew of support services and in the end, I chose to focus on occupational therapy (OT) for his sensory issues and social play groups with two different centres to encourage social interaction. We also placed him in a day care facility which was equipped with the trained professionals to manage children with special needs. When he was five, I also embarked him on the Kumon journey. I know that not everyone is a Kumon fan. I just felt that their learning style suited my son. It was very structured and time-controlled, the steps are very systematic and predictable and the repetitive practices helped to reinforce his learning. Also, Kumon helped prepare him for the eventual school syllabus so that he already has a preview of the content to be taught prior to the topic being taught in class. Believe me, it helped tremendously with his self-confidence. Beyond all these sessions, based on the recommendations of the OT and teachers, we also engaged in external activities to help him generalize the skills he acquired during the school and therapy sessions. So lots of experimentation with different textures of food, clothing and tactile materials. And loads of vestibular stimulation in the form of rides in amusement parks and in cars, buses and planes even. And when he grew older, we started him on social stories and social scripts to help him along with his interaction with his peers. Visual schedules work great to help him structure his day and to promote predictability. We used to have it on cards and notebooks for him but when he grew older and got a bit self-conscious about his schedules, we recently got him a handphone so that he can have his schedule in the handphone. More age- and socially-appropriate, we thought. Recently, he told us he has a best friend. I was ecstatic. I mean – my ‘live in my own world and talk all day about my LEGO and World War II obsessions’ son, has a best friend?! WOW! 

So during one of the school events when we were in his school, he introduced his best friend to us and I could have hugged that wonderful boy for giving my son a chance at friendship. Well, there are hiccups. My son tells me that some days, he is more comfortable texting rather than talking directly to his friend so they text to each other even when they are face to face sometimes. Oh well – I guess we can work on that.

 

So you see, we were in denial for quite some time, but for the last few years, we learnt to accept - with a good understanding of his condition, being kind and tolerant – not just with him but also with ourselves and with others, and we used humour - in a kind way. I sometimes teased him that he is taking up my talk time when he talks non-stop about his World War II stuff and I still offer him hugs and do not get upset when he does not return or does not seem to want it. But every time he returns a hug, which is becoming more often these days, my heart melts. 

I also think it is important to have realistic expectations. My son will sit for the PSLE next year. My husband and I have had discussions with him on his grades and together, we have set high but realistic, achievable goals for his PSLE. This is because, even as I make accommodations for his special needs, I need him to know that he cannot and should not use his condition as an excuse to not push himself to greater heights and excel. 

I do all these because I will eventually move to my next stage of intervention with him – empowerment. We will all die someday. So before that time comes, I need my young man to not only be able to manage himself, but to eventually be independent and empowered enough to lead  a meaningful life, even when I am no longer with him. This may sound cliché but I want my son to not see the disabilities, but to be thankful for his abilities and celebrate and capitalise on those. And that is the same mind-set that I carry with me in my work with special needs now. I mean, God made all of us unique and wonderful, didn’t He? So we should likewise carry on with his work and let the world see what wonderful beings our individuals with special needs are. Yep, they truly are a WONDER.

Thank you.

Special thanks to this beautifully-spirited mum, who chose to share her heartwarming story with all of us. She chooses to remain anonymous, as she blesses us with her story.

Origins Of Speech

A picture paints a thousand words. I am sure that upon looking at this picture, you will be smiling already. It is adorable?

You baby starts communicating with you from the time he is born. There is no languages involved, but you can still comprehend his basic needs. As his needs get more complex, the use of grunts, gestures and then language, helps it along. You may find that your child will grunt at a certain time in the early stages. They are interesting, each grunts stands for a different need. One may indicate hunger, while another type indicates tiredness. 

But what if your child faces a delay in speech? A speech disorder? What are they? After the two blog articles I have shared, I decided that I should do more research. And when I did, I realized that there was so much more to cover. So I will be sharing it with all of you, weekly. (keeping my fingers crossed)

Until then, let me leave you to think about this...

"Learning adult speech is an extremely complex procedure involving the coordination of no fewer than 70 different muscles, and babies have to be patient while slowly gaining full control of these muscles." - Now that's tough!

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Book: Baby by Desmond Morris

Hazardous Haze Reveals Itself

This is a scary sight, I saw when I entered the study. Here's a picture of my printer that sits near the windows. Despite having all the windows shut for a week.  I noticed this today.

