Advice from the experts
Parenting Hub

When should a child be referred to an occupational therapist?

  Following is a few easy questions that could help you to determine if a child should be referred to an O.T.  What is fine eye-hand coordination? This is the ability to use eyes and hands together to perform a task.  We all use this skill every day in all different kinds of situation:  tying shoe-laces, writing, cutting, dressing, the list is endless. How will I know if a child has a problem? Drawing shows poor orientation on the page and the child is unable to stay within the lines when colouring/writing. Your child will struggle with activities that kids the same age finds easy e.g. buttoning small buttons when dressing, picking up small objects Your child will rather get involved in gross motor activities e.g. swinging than doing colouring, pegboard tasks, etc. Threading activities will be difficult or avoided Child will find it difficult to cut neatly on a line Handwriting won’t be neat. Muscle tone  Muscle tone refers to the natural stress in the muscle when at rest. It is not the same as muscle strength. A child with a natural lower tone in his muscle will use his muscles with more effort than a child with a natural higher muscle tone. How will I know if a child has a problem? Tires easily / or moves around the whole time to maintain muscle tone Appear clumsy / uncoordinated Child will over emphasize movement / use exaggerated movement patterns Lean on to objects Find it difficult to maintain one position for a long time Slouch in chair Use broad base of support when sitting Drool Fidgety – uses this to build up tone when sitting for long periods of time Usually doesn’t part-take in endurance sport What are visual perceptual skills? These skills are necessary to interpret seen information in the brain. These skills are the building blocks for reading, writing and maths. How will I know if a child has a problem? Kids who struggle with foreground-background will ‘steals’ words/letters from other sentences/words and add it to the word/sentence they are busy reading.  They also find it difficult to find specific words/numbers on a page. Kids with a limitation in position in space and/or spatial-relationships will confuse p/b/d, switching of words in a sentence or switching of syllables. Kids with a limitation in form-constancy will struggle to read different types of fonts/hand writing and to copy writing from the black board. Kids with closure impairment will confuse letters with each another when different fonts of writing are used e.g. a/d; u/a; c/e. Kids with impairment in discrimination will for example struggle to find words/numbers that is the same. Kids that struggle with analysis and synthesis finds it difficult to read words that they have to spell Kids with a limitation in memory will for example struggle to copy work from the black board Kids that struggle with consecutive memory will for example find it problematic to copy words/sentences/numbers correctly from the black board. What is bilateral integration? That is the ability of both sides of the body to work together to perform a task. How will I know if a child has a problem? Appears to be uncoordinated when doing tasks Difficulty in performing gross motor tasks e.g. skipping, galloping, jumping-jacks, etc. Prefers not to cross the imaginary midline of the body Not choosing a dominant hand to write/draw/colour (after age 5) Swapping hands when doing tasks What is dyspraxia? Praxis (a.k.a motor planning) is the ability of the brain to conceive, organize, and carry out a sequence of tasks/actions. Praxis is the ability to self-organize. Praxis includes motor planning, cognitive events and communication. The child may present with the following: Appear clumsy Poor balance Difficulty with riding a bike Poor handwriting Difficulty with remembering instructions and copying from the blackboard May have difficulty with speech and the ability to express themselves Bumping into objects Late establishment of laterality (right- or left-handedness) Poor sense of direction Difficulty in learning new motor skills (crawling, using utensils and tools, catching a ball, penmanship) Difficulty in completing tasks with multiple steps (playing board games, sports,  solving puzzles and learning math skills) Difficulty in doing tasks in the proper sequence (dressing, or following directions with multiple steps, putting together words and sentences in the right order) Difficulty copying designs, imitating sounds, whistling, imitating movements Difficulty in adjusting to new situations or new routines Difficulty in judging distance in activities (riding bicycles, placing objects) or with others (standing too close or too far away) Present with delayed skills – remaining in the early stages of skill acquisition Poor at holding a pencil Forgetful and disorganized Have a poor attention span Need to go right back and begin again at the very beginning of the task when experiencing difficulty, instead of just ‘getting on with it’ Have difficulty using tools – cutlery, scissors, pencils – lots of handwriting problems (although not all handwriting difficulties are the result of motor Dyspraxia) poor balance; Have poor fine and gross motor co-ordination Have poor awareness of body position in space Have difficulty with reading, writing, speech and maths Other signs/symptoms Child acts immature (cries easily, separation anxiety, etc.). Concentration difficulties / easily distracted by things/people/sounds around himself/herself. If a child is struggling with reading, writing, spelling, maths. If a child’s school progress is behind the other kids in the class. If a child has a physical impairment that is influencing his/her playing, walking, running, etc. Hurts himself or other children / appear to be aggressive  –  when children struggle with certain developmental skills they may become angry easily because of frustration.  Kids who have poor self-control/impulsivity often cannot control themselves physically when angry. Hyperactive child / child who fidgets / cannot sit still / talks non-stop – this child may have ADD or ADHD Children who turn the paper when drawing/colouring/writing – this may be because the child is avoiding to cross the imaginary midline of the body A complete occupational therapy assessment will be

June 12, 2015
Parenting Hub

Alternative Therapy For ADD / ADHD?

