Early childhoodintervension awareness

FOR SCHOOLS WITH INCLUSION
SRIKANTH K S
NOV-2015
Updated 1-02-2021
Early years identification and
Intervention – Childhood disorders
© Srikanth KS 2015 . All rights reserved. Copying contents without written permission forbidden
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Some statistics
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Terms and Definitions
⚫ Impairment : Any loss or abnormality of psychological,
physiological or anatomical structure or function. In
simple Deviation from the normal
⚫ Dis-ability : Any restriction or lack (resulting from an
impairment) of ability to perform an activity in the
manner or within the range considered normal for a
human being. In simple unable to do what an average
person of that age can do
⚫ Primary Handicap : a disadvantage for a given individual
that limits or prevents the fulfilment of a role that is
normal.
⚫ Secondary Handicap: A disadvantage that was created by
the person due to lack of movement
A SECONDARY HANDICAP IS MAN MADE!
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The human brain
THE REGION OF USED MORE GROWS MORE
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Nerve and connections
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Nerve connections
THICKER THE CONNECTIONS LONGER IT REMAINS
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Bundles of nerves and its relationship
NERVE ENDINGS ARE BELOW THE SKIN
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Bundles of nerves and its relationship
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MORE YOU WALK TO THE WELL LESSER THE WEEDS

Neural Plasticity and Pruning
⚫Plasticity describes how experiences recognise
neural pathway in the brain.
⚫A newborn infant will get a lot of signals directed to
the brain. The data from the eyes is sent to the
occipital lobe which is the spot for vision and not the
temporal lobe which processes language
⚫An infant's brain can have upto 15000
Synapse per neuron.
⚫As age increases, the syaptic connections
are cut by a routine process called
Synaptic Pruning
BRAIN ALWAYS KEEPS GROWING
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Neural Plasticity
⚫Normal brain undergoes pruning on a routine basis,
the stronger experience has a stronger path way
where as a less used experience is pruned.
⚫Pruning can also happen as a part of an adaptive
mechanism called as Injury induced pruning like
stroke or trauma.
⚫In case of children with ADS, the process of pruning
is not complete
THE PRINCIPAL ACTIVITIES OF BRAINS ARE MAKING CHANGES IN THEMSELVES."
--MARVIN L. MINSKY
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Developmental milestones 0 – 3 months
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0 – 3 months Observation Alarm
Hearing fully
developed
Child able to turn in the
direction of sound
Does not respond to loud
sound or does not turn in the
direction of sound
Vision 8-11 inches
black and white
Child able to react to
bright light
Feeds slowly, sloppy behaviour
does not react to bright light
Motor skill Can move hands close to
mouth while lying
Able to shake hands and
legs
EVERY CHILD MUST REACH THESE MILESTONES

Developmental milestones 3 months
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3 months Observation Alarm
Motor skill Can support head. Can lift
his/her head and tend to turn
around, does mini push-up
Cannot support head well
Cannot grasp toys (fine
motor)
Speech Starts babbling with VCV
double syllable, puts lips
together to say “m”
Nasal sounds heard. Cries
with different tone for
different needs
Vocally expresses eagerness
Cant focus on moving
object
Does not smile on seeing
familiar face ignores new
faces

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Motor skill Can roll over tummy, sit
without help support his/her
weight using legs Pulls toys
closer, can move toys from
one hand