Hazardous Haze

We used to be known as sunny Singapore... but now we are all praying for rain. Maybe we ought to start a bonfire and do the rain dance? It's a sad sight all around. For working parents, their children have to still go to school. For those who can make other arrangements, they rather  stay home.

The haze level started to rise to a hazardous high starting this Monday. My eldest son, was sent back from his OBS Camp. He was rather disappointed, but made up for it by catching a movie with friends. I am glad he did, because the rest of the week was to be worse. 

As for Ivan, he has been entertaining himself with this Ipod and DVDs. Little Iggy on the hand is rather upset about not being able to go for our walks. Around Wednesday night, we hit a high above 300. It was bad, we figured it was going to be house arrest for a while.

The next day, I woke up to the smell of smoke and itchy eyes. I knew we had to step it up a notch. I then realized that here in Singapore, we have been so blessed that we hardly have a back up plan for such things. I hear the face masks have been sold out, and everyone"s rushing to get their hands on air purifiers.

Fortunately, I have the scented kind of air purifiers, not that great, but would have to do. I turned on the air condition, in my living room and shut off the rest of the house. We sat around with our books, and gadgets, hoping to hear good news from on the PSI levels. But that was not the case, if anything, it was getting worse. I then thought of my little nephew, who would be so lonely. So my boys, and I invited him over. It was fun, the boys, rolled around and played. My nephew, ran through the house not knowing what was actually going on. 

Here's a picture of the two little ones, watching TV after lunch, feeling bored. Haze.... hazardous haze please go away.

Baby and Gas...

I am a breastfeeding mum and this is the first time I am able to do it exclusively. It wasn't planned for it, but it fell in place. So, like every other first newly nursing mums, I read a lot to get to know what I should be doing, for little Iggy. As I was reading this particular book, I found that this information is rather helpful and wish to share it with you.

It may sound odd that I want to talk about gas, but bare with me and you will see why. Everyone of us has gas, yes, sometimes it can remind us in an embarrassing way.

"Generally, most gas created in the intestines is absorbed into the bloodstream; then part of it is filtered out by the liver, and part is expelled through the lungs. Excess gas that is not absorbed will be passed. Prior to solid food, the breastfed infant who is not reacting to any foods in his mother's diet should pass very little gas. More gas is produced when a child is fed when not hungry, when the child is fed harder-to-digest infant formulas on early solid foods, when digestion and adsorption are reduced by food sensitivity reactions, and when undirected milk lactose is passed into the large intestine in the much older children whose lactose enzymes are no longer sufficient."

With my first two boys, I fed them, like clockwork, as advice by my mum. That was how they did things, in their time. The fatter the baby, the better. But now with Iggy, and the abundance of resources, I choose to make alternative decisions in certain matters, like feeding.

Iggy used to feed every hour, when we came home from she hospital. It was crazy difficult for me. I had to keep eating, feed, rest, eat, feed and rest. It was not the ideal picture I had in mind. All the books I read made nursing sounds like a mothers dream. But after a rough start, things started to work out fine. And I am glad I stuck it out. I guess what I wish to share is that, if its workable for you, be patient and breastfed your baby, for both your benefits. 

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Book: The Baby Bond by Dr. Golden Palmer

Utter or Boobs

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I was having tea today with my sis and nephew, when we started exchanging tips on feeding our boys. After talking to her, I felt that I should upload this article. I was going to keep it for another day, but felt that its important should it help someone today.

As parents we all want the best for our little ones. But sometimes when it comes to food and nutrition, we may need to know, that it goes beyond the eating and excreting. Food is our health too. We have to be diligent in what we feed out kids. Where we buy our food from and how we prepare them. Going organic is huge today. But it can break the bank too. We all can agree that choosing natural ingredient is the best way to go for our health.

With this article I wish to share a little on cow's milk. I wish to say that my first two boys grew up on cow's milk, as I only had two months of maternity leave and stopped when I returned to work.

I know that here in Singapore, we have the kiasu mentality to push our children in all aspects. My first two boys were given cereal in their milk when they were merely four months old. My mum and many older people would keep saying that the baby needed it to grow or he would be skinny, thus, according to them, malnourished. Back in the day, I didn't know better and I followed as I was told. But now with information at our fingertips and the loads of books in the library, we have options to know more. Both Peter and I decided that we would do what we felt we needed to do and change what we needed to change for Iggy. After all it is a new generation, a new breed of babies that we have these days.