Neurofeedback is a non-invasive learning strategy that works to improve the brains ability to produce certain brainwaves without the need for medication. You can think of it as “exercise for the brain”. By creating awareness about your own brainwave characteristics, you can learn to change them. Neurofeedback instruments show the kind of waves a person is producing, making it possible for the individual to learn to change in ways that improve attention and facilitate learning. It is essentially self-regulation training ideally suited to those with ADHD, ADD and specific learning disabilities. What are brainwaves? Brainwaves are the electrical wave patterns found in every person’s brain. Through EEG technology we can determine the strength and frequency of brainwave activity as it flows through the different areas of the brain. Beta is the fastest brainwave and is produced during focused activities and is essential for attentiveness and learning. Alpha is a slightly slower brainwave and is associated with a relaxed yet alert state of mind. Theta is an even slower brainwave and is associated with dreaminess, relaxation and sleep. Research indicates that children with ADHD are less able to produce Beta activity and experience excessive slow wave activity. In fact, when challenged with academic tasks, such children show greater increases in Theta activity and a decrease in Beta readings. In order for your brain to concentrate and learn, your brain needs to emit a high level of Beta waves, which the ADHD child is unable to do. No wonder children with ADHD have trouble concentrating! Other children become increasingly anxious in exam situations, generating too much Beta activity which also interferes with the learning and retrieval process, creating increased levels of anxiety. Assessment & Treatment The assessment procedure begins when a teacher / parent becomes concerned about a child’s ability to concentrate and learn. A thorough evaluation must be carried out in order to determine whether the clinical picture is consistent with ADHD. A useful tool for Neurofeedback practitioners is the involvement of a QEEG (quantitative electroencephalogram – computerized EEG evaluation). If the pattern of ADHD brainwave activity is detected, and fits in with the clinical picture, Neurofeedback training can commence. Through Neurofeedback training it is possible to increase Beta and decrease Theta, allowing for more focused learning in most children. How does one “train your brain”? Much like a clinical EEG sensors / electrodes are placed on the child’s scalp and fed through an amplifier into a computer programme. The child then proceeds to play computer games or watch a movie, the only difference is that the child must use their own brainwaves to control the game / show. When the child is focused in the correct way i.e. producing the perfect amount of Beta and Theta brainwave activity, the game / movie will play, if not, the screen will fade and the brain will know to readjust. The treatment is non-invasive and does not involve any medication. Individuals learn to voluntarily control their brainwave activity through operant conditioning. Is this a cure for ADHD? Neurofeedback never claims to “cure” any diagnosis. The goals of Neurofeedback are to teach the child to become increasingly self-aware and to train the brain to be more flexible. The goal of Neurofeedback training is not to change the child, but to make the child more self-aware and provide tools for the brain to re-organise itself and quickly shift into a more focused mode when required. It is important to remember that as humans we operate within a system and, as with more traditional therapies, additional support and guidance will be needed to treat the person as a whole. With Neurofeedback the child can still be the person they are, but with increased focus and awareness and an ability to “change gears” without relying on medication, thereby learning valuable and lasting skills. What are the results? • Finishing tasks • Listening better • Less impulsivity • Greater motivation and focus • Higher self-esteem  

June 10, 2015
Parenting Hub

Understanding Your Child’s Concentration Problems

As the mid-year exams loom, children will write tests to measure how much they remember what they have learnt. Being able to concentrate in class is a critical step in the learning process and is fundamental for success at school. When a child struggles to concentrate, a worried teacher may approach parents to discuss types of intervention.  “When it comes to lack of concentration in the classroom, there are various options available to help learners to focus their attention better. The difficulty however, is knowing which one will really help your child,” says Susan du Plessis, Director of Educational Programmes at Edublox. A research study to test treatment of Attention Deficit Hyperactivity Disorder (ADHD) with prescription medication showed that “only 56% of the patients in the medication group met the definition of success at the end of treatment.”* Researchers list concerns about the use of such medication in children: side effects have been reported, for some serious and life-threatening; insufficient evidence of long-term efficacy of medication; and “symptoms of ADHD reappear after discontinuing drug treatment.” There are a variety of neurofeedback approaches offered for children with attention problems which claim to enhance concentration and optimise brain performance after multiple consultation sessions. In some cases devices like headbands are worn to measure blood oxygen levels in the brain; if these levels decrease below optimal performance when watching a DVD, the volume or brightness of the screen is reduced, sending feedback to the viewer that their concentration is waning. In 2013 the Journal of Clinical Psychiatry published the results of a clinical trial** that tested the efficacy of electroencephalographic (EEG) neurofeedback in reducing ADHD symptoms. Forty-one children between the ages of 8 and 15 years who were diagnosed with ADHD participated; one group received EEG neurofeedback treatment while a placebo group were given treatment with random feedback. If the results achieved in the placebo group are similar to the results achieved with the group who had proper treatment, it means that it was not the treatment that made them better. This was the result in the research study, and the researchers concluded that “EEG-neurofeedback was not superior to placebo-neurofeedback in improving ADHD.” Du Plessis explains that there are three types of attention: “When a child is easily distracted by a pencil falling off their desk or sounds outside the classroom window, they lack focused attention. Sustained attention is required to focus for long periods of time. Then there is divided attention,” says du Plessis, “which is quite similar to multi-tasking. It’s a higher-level skill where you have to perform two of more tasks at the same time. If the task is to write a story, a learner must be able to think about their characters and plot, as well as spelling and punctuation rules that apply.” Lack of concentration is often linked to poor memory, says du Plessis. Parents may think that their child has a concentration problem, du Plessis however cautions that the root cause is often a memory problem. Working memory is the cognitive system responsible for the temporary storage and manipulation of information. Du Plessis describes three other types of memory: “If a child struggles to copy work from the board into their workbook, they struggle with visual memory. If they find it difficult to remember a number of verbal instructions, their auditory memory may be weak.” Sequential memory, says du Plessis, is remembering the order in which events take place. There are practical cognitive development exercises that can be introduced in the context of a learning environment, which can help improve one’s memory and ability to concentrate with long-term results, says du Plessis. A research study conducted last year, sponsored by natural medicines company Flordis SA, and analysed by the Centre for Evaluation and Assessment at the University of Pretoria, showed a significant increase in focused attention among children who had participated in a five day cognitive development training course. The effect of such training on visual memory has also been examined in an unpublished study by Dr Jaiden May from the University of Johannesburg where children’s visual memory increased by 1.3 years after 22 hours of cognitive training. Du Plessis offers tips for parents looking for intervention programmes for their child: “Solve the cause of the concentration problem. Avoid programmes that operate in a secluded environment. Rather choose a programme that replicates a classroom because it is at school that your child’s concentration will eventually be tested.” In-house measures that track intervention performance are not sufficient, says du Plessis. “Intervention programmes should be based upon scientific research with proven results. Improved grades on a school report card are an excellent, unbiased indicator to show that an intervention programme is working.” There are a variety of ways to help your child improve their attention and memory at home, says du Plessis. “Parents can help their child improve sequential memory by asking them to re-tell a story that they have just listened to.” The Stroop Test helps improve divided attention. Du Plessis explains, “The test is to look at the words and say the colour of each word. You will struggle at first because you’re more likely to read the word.” Images for the ‘Stroop Test’ can be found by conducting an online search, an example of one is illustrated below. Edublox are leading specialists in cognitive development with 22 reading and learning clinics across the country. Edublox offers multisensory cognitive training, aimed at developing and automatising the foundational skills of reading, spelling and Mathematics. For more information about Edublox visit www.edublox.co.za.   * http://repository.ubn.ru.nl/bitstream/handle/2066/125153/125153.pdf ** http://www.ncbi.nlm.nih.gov/m/pubmed/24021501/  

June 9, 2015
Parenting Hub

ADHD And The Foods We Eat

ADHD: The most common childhood disease ADHD is the most commonly diagnosed childhood disease and is said to affect approximately 10% of the South African population. It could be present from birth (often not recognised) or early childhood and usually persists into adulthood. It is often undiagnosed in adult, which is an unfortunate oversight, since appropriate treatment helps control symptoms and improves quality of life. The term ADHD denotes Attention Deficit Disorder with &/or without hyperactivity & has been used to describe both ADD and ADHD as well as all aspects of the condition more accurately. ADHD is a chronic condition of the brain that makes it hard for those affected to control their behaviour. According to the American National Institute of Mental Health, two to three times more boys than girls are affected by the disorder and the reason for this is uncertain. Problems generally associated with ADHD include inattention, hyperactivity and impulsive behaviour. This can affects nearly all aspects of life. How can I tell if my child has ADHD? Most specialists believe that a child shouldn’t receive a diagnosis of ADHD unless the core symptoms of ADHD appear early in life and create significant problems at home and at school on an ongoing basis. Ideally ADHD should be assessed and diagnosed by a multi-disciplinary team. As there is no proven diagnostic test for ADHD at this time, a clinical diagnosis is usually made by a paediatrician based on specific criteria. It is a process that involves several steps and it requires information on behaviour. Information is required form parents, teachers, carers, health professionals for an official diagnosis to be made. In most children with ADHD, a diagnosis are made from the age of 5 – 7 years (formative school-going age), although some of the symptoms could be present from birth. These symptoms must significantly affect a child’s ability to function in at least two areas of life – typically at school and at home. It is important that the symptoms, be present for a period of more than six months in all situations. This helps ensure that the problem isn’t with only a particular teacher or with their parents. Most children with ADHD don’t have all the signs and symptoms of the disorder, and they may be different in boys and girls. Boys are often more likely to be hyperactive and girls tend to be inattentive. In addition, girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly. Boys also tend to be less compliant with teachers and other adults, so their behaviour is often more conspicuous. What causes ADHD? Parents often blame themselves when a child has been diagnosed with ADHD. However, the cause of ADHD is at present still unknown. Experts are investigating a number of genetic and environmental causative factors – some of these theories have led to dead ends, some to exciting new avenues: Altered brain function & anatomy: There is an imbalance of certain neurotransmitters or poor nerve communication and transport in certain parts of the brain. Genetics (70-80% of cases): There is great deal of evidence that ADHD runs in families and if one person in a family is diagnosed with ADHD there is a 25-35% probability that another family member also has ADHD. Exposure to toxins such as cigarettes and alcohol during pregnancy, high levels of lead in the bodies of children. Brain injury: only small percentage of children with ADHD has been found to have suffered from traumatic brain injury. There is no clear answer! What we do know is that ADHD is a condition of the brain, likely caused by unknown factors which influence nerve communication and transport in certain parts of the brain, which has a strong genetic basis. Common misconceptions:  Food additives and sugar has long been controversial. Some research suggests that artificial colourings and preservatives may be associated with hyperactivity in children. But an association is not the same as a proven “cause-effect” relationship. There is no proof that food additives cause ADHD. Poor parenting, family problems, excessive TV watching, poor teachers and schools, food allergies or excessive sugar intake are not thought to cause ADHD. These environmental factors may contribute and worsen ADHD symptoms though but are not the cause. How is ADHD treated? Optimal treatment is still a matter of debate and every family wants to determine what treatments will be the most effective. It is thought that lifestyle can either reduce or strongly exaggerate symptoms of ADHD. Clinical experience has shown that the most effective treatment for ADHD is a combination of: Medication, when necessary Dietary intervention The correct supplementation of vitamins and minerals Exercise Therapy and counselling to learn coping skills and adaptive behaviours Medication  There is a wide range of medications available, the most common being Ritalin, Dexedrine, Adderall, Concerta. Medication does not cure ADHD. The role of medication is to control the symptoms when taken and works effectively in 70% of ADHD cases. Each medication has its negatives. The most likely side-effects include reduced appetite, corresponding weight loss, headaches, nervousness, irritability, tummy aches, nausea & vomiting, sleep disturbances. It is found that 30% of cases don’t respond or do not tolerate prescribed medication for ADHD. In these cases there is no other option then to opt for dietary treatment. Diet and ADHD Each child requires an individual approach. Helping a child with ADHD is like trying to solve a jigsaw puzzle. Puzzle pieces might include low iron status, poor diet, essential fatty acid deficiencies, magnesium deficiency, zinc deficiency, sensitivity to food stuffs such as artificial colourants, flavourants and preservatives. Remember each child is a unique puzzle with different puzzle pieces. It is therefore essential to consult a dietitian specialising in the field. Diet in itself does not cause ADHD but can worsen the symptoms. Diet modification however does play a major role in the management of ADHD and the associated symptoms. When dietary changes are made the results could