The first thing we agreed upon was that Iggy would be breastfed. I had not planned to make it exclusive, but I got lazy and found it to be more convenient for me (lazy mum, I know). Later, I was glad I did so, because as I read I found out that although the baby has his digestive system kick started at birth, maturation of numerous digestive processes still carry on for a couple of years.

"Hunger starts the digestive process going, and enzymes are released in the stomach and small intestine. If one ways or is fed when not hungry, these enzymes are not present, and indigestion can occur. Therefore, when infants are fed on a schedule rather than when hunger is expressed, poor digestion and painful indigestion might be the result."

"The digestive system of the newborn infant is not at all equipped to handle solid foods or digest anything but mother's milk. Human infants, like all other mammals, are designed to survive on nutrition made by the mammary glands of the mother, just as they were previously supported by her placenta. This arrangement provides many survival advantages because it ensures parental protection, loving social contact, and controlled, optimal nutrition."

It's easy to understand that a baby's little body only produces a very small amount of digestive enzymes as compares to a mature system. So take this information with a pinch of salt and decide for yourself.

Book: The Baby Bond by Dr. Linda Folden Palmer

Speech Language Disorder - Part 2

Here's the part 2 of the article I started on Speech Language Disorder. As the topic is very wide and there are many sub-categories to cover, I figured I would start off by giving you the signs to look out for.

Here are some signs and symptoms to look out for:

• articulation impairments
• awkward and clumsy physically
• delayed first words with many sounds omitted or replaced by easy-to-pronouce consonant sounds
• difficulty imitating sounds and words
• difficulty understanding spoken language
• difficulty with nursing or feeding during infancy
• distractibility
• fine motor problems 
• groping for words while speaking
• grunting instead of using first words
• handwriting problems
• high frequency of vowels and voicing errors
• history of ear infections
• improper use of words
• inability to express ideas
• inability to follow verbal directions from ages 2-3
• inapporpriate grammatical patterns
• inappropriate responses to simple questions from ages 2-3
• inattention to spoken language
• late onset of first words
• learning disabilities
• little or no cooing or babbling in infancy
• not using two-word phrases by 24 months
• pointing instead of using first words
• poor organizational skills
• reduced vocabulary 
• repeating words and phrases but not comprehending them
• saying easy sounds (b, m, p, t, d, and h) from ages 2 to 3 but unable to use them in words
• seeing a word but not understanding its meaning
• sensory problems, such as being sensitive to touch
• slow, halting speech that is full of effort
• slow or no progress with traditional speech therapy
• trouble getting across what they are trying to say
• unable to use consonants
• unintelligible speech
• unpredictable speech errors
• voice fluency not present

I hope that you would use these pointers as an objective marker. Should you think that your child shows about half the symptoms here, please try to get hold of a Speech Pathologist, to advice you.

Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Love Ya Daddy!

We want to take this chance to wish you a Happy Father's Day. We have taken a number of pictures and want to tell you how we feel. We wish you were here to celebrate Father's Day with us, but we understand that you do what you do for our benefit. Sending lots of love your way, dear daddy...

Here's a picture of our very smart looking daddy. (by nature he is very, very vain)

Here  he is taking us out for ice cream at Ben & Jerry's. It was a sweet time we shared.

Here he is just being silly, which is what we love most about him. He makes us laugh and spreads cheer to fill the house and our hearts. It's what, we miss the most when he isn't home.

Here is a picture of him doing awesome activities with us. He is always a hands-on dad, and we love him for that. He will go all out just to make us happy.

Here we are all together again.

We learn the importance of friendship, as we watch you love, cherish and protect your friends. We see the bond that you have and hope to make such wonderful friendships in our lives.

We love the way you place family, as an important part of your life. The stories you shared about your dad gives us a strong sense of love for him that we wish to visit him often, even though he is so far away. You teach us the pride in carrying on our family name, and we hope to do you proud.

You brought Tyke into our lives to love and care for, but sometimes we get lazy. Here's you taking Tyke for a Vet's visit.

We love that you cook when you are back home. It's fun messing around the kitchen with you.

And mummy says you are a sweetheart for helping to clean up too.