March 26, 2015
Parenting Hub

ADD And ADHD In Adolescence

Adolescence is the period in a child’s life which is filled with much turmoil and changes. Not only are there physical changes (including hormonal) but an emotional shift where the youngster has to grapple with several of the following: Acquiring a feeling of identity (self-identity such as “who am I”; social identity such as “which group/s do I belong” and certainty about his/her own values and ideals “where am I going with my life”). In establishing an identity for themselves, the adolescent phase is characterised by experimentation and rebelliousness, which leads to conflict with parents mostly about authority and decision-making. Being acknowledged by peers as well as being accepted by them (fitting in). Concerns and worries about school, exams and careers after school. Foray into romantic relationships with accompanying insecurities etc. During a youngster’s development from childhood to adolescence it becomes common for the symptom pattern of ADD/ADHD to change, most notably by a decrease in hyperactivity. Nevertheless, difficulties with attention and impulsivity remain. It was thought that ADHD tends to “burn out” by the time children reach adolescence and rarely continues into adulthood, however research suggests that this is not the case. Other difficulties that can appear for an adolescent suffering from ADD/ADHD over and above the usual teen concerns are: Adolescents with ADHD often feel “different” from others and they may become socially isolated, especially if they are impulsive and act before they think without due consideration for the feelings of others. They may also still carry the remnants of a lowered self-esteem developed in childhood as a consequence of ADHD. Remember that children and adolescents that have been diagnosed with ADD/ADHD would have experienced the gamut of difficulties on an academic, social and personal front. Low self-esteem may lead to a teenager refusing medication, avoiding educational or other activities and be more vulnerable to peer pressure in order to fit in. They may also lack motivation as they could have internalised that they are not as competent as their peers. Difficulties with focusing, organizing and long-term planning usually pose a difficulty for the ADHD adolescent as the workload at school increases and becomes more complex. As a result adolescents may have difficulty completing tasks, taking good notes, being able to prioritize important tasks and apply adequate study methods for tests and examinations. Adolescents with ADD/ADHD are to some extent more likely to experiment with undesirable behaviours at an earlier age because of their impulsivity and not considering the consequences of their actions. Usually teenagers tend to develop new strengths that help them with decision making, consequently, their ability to think long term, resist instant gratification and regulate their own behaviour does improve. The teenagers with ADHD, however, are simply likely to lag behind in these areas. Therefore, teenagers with ADHD have much more of a harder time regulating their impulses, even when they know their behaviour is destructive. As such, impulsiveness can potentially lead to substance abuse, aggressive acting out, unprotected sex, promiscuity, reckless driving or any other high-risk activity. Like all teenagers, the need for acceptance and to “fit in” is substantial. Some teenagers with ADHD will be more at risk of becoming the “class clown” or becoming the “most rebellious” or the “outrageous” one to get some attention and acknowledgement from their peers. On the whole, ADD/ADHD is a complex disorder and usually there are accompanying conditions such as depression, learning difficulties, anger and anxiety which can affect adolescents with ADD/ADHD in widely contrasting ways. Sandton Psychology Centre has psychologists that work with adolescent difficulties and issues. It may become necessary for a parent to seek professional assistance for their teenager during this period. Adolescents will likely benefit from psychological intervention that will teach them how to deal with impulsive behaviour, difficulty with remaining focused and/or organisational skills, long-term planning and low self-esteem which are all aspects related to ADHD

March 2, 2015
Edublox - Reading & Learning Clinic

What Is Dyslexia Really? Part 2

Di dunia kini kita, tiap orang harus dapat membaca…. Unless one has FIRST learned to speak Bahasa Indonesia, there is no way that one would be able to read the above Indonesian sentence. This shows that language is at the very bottom of the reading ladder. Its role in reading can be compared to the role of running in the game of soccer, or ice-skating in the game of ice hockey. One cannot play soccer if one cannot run, and one cannot play ice hockey if one cannot skate. One cannot read a book in a language – and least of all write – unless one knows the particular language. If a child’s knowledge of English is poor, then his reading will also be poor. Evidence that links reading problems and language problems has been extensively presented in the literature. Research has, for example, shown that about 60 percent of dyslexics were late talkers. In order to prevent later reading problems, parents must therefore ensure that a child is exposed to sufficient opportunities to learn language. The second rung consists of cognitive skills While language skills comprise the first rung of the reading ladder, cognitive skills comprise the second. There is a whole conglomeration of cognitive skills that are foundational to reading and spelling. Attention “Everyone knows what attention is,” wrote William James in his Principles of Psychology (1890). “It is the taking of possession by the mind in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought… It implies withdrawal from some things in order to deal effectively with others, and is a condition which has a real opposite in the confused, dazed, scatterbrained state.” Needless to say, attention or concentration (the words attention and concentration are used synonymously) plays a critical role in learning. Focussed attention is the behavioural and cognitive process of selectively concentrating on one aspect of the environment while ignoring other things, while sustained attention refers to the state in which attention must be maintained over time. Both are important foundational skills of reading. Because attention is so important for reading, ADHD and dyslexia commonly co-occur. Approximately 25 percent of children who are diagnosed with ADHD, a learning difficulty known to affect concentration, are also dyslexic. Visual perception Visual perception plays a significant role in school learning, particularly in reading. Visual perceptual deficit refers to a reduced ability to make sense of information taken in through the eyes. This is different from problems involving sight or sharpness of vision. Difficulties with visual perception affect how visual information is interpreted or processed. The person may have a difficulty to discriminate in terms of foreground-background, forms, size, and position in space. He may also be unable to synthesise and analyse. Foreground-background differentiation involves the ability to focus on selected objects and screen out or ignore the irrelevant ones. The child experiencing a difficulty in this area is unable to recognise an object which is surrounded by others. For example, the child cannot locate a ball in a picture of several toys, or a word in a word-find puzzle. Form discrimination: Whether it is to differentiate a circle from a square, or the letter B from P, the ability to perceive the shapes of objects and pictures is an important skill for the developing child to acquire. There is hardly an academic activity that does not require the child to engage in form discrimination. The most obvious classroom activity requiring the child to discriminate forms is that of reading. The learning of the letters of the alphabet, syllables, and words will undoubtedly be impeded if there is difficulty in perceiving the form of the letters, syllables, and words. That the discrimination of letters is a crucial skill in the early stages of reading is evidenced by an extensive literature review conducted by Chall (1967). She concluded that the letter knowledge of young children is a better predictor of early reading ability than the various tests of intelligence and language ability. Size discrimination: Capital letters, being used at the start of a sentence, sometimes look exactly the same as their lowercase counterparts, and must therefore be discriminated mainly with regard to size. A person who is unable to interpret size may, for example, find it difficult to distinguish between a capital letter C and a lowercase c. Spatial relations refer to the position of objects in space. It also refers to the ability to accurately perceive objects in space with reference to other objects. A person with a spatial problem may find it difficult to distinguish letters like b, d, p, and q. Synthesis and analysis: Synthesis refers to the ability to perceive individual parts as a whole, while analysis refers to perceiving the whole in its individual parts. Synthesis plays an important role in reading, whereas analysis is of special importance in spelling. Auditory perception Myklebust defines auditory perception as the ability to “structure the auditory world and select those sounds which are immediately pertinent to adjustment.” Berry and Eisenson state that children with auditory perceptual deficits can hear sounds but are unable to recognise them for meaning. Defined as the ability to recognise or interpret what is heard, auditory perception plays as important a role as visual perception in reading. Problems with auditory perception generally correspond to those in the visual area and are presented under the following components: Auditory foreground-background differentiation refers to the ability to select and attend to relevant auditory stimuli and ignore the irrelevant. The child who has a difficulty in this area is unable to make such differentiation. As a consequence, everything heard is attended to equally. Thus, the teacher’s voice is lost in the background noises of other children’s whispers, or the voices in the corridor, or the traffic sounds coming from the street. Auditory discrimination refers to the ability to hear similarities and differences between sounds. The child who has a problem in this area is unable to identify gross