Here's you at Ivan's exhibit. You are always there to support us in all our achievements, struggles and obstacles that we face.

And here is a classic you, counting our bills, as we shop crazy on holidays.

You don't have daughters, but we know you would still be great. Look at you wearing a bangle as a earring just to please your God-daughter.

Here's you are waiting at the hospital room, for baby Josh to arrive. So coolly you await to do it from start for him all over again.

And you start the journey from birth with Josh, while still keeping up with us. (still can pose)

A wonderful picture, to show that you have us protected in your arms day and night. Helps us understand how God our Father, has us.

Ending with a funny note. "What can I say, I am just wonderful!"

Baby Sardines Aglio Olio

I have so many things to cater to, on a daily basis. Cooking is the last, in my list to do. We are blessed here in Singapore, with hawker centers, coffee shops, fast food delivery and all. I must admit that I am guilty of eating out lately. It's not that I don't like to cook, on the contrary, I simply love to cook, but I  figure my boys needed time with me. Spending time with my boys is always my top priority. 

Once in a while, I do steal some time to whip a quick dish. And this is one such very quick dish. Since I work very fast to make this, ingredient measurements are not very ideal. So my apologies for that.

 Now let's get started. 

Ingredients:

some red hot chili flakes

a couple of garlic cloves

a couple tbsps olive oil

a tin of sardines in olive oil

a tin of diced tomatoes

grated fresh cheese

pasta of your choice

Steps:

In a saucepan, heat up some olive oil. 

Add in the chili flakes, to your level of spiciness.

Add in the garlic, saute a bit and then add in the sardines.

 

 Add in the diced tomatoes, and saute a little longer. Along side cook some pasta.

 

 

Add in the cooked pasta and stir well.

 

Dish it out and garnish with freshly grated cheese, and Italian herbs of your choice. 

 

And that's it folks. I hope you liked this very easy recipe. Adjust the recipes to your fancy. This is one of my son's favorites. He loved to drizzle extra virgin olive oil over it once the dish is done. And load it up with freshly grated Parmesan.

Childhood Apraxia And It's Myths

There are many myths and old wife's tales when it comes to bringing up children. I am  pretty sure that you must have heard your fair share of tales too. It just gets a little harder when you are challenged with a child having special needs.

Here are some of their wisdom, that they may wish to share with you:

• Einstein was a late-taker.
• Some very bright children won't talk because they are bored with "baby talk".
• He'll talk when he has it all perfected in his mind.
• He just doesn't have anything to say.
• You (or big sister) do all of the talking for him.
• He has all of his needs met and doesn't "need" to communicate.
• He'll talk when something really interests him, or he really wants something.

So do you think that your chis is a"Late-Taker?"

According to Becca Jarzynski, a pediatric speech-language pathologist and blogger of Child Talk (www.talkingkids.org), "If a child reaches 24 months and isn't yet using 50 words and/or isn't yet putting two words together into short phrases (e.g., "more juice," "bye mama"), we typically recommend that (parents) talk to their pediatrician about an evaluation by a speech-language pathologist."

• What does the child understand?
• Can he follow a wide variety of directions?
• Find objects when Mom and Dad ask him to do so?
• Point to pictures in a book?
• Show off some body parts when they are named?
• Follow silly directions like "put a cup on your head?"

• How he is communicating with gestures and facial expressions? 
• Is he nodding and shaking his head no?
• Pointing at things that he wants or that interest him?
• Waving "hi" and "goodbye?"
• Clapping with delight? 

• How he is using the words he does have? 
• Is he using them appropriately?
• Does he have inflection in the right places?
• Can he articulate well?

• What kinds of sounds is he using?
• Does he uses his voice to get attention?
• Does he vocalize often throughout the day?
• Did he babble often as a baby?
• Does he use his voice in a way that sounds like he having a conversation, even if there are no real words involved in that conversation? (At 24 months, for example, a child should be using a variety of sounds such as p, b, m, n, t, d, h, and w- and using them in a variety of words.)

• How is he playing?
• Does he use pretend play in some very simple ways?
• For example, does he give a bottle to a baby, or feed a stuffed bear with a spoon? 
• Is he able to play simple rolling or fetching ball games with others, and starting to imitate housework?

• How does he imitate actions? 
• Will he clap when an adult does?
• Does he imitate stacking blocks?
• Will he imitate you if you do something silly and unexpected, like place a block on top of your head? 