November 18, 2014
Parenting Hub

What Is Dyslexia Really? Part 1

The term dyslexia was coined from the Greek words dys, meaning ill or difficult, and lexis, meaning word. Spelling and writing, due to their close relationship with reading, are usually also included. According to popular belief dyslexia is a neurological disorder in the brain that causes information to be processed and interpreted differently, resulting in reading difficulties. Historically, the dyslexia label has been assigned to learners who are bright, even verbally articulate, but who struggle with reading; in short, whose high IQs mismatch their low reading scores. When children are not as bright, their reading troubles have been chalked up to their general intellectual limitations. What does it look and sound like? One of the most obvious tell-tale signs is reversals. People with this kind of problem often confuse letters like b and d, either when reading or when writing, or they sometimes read (or write) words like “rat” for “tar,” or “won” for “now.” Another sure sign is elisions – that is when a person sometimes reads or writes “cat” when the word is actually “cart.” The person may read very slowly and hesitantly, read without fluency, word by word, or may constantly lose his place, thereby leaving out whole chunks or reading the same passage twice. The person may try to sound out the letters of the word, but then be unable to say the correct word. For example, he may sound the letters “c-a-t” but then say “cold.” He may read or write the letters of a word in the wrong order, like “left” for “felt,” or the syllables in the wrong order, like “emeny” for “enemy,” or words in the wrong order, like “are there” for “there are.” He may spell words as they sound, for example “rite” for “right.” He may read with poor comprehension, or it may be that he remembers little of what he reads. The person may have a poor and/or slow handwriting. Some misconceptions Because of the erroneous belief that the brain cannot change, it was historically believed that dyslexia is “incurable”: “Dyslexia is like alcoholism … it can never be cured” (Clark, M., & Gosnell, M., “Dealing with dyslexia,” Newsweek, 22 March 1982, 55-56.) Advocacy groups, in the rush to generate public awareness for the condition of dyslexia, with the cooperation of a compliant media, have perpetuated the belief that a host of famous individuals such as Albert Einstein, Leonardo da Vinci, Thomas Edison, Walt Disney, Winston Churchill and Hans Christian Andersen were dyslexic. The folk myth – the “affliction of the geniuses” – continues to be spread despite the fact that knowledge of the definition of dyslexia and the reading of any standard biographies would immediately reveal the inaccuracy of many such claims. For example, as educational psychologist Dr Coles points out, Einstein’s reading of Kant and Darwin at age thirteen is hardly representative of individuals who are currently labelled dyslexic. New technology sheds new light By the turn of this century, the advancement in technology has made it possible for scientists to see inside the brain, resulting in the knowledge that the brain is plastic. New connections can form and the internal structure of the existing synapses can change. New neurons, also called nerve cells, are constantly being born, particularly in the learning and memory centres. A person who becomes an expert in a specific domain, will have growth in the areas of the brain that are involved with their particular skill. Even if the left hemisphere of a person’s brain is severely injured (in 95% of people the left hemisphere controls the capacity to understand and generate language), the right side of the brain can take over some language functions. With fMRI-scans et cetera it has now been confirmed that – as was always suspected – there are indeed differences between the brains of dyslexic persons and good readers. More and more research studies, however, suggest that the cause-effect relationship should be reversed, i.e. that these differences might not be the cause, but the effect of the reading difficulty. Using brain imaging scans, neuroscientist John D. E. Gabrieli at the Massachusetts Institute of Technology have found that there was no difference between the way poor readers with or without dyslexia think while reading. The study conducted by Dr Gabrieli involved 131 children, aged 7 to 16. Following a simple reading test and an IQ measure, each child was assigned to one of three groups: typical readers with typical IQs, poor readers with typical IQs, and poor readers with low IQs. During the test, researchers used functional magnetic resonance imaging (fMRI) to observe the activity in six brain regions identified as being important in connecting print and sound. The results indicated that poor readers of all IQ levels showed significantly less brain activity in the six observed areas than typical readers. But there was no difference in the brains of the poor readers, regardless of their IQs. Another study, published online in the Journal of Neuroscience, researchers analysed the brains of children with dyslexia and compared them with two other groups of children: an age-matched group without dyslexia and a group of younger children who had the same reading level as the children with dyslexia. Although the children with dyslexia had less grey matter than age-matched children without dyslexia, they had the same amount of grey matter as the younger children at the same reading level. Lead author Anthony Krafnick said this suggests that the anatomical differences reported in left-hemisphere language-processing regions of the brain appear to be a consequence of reading experience as opposed to a cause of dyslexia. One must also consider that neurological differences do not equal neurological disorders and disabilities. We now also know that there are differences between the brains of people who can juggle and people who cannot juggle, between the brains of people who can play a musical instrument and people who cannot play a musical instrument. Then logically there will be differences between the brains of people who read

November 13, 2014
Parenting Hub

ADHD and Diet – is there a link and what should parents of a child with ADHD consider?