•  How is he hearing?
• Any concerns with hearing should be evaluated to rule out a hearing loss. 
• Some kids can hear some sounds but not others.

What's a Parent to do?

If you are faced by ignorant loved-ones, or insensitive people, here are a few ways to go around it graciously, so you spare misunderstandings:

• He's takes a while to warm up
• Not all our kids develop the same, right?
• I am grateful, that he is quiet and manageable, at this age.
• He's quiet, just like his dad, men of a few words.
• Gosh, really, you think I should be concerned? What do you recommend?

I am sure you can find your own way of brushing them aside. Try not to offend them if you possibility can, you will need a good support system as your child grows and you may need to depend on them. Their ignorance is what's making them misunderstand. If you have the patience, try to fill them in, on what's going on in your child's life. Having more loved ones, is only going to be beneficial to your child.

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Book: Speaking of Apraxia by Leslie A. Lindsay, R.N., B.S.N.

Speech Language Disorder - Part 1

I love to watch children play, they are so original and innocent. Their transparency makes them such adorable play writers. Speech is an important part of play. Without the fluency of speech, children will struggle to fit in and become loners as a result. 

The number of children who struggle with speech disorders, nowadays are on the rise. My first born spoke when he was one, but Ivan only spoke when he turned five. So if you are in a situation, wondering if your child has a challenge in the area of speech, read this entry, I hope it helps you.

"With a typical child, receptive abilities (understanding language) and expressive skills (vocabulary, the production of complex sentences, and recall of words) usually develop at the same pace. However, when there is board disparity between the two and when a child's communication is noticeably lagging behind his or her peers in the attainment of these skills, a serious disorder is indicated  and red flags go up.

When a child's ability to understand language is in the normal range but his or her expressive ability, speech, is critically inadequate- it might be completely absent, somewhat impaired, or just difficult to understand- then they have a speech or language disorder." Here we are talking about children under the age of three.

You may think that your child is a "late bloomer". Like Peter did with Ivan, he kept telling me that we should just wait it out. Neither of us knew better. In time, I came to realize that even if Ivan was a "late bloomer", a weekly visit to the therapist would have helped speed along the process. Either way, it would have only helped the boy. So I encourage you, if you see fit, do make an appointment with a Speech Therapist to see your concerns through. At the most, if you are not comfortable, at least you took step one.

Here are three types of speech language disorders:

1. Agrammatism - telegrahic speech (Me, you, uh, watch television)

2. Anomia - difficulty in retrieving or recalling a specific word

3. Aphasia - problem with language caused by brain damage. 

The thing to remember here is that, should your child be affected by these three above mentioned, do know that this only affects his speech not his intellect.

As, there are many to cover, I will pause here and continue in the next article. Stay tuned.

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Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Separation Anxiety Disorder

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When you have a newborn, you will realize that once he gets to recognize you, they will cry when you leave the room. He cries due to the anxiety that you would not return. As he grows older, he will understand that when you leave the room, you are not gone forever. He needs the security and the reassurance that he will not be neglected, maybe it's in our primal instinct.

If you have had the experience of sending your little one to school, you know how difficult it is for both of you. As an early childhood educator, I have witness many children go through the phase of separation anxiety. They scream, yell, kick and cry until they tire themselves eventually, and it starts all over again  the next day. All children, take a different amount of time to understand the concept of mummy and daddy leaving them at school, to go off to work. For a little one, it is a concept far too difficult to comprehend. 

He wonders why, why do you need to go to work? 

Why do you need to leave him at school? 

Why can't you take him along? 

Why would you take to so long to come back for him?

The most important thing, I realize as a teacher is the importance of reassurance. Reassuring the child that the parents are coming to fetch them soon, helps immensely. Then, if the child is able to understand, state a time that the parent most likely would arrive. This way the child will ease into the separation from family and the anxiety will diminish.

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Sometimes, its not the child that has the anxiety but the parent. I have witness, children who have settled down fine, and the mothers, crying outside before they leave. So, if this is so common, why is it a disorder you may ask. Will it only becomes cautionary if it's as follows.

"According to the DSM, separation anxieties become a disorder when the child's anxiety or fear causes anguish and starts to affect social, academic, or for adolescents, work-related situations, and this anxiety lasts at least one month." 