What is ADHD? Attention-deficit/hyperactivity disorder (ADHD) is a syndrome diagnosed in many children. The exact percentage of children with ADHD is not known but figures are estimated at about 3-5% of school age children¸ with the incidence being slightly higher in boys. The main symptoms of ADHD are reduced attentiveness and concentration, excessive levels of activity, distractibility and impulsiveness. Some children may be affected by other behavioural problems. Sometimes children outgrow the symptoms or learn to control them; in some cases symptoms may persist into adulthood. ADHD can have a significant effect on families particularly when a child’s ability to learn is compromised. This can have a knock on effect on the child’s self-esteem and put stress on the rest of the family particularly when the child has difficulty focussing on essential activities or controlling impulsive behaviour. Is there a link with diet? For some time there has been much controversy regarding whether or not diet can trigger symptoms of ADHD. It was first suggested by Feingold in the mid-1970s that there was a possibility that food additives and natural food constituents could affect children’s behaviour, particularly those with ADHD. Scientists began to look into the theory with further research being conducted. Unfortunately many of the studies are small or flawed, and thus there is little consensus about how such additives might contribute to ADHD symptoms. Artificial additives… Recently the link between diet and additives has been explored in a study in Britain. The results of this study led the UK’s Food Standards Agency to urge food manufacturers to remove six artificial colouring agents from food marketed to children in Britain.  They looked at the effects of the preservative sodium benzoate (E211) and six artificial food colourings on hyperactivity in 153 preschoolers (3 years old) and 144 students (8 or 9 years old). For six weeks, the children consumed foods and drinks free of sodium benzoate and the six colouring agents. At certain intervals, the children consumed plain juice or juice containing one of two additive mixes every day for a week. Mix A contained the preservative plus the colourings sunset yellow (E110), carmoisine (E122), tartrazine (E102), and ponceau 4R (E124); mix B contained the preservative plus sunset yellow(e110), carmoisine (E122), quinoline yellow (E104), and allura red AC (E129).  The investigators found a mild but significant increase in hyperactivity in both age groups of children, regardless of baseline hyperactivity levels during the weeks when they consumed drinks containing artificial colours. Sugar… With the belief by some parents and health professionals that refined sugars trigger hyper-activity, the evidence for this has also been reviewed; however assessing the effect of “sugars” on behaviour can be tricky as there are several different types of sugar added to foods, for example: sucrose, glucose and fructose. Unfortunately there are only a few reliable studies that have been conducted. The studies show that sugars may affect a small number of children. We do know that these days in some cases children are having well over double the recommended daily added sugar intake and so to avoid excess empty calories if for no other reason, families should be aiming for a reduced added sugar intake. Omega-3’s… Because fatty acids perform a number of functions in the brain, including helping brain cells to communicate, researchers have explored whether a deficiency of omega-3 fats might contribute to symptoms of ADHD. There are some studies which do show an improvement, none have definitively resolved the question of whether omega-3 or omega-6 supplements might help children with ADHD. Further studies are being conducted to explore this. Where does this leave the parent of a child with ADHD? Getting to the bottom of whether you child’s behaviour is affected by diet, can be tricky but not impossible. One of the most important principles to remember is to choose a balanced diet with the correct proportion of macronutrients and micronutrients from meats, wholegrain starches, dairy, fresh fruit & vegetables and the good oils like olive and canola. This will ensure that your child’s diet is providing an optimal source of all the important nutrients and prevent any deficiencies which might exacerbate symptoms of ADHD. Choose wholegrain cereals as the basis for meals. These will provide slow release energy and prevent any peaks and troughs in sugar levels which can also affect moods and behaviour. Whole-grains are also rich in b-complex vitamin and minerals Choose wholegrain and rye breads, cereals, pastas and rice instead of sugary cereals and refined breads Have meat or meat alternatives twice per day, a portion roughly size of your child’s palm Try to serve oily fish twice a week to optimise intake of omega-3’s Try homemade salmon fish cakes or a sardine pate Opt for fresh fruits fruit, milk or yoghurt and nuts as snacks between meals These provide slow release energy and are a great source of good fats and minerals Try fruit kebabs or a homemade fruit smoothie Avoid excess sugar Excess refined carbs in the form of excess sugar leads to excess energy which will need to be expended or stored somewhere!!! Avoid carbonated beverages, fruit juices, cordials, sweets, chocolates, cakes and biscuits – have as a treats on special occasions or a day of the week rather than every day Consider an exclusion diet if necessary Preferably do with dietetic and/or medical supervision Look at avoiding additives particularly in the form of artificial E-numbers (E102, 104, 110, 122, 124, E129) & sodium benzoate (E211) as well as other more specific foods like chocolate if necessary. In certain cases an appropriate option might be a few foods diet with gradual re-introduction of foods to determine if any are causing symptoms. REFERENCES: McCann et al (2007) The Lancet DOI:10.1016/S0140-6736(07)61306-3 : Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial Diet & ADHD Behaviour CSPI Review (1999)

October 13, 2014
Parenting Hub

ADHD?