What are the Sign & Symptoms to look out for?

• apathy
• aversion to school
• bedtime fears
• clinging to parents
• crying
• depression and sadness
• desire to sleep in parents' bed
• difficulty concentrating
• difficulty falling asleep
• dizziness
• excessive worry
• fear of carpooling
• fear of getting sick on school bus or in school
• fear of meeting new people
• feeling unsafe being alone
• headaches
• hiding, especially behind parent
• nausea
• shadowing parents
• shortness of breath
• sleep disorders such as inability to sleep and nightmares
• stomachaches
• sweating
• tantrums at school
• trembling
• unreasonable fear of harm or death
• unwillingness to interact with anyone other than parents
• wanting to be held
• whining
• withdrawal

My first two boys settled down fine in school, but now I have little Iggy. I hope, I do not end up being one of the mothers that are crying outside the school.
 

Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Rett's Syndrome

I recall one afternoon, when I was having a conversation with another mum, as we were waiting on our boys to finish school. Ivan was around five back then. I was still having very mixed and unpleasant emotion attacks. Life felt miserable and the future was dark. The parent I was talking with had an older boy, she had pasted the stage I was in. She told me something, that opened up my eyes. She said, "Be thankful we have sons, can you image their lives and ours, if we had them as daughters?" Just then, I felt a quick wake up call. Yes, I was thankful that Ivan was a boy. Puberty would be much easier on a boy, and that was just one aspect. From that day one, I chose to make sure I looked out for the silver lining.

We do see a majority of children affected by autism and similar diagnosis, to be boys. But I wish to draw your attention today, to one PDD (Pervasive Development Disorder) that attacks the majority of girls. In the group of PDDs, Rett's syndrome is one of the most disabling. It is known to be affecting the majority of the female of our species, by the age of twelve. 

A Little History

Andreas Rett, M.D. was the very first to introduce this in the year 1965 in Vienna, Austria. It has been known to show normal development in the early years, followed by an onset of the disorder between six to eighteen months of age.

"At the start, RS girls (a very slight percentage of boys are diagnosed with RS, and most die in utero) will exhibit appropriate speech (using words or phrases) and motor development as well as age-appropriate sitting and walking. But, eventually, the child will lose use of her hands and exhibit distinctive repetitive hand movements, slowed brain and head growth, abnormalities when she walks, seizures, and MR (Mental retardation).

The girl enters a period of regression, losing speech and motor skills. This period of regression between 1 and 4 years old can be sudden, but it can also be slow and indistinguishable from normal behavior and be missed in diagnosis if the symptoms come on singularly and slowly.The regression can last for a few days or it can go on for months."

What are the Sign & Symptoms to look out for?

• autistic behaviors
• bone fractures
• cessation of social interaction
•  cold, sometimes bluish-red or purple extremitites
• constipation
• decreased body fat and muscle mass
• diminished eye contact
• EEG abnormalities and changes
• extreme motor control problems
• gait abnormalities (unsteady, wide-based, and stiff-legged)
• hand tapping and hand wringing
• irregular breathing patterns such as hyperventilation
• irritability
• loss of motor skills
• loss of speech
• MR (mental retardation)
• muscle rigidity
• normal development before symptoms arrive
• obsessive-compulsive behaviors
• persistent clapping
• persistent hand washing
• reflux
• scoliosis
• seizures
• sleep apnea
• slowed growth (after 1 year old)
• slowed head growth (after 3 months old)
• slowed weight gain (after 1 year old)
• small feet
• small head (microcephaly)
• spasticity
• swallowing problems
• teeth grinding (bruxism)
• toe walking
• torso shaking
• weak muscle tone (hypotonia); dangling arms, legs, and head are usually the first symptoms 
• well behaved

These are the sign and symptoms that you could look out for.  You will come to notice that more than a few of the symptoms, are similar to that of other diagnosis, such as autism. There really isn't any clear boundaries, as to where one disorder stops and the other starts. We just have to be observant and trust our gut, as to when and where we need to seek for professional help.

I hope this blog entry is helpful to you. 

credit for picture

Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Why Is My Child Different?