“There was a little girl who had a little curl Right in the middle of her forehead. When she was good she was very, very good, And when she was bad She was diagnosed with Attention Deficit Hyperactivity Disorder.” This is quote from the British Satirical Magazine, Private Eye. Amusing maybe but also very sad, and makes me wonder how often a perfectly normal child is diagnosed with ADHD. Ritalin Deficiency? ADHD is characterized by impulsive behavior, inability to concentrate, short attention span, ease of distraction, and hyperactivity. The number-one drug used to treat ADHD is Ritalin, a central nervous system stimulant. Is it possible we are breeding a new generation of children who are Ritalin deficient? Highly unlikely. Try this theory rather: ADHD is caused by the food that children of this generation are putting into their mouths. How do we expect a child to have normal behaviour if he is fed refined grains, sugars, processed foods loaded with chemicals, juices and fizzy drinks? Then add to that 90 percent fewer vegetables than required along with an overabundance of omega-6 fats and a virtual lack of omega-3 fats. Fish oil does it again A study by the University of Adelaide in Australia found that fish oil improves the symptoms of ADHD more effectively than drugs like Ritalin and Concerta and without any of the side effects. When 130 children between the ages of 7 and 12 with ADHD were given fish oil capsules daily, behaviour dramatically improved within three months. Furthermore, after seven months, the children were not as restless and showed improvements at school in concentration and attention, reading abilities and vocabulary. When the researchers compared their results to studies of Ritalin and Concerta for ADHD, they found that fish oils were more effective. This poses the question: “Why treat millions of ADHD kids with drugs more powerful than cocaine when a simple food change is far more effective?” – I leave that one for you to think about. The Cleverness Capsule The Daily Mail reported the following on 10 May 2005: “Jamie Oliver may be responsible for revolutionising school dinners, but now it seems one simple change to children’s diet could not only boost their brain power but also make them better behaved.  A major new study found that adaily dose of fish oil supplements had a dramatic effect on the abilities of underachieving children in Durham.” Apart from the fact that parents reported a significant improvement in their behaviour, after just three months on the fish oils, they were reading at18 monthsabove their age.In addition, most of the pupils showed a 10 – 20% improvement in memory. The supplement was also given to children without behavioural or learning difficulties and in some of these cases a dramatic and even immediate effect was reported. Numerous studies Numerous studies conducted in all parts of the world on the effect of supplementing with Omega-3 from fish oils have shown similar results leaving a strong suggestion that some children with developmental problems, including ADHD and dyslexia, can benefit from taking omega-3 supplements. And no adverse effects have been reported to date. Researchers believe that fish oil works via effects on brain function. You simply cannot have a healthy functioning brain in a child that is not given the proper ingredients to develop optimal brain function. What else is needed? If you have a child with learning or behavioural difficulties, before you allow him or her to be labeled ADHD and placed on Ritalin, it may be worth giving fish oil a chance. However this will need to go hand-in–hand with a healthy diet and a good multivitamin and mineral supplement. All the fish oil in the world is not going to help a child who is still being fed junk food.

July 14, 2014
Parenting Hub

Dyslexia Symptoms and Signs: How to Recognize Dyslexia

“Deer momee and dadee I bo not wont to do to shool eny more becouse the children ar lafing at me. I canot reed pleese help me your sun david” David is not a dunce. In fact, according to the evaluations of a few professionals, he is rather intelligent. Yet he certainly has a problem, and he shares his problem with millions of other children and adults. David is dyslexic. The term “dyslexia” was introduced in 1884 by the German ophthalmologist, R. Berlin. He coined it from the Greek words dys meaning ill or difficult and lexis meaning word, and used it to describe a specific disturbance of reading in the absence of pathological conditions in the visual organs. In a later publication, in 1887, Berlin stated that dyslexia, “presuming right handedness,” is caused by a left-sided cerebral lesion. He spoke of “word-blindness” and detailed his observations with six patients with brain lesions who had full command over verbal communications but had lost the ability to read. In the century to follow the narrow definition Berlin attached to the term dyslexia would broaden. Today the term dyslexia is frequently used to refer to a “normal” child — or adult — who seems much brighter than what his reading and written work suggest. While the term is mostly used to describe a severe reading problem, there has been little agreement in the literature or in practice concerning the definition of severe or the specific distinguishing characteristics that differentiate dyslexia from other reading problems. Instead of getting involved in the wrangling over a definition, one could simply use the “symptoms” below as an indication that a child has a reading problem and therefore needs help. DIRECTIONAL CONFUSION Directional confusion may take a number of forms, from being uncertain of which is left and right to being unable to read a map accurately, says Dr. Beve Hornsby in her book Overcoming Dyslexia. A child should know his left and right by the age of five, and be able to distinguish someone else’s by the age of seven. Directional confusion affects other concepts such as up and down, top and bottom, compass directions, keeping one’s place when playing games, being able to copy the gym teacher’s movements when he is facing you, and so on. As many as eight out of ten severely dyslexic children have directional confusion. The percentage is lower for those with a mild condition, she says. Directional confusion is the reason for reversing of letters, whole words or numbers, or for so-called mirror writing. The following symptoms indicate directional confusion: The dyslexic may reverse letters like b and d, or p and q, either when reading or writing. He may invert letters, reading or writing n as u, m as w, d as q, p as b, f as t. He may read or write words like no for on, rat for tar, won for now, saw for was. He may read or write 17 for 71. He may mirror write letters, numbers and words. SEQUENCING DIFFICULTIES Many dyslexics have trouble with sequencing, i.e. perceiving something in sequence and also remembering the sequence. Naturally this will affect their ability to read and spell correctly. After all, every word consists of letters in a specific sequence. In order to read one has to perceive the letters in sequence, and also remember what word is represented by the sequence of letters in question. By simply changing the sequence of the letters in name, it can become mean or amen. The following are a few of the dyslexia symptoms that indicate sequencing difficulties: When reading, the dyslexic may put letters in the wrong order, reading felt as left, act as cat, reserve as reverse, expect as except. He may put syllables in the wrong order, reading animal as ‘aminal’, enemy as ’emeny’. He may put words in the wrong order, reading are there for there are. The dyslexic may write letters in the wrong order, spelling Simon as ‘Siomn’, time as ‘tiem’, child as ‘chidl’. He may omit letters, i.e. reading or writing cat for cart, wet for went, sing for string. Dyslexics may also have trouble remembering the order of the alphabet, strings of numbers, for example telephone numbers, the months of a year, the seasons, and events in the day. Younger children may also find it hard to remember the days of the week. Some are unable to repeat longer words orally without getting the syllables in the wrong order, for example words like preliminary and statistical. DIFFICULTIES WITH THE LITTLE WORDS A frequent comment made by parents of children struggling with their reading is, “He is so careless, he gets the big difficult words, but keeps making silly mistakes on all the little ones.” Certainly, the poor reader gets stuck on difficult words, but many do seem to make things worse by making mistakes on simple words they should be able to manage — like ‘if’, ‘to’, ‘and’. The following are indications of problems with the little words: Misreads little words, such as a for and, the for a, from for for, then for there, were for with. Omits or reads twice little words like the, and, but, in. Adds little words which do not appear in the text. It is important to note that this is extremely common, and not a sign that a child is particularly careless or lazy. LATE TALKING Research has revealed a dramatic link between the abnormal development of spoken language and learning disabilities such as dyslexia. The following are just a few examples: A study in 1970 of Doctor Renate Valtin of Germany, based on one hundred pairs of dyslexic and normal children, found indications of backwardness in speech development and a greater frequency of speech disturbances among dyslexics than among normal children. According to Doctor Beve Hornsby, author of Overcoming Dyslexia, about 60 percent of dyslexics were late talkers. In her book Learning Disabilities, author Janet Lerner states, “language problems of one

April 27, 2014
Parenting Hub

Is Dyslexia a Brain Dysfunction? An Alternative Interpretation of the Facts

Research indicates that the dyslexic’s brain differs from that of a “normal” reader. Does this mean that dyslexia is caused by a neurological dysfunction or is there an alternative interpretation that explains these differences? Many methods and measuring instruments have so far been employed to either prove or disprove that dyslexia has a biological basis, ranging from autopsies on the brains of deceased dyslexics, to advanced technological tools such as the computerized axial tomography (CAT) scan, magnetic resonance (MR) imaging, functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and single photon emission computerized tomography (SPECT). While researchers still differ in opinion about the affected brain area(s), the majority nowadays agrees that the dyslexic’s brain differs from that of a “normal” reader. Booth and Burman found that people with dyslexia have less gray matter in the left parietotemporal area than nondyslexic individuals. Deutsch et al. found that many people with dyslexia also have less white matter in this same area than average readers, which is important because more white matter is correlated with increased reading skill. Having less white matter could lessen the ability or efficiency of the regions of the brain to communicate with one another. Using functional magnetic resonance imaging (fMRI), NIH scientists Guinevere Eden, D.Phil., and colleagues demonstrated in a small controlled study of adult males that people with dyslexia showed no activation in the V5/MT brain area, which specializes in movement perception. Dr. Eden’s research confirms that people with dyslexia, hobbled by problems with reading, writing, and spelling, have trouble processing specific visual information. “We found that maps of brain activity measured while subjects were given a visual task of looking at moving dots were very different in individuals with dyslexia compared to normal control subjects,” said Dr. Eden. The control subjects showed robust activity in brain region V5/MT when viewing a moving dot pattern. Almost no activity was present in those areas in people with dyslexia. The problem is that such observations have to be interpreted, especially in relation to the question of cause and effect. Which of the two, the brain differences or the reading disability, is the cause and which one is the effect? Because of the biological determinists’ reluctance to recognize that the environment can affect brain function and structure, they assume that these differences must be the cause and the reading disability the result. Some maintain that the brain develops in definite stages. They call these stages “critical periods” in brain development: if you haven’t learned the skill by then, you never will. They maintain that this is because as the brain develops, certain circuits are set up which cannot be changed. We, however, hypothesize that dyslexia causes differences in brain function and structure, and that the brain structure and function will change if the dyslexic person is taught to read properly. A logical point of departure for such an argument would be to first establish if brain function and structure could be altered. There is ample confirmation in the literature that indeed it can. The Brain CAN Change, Experts Say In 1979 already, in an article in the Journal of Learning Disabilities, Doctors Marianne Frostig and Phyllis Maslow stated, “Neuropsychological research has demonstrated that environmental conditions, including education, affect brain structure and functioning.” In their book Brain, Mind, and Behavior Floyd E. Bloom, a neuropharmacologist, and Arlyne Lazerson, a professional writer specializing in psychology, state, “Experience [learning] can cause physical modifications in the brain.” This is confirmed by Michael Merzenich of the University of San Francisco. His work on brain plasticity shows that, while areas of the brain are designated for specific purposes, brain cells and cortical maps do change in response to experience (learning). Recently, German researchers found that juggling increases the size of your brain. Arne May, neurologist at the University of Regensburg, and colleagues asked 12 people in their early 20s, most of them women, to learn a classic three-ball juggling trick over three months until they could sustain a performance for at least a minute. Another 12 were a control group who did not juggle. All the volunteers were given a brain scan with magnetic resonance imaging at the start of the program, and a second after three months. After this, the juggling group was told not to practice their skills at all for three months, and then a third scan was taken of all 24 volunteers. The scans found that learning to juggle increased by about three percent the volume of gray matter in the mid-temporal area and left posterior intra-parietal sulcus, which are parts of the left hemisphere of the brain that process data from visual motion. Students who had not undergone juggling training showed no such change. After the third scan, by which time many recruits had forgotten how to juggle, the increases in gray matter had partly subsided. “Our results contradict the traditionally held view that the anatomical structure of the adult human brain does not alter, except for changes in morphology caused by aging or pathological conditions,” their study says. Researchers at University College London studied the brains of 105 people, 80 of whom were bilingual, and found that learning a new language altered gray matter the same way exercise builds muscles. Gaser and Schlaug found gray matter volume differences in motor, auditory, and visual-spatial brain regions when comparing professional musicians with a matched group of amateur musicians and non-musicians. Gray matter (cortex) volume was highest in professional musicians, intermediate in amateur musicians, and lowest in non-musicians. It seems that, while stimulation causes brain growth on the one hand, the lack of stimulation, on the other hand, causes a lack of brain growth. Doctors Bruce D. Perry and Ronnie Pollard, two researchers at Baylor College of Medicine, found that children raised in severely isolated conditions, where they had minimal exposure to language, touch and social interactions, developed brains 20 to 30 percent smaller than normal for their age. Let us now theorize on these findings and compare the development of

March 6, 2014
Load More

Sidebar Image

Scroll to Top