When one looks back to reconsider the possible causes for a child having special needs, one may consider many theories. You may have your lists of concerns, as I have mine. Amongst the "theories galore: vaccines; environmental toxins; genetics; age of parents at conception of the child (especially the father); hormonal factors, especially testosterone levels; jaundice at birth; strep and use of antibiotics as a child; physical trauma in either mother and child; diet; medications- the lists goes on. All the theories could be correct, or none, but one thing on which many researchers and experts agree is that the child needs to be predisposed to this type of disorder. So, while a vaccine might not affect one child negatively, it might affect another completely differently."

When my third baby, Iggy, was born, he had jaundice. I panicked upon hearing the news. Friends and family, comforted me saying that it was very common and that I had nothing to worry about. Even though, he was my third born, I still freaked. I guess the protectiveness of a mother will always be there.

After doing lots of research for Ivan, I came to realized that a couple of them stated jaundice as a possible trigger. But nothing has been carved in stone. 

credit for picture 

Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Stressful Pregnancy and Baby

I have spent many years, wondering where I went wrong with Ivan. How in the world did autism get it's hands on him? Was it the pregnancy? My health? The childbirth? His nutrition? I could go on and on.

Each time I read an article in line with a possibility of him being exposed to autism, I do get grief stricken. In this case, it's more threatening to his immune system. I don't spend much time pondering in the "what if's". But I do go there sometimes.

Here's a portion of an article I read, that may help you.

"When a mom is under stress during pregnancy, her stress hormone levels become elevated even though pregnancy hormones are designed to have a calming effect on the mother-to-be. Stress hormones disrupt some of the protection induction by the hormonal state of maternity. Increased levels of these stress hormones increase the chances of a preterm delivery. The stress regulation systems of fetus subjected to this hormonal environment are disrupted as well, just as the hormonal balance is altered in infants living in stressful home environments. Exposure to loud noise during uterine life, such as a mother working in noisy surroundings, had been shown to reduce the newborn's protective immune system, possibly due to stress."

Living in Singapore stress is inevitable to a certain extend. I worked in a noisy environment with kids all throughout my pregnancy with Ivan. I hope you don't freak out and quit your job, but the lesson to take with you, is to take it slow. Try not to exert yourself during your pregnancy.

True or not, why risk it, right?

Book: The Baby Bond by Dr. Linda Folden Palmer

Holiday Heartache

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It's 6.30am and I am awake. Mentally, I tell myself that it's a Sunday and I can sleep in. The holidays are here. In many households, the school holidays are a much anticipated time. A beautiful time for family bonding and trips overseas. But in our household, things are slightly different. The extra time, and lack of routine, causes instability and stress, to Ivan, and especially to me.

It's the first Sunday, the beginning of the week and the month that marks the June holidays. After attending a kid's birthday party last night, I turned in tired. I had no idea that today was going to be a rough one.I awake many times throughout the night, as baby Iggy needs his feed. So I try to catch up on sleep whenever I can. Iggy is a light sleeper, so I try to keep things quiet.

Somewhere, around 7am, Ivan enters my room, asking for his Ipod. I tell him that it's too early in the morning. On a regular school day, he knows that he gets it only after school. But now that it's the holidays, and he is well aware of it too, he is just trying his luck. After ten minutes, he enters my room asking for it again. I reply the same thing, and he leaves. I try to catch some sleep myself as Iggy is asleep. Ivan enters again after ten minutes, asking the same thing.

Trying to maintain the noise level, so that Iggy sleeps, and sending Ivan out each time, starts to get on my nerves. But still I try to tuck under the sheets and try to steal a nap.

Ivan comes in again, asking the same thing again.This goes on, where the intervals are shortened. I know that it's not his fault, but mine. I normally, always have a planned out schedule for the holidays. But with a new baby, I had not done so this time. I didn't want to lose it, so early in the morning, so I took long deep breathes to calm down. Finally, I locked my bedroom door, and hid the Ipod.

After sometime, when I opened the door to leave my room, I saw Ivan seated crossed legged, on the floor outside my room. It was such a sad sight. But he was not going to give up. He would keep asking me until he finally got it. 

I now have to plan something pronto for him to do, until noon when he gets his Ipod time. These are times, that are very trying for me, especially with a new baby. I feel so frustrated, that I just break down in tears. Each time Peter leaves for a job during the holidays, I feel the weight of a ton of bricks added onto my shoulders. But like a sliver lining in every dark cloud, I am encouraged by beautiful friends I found on FB. They send their love and concern to me, encouraging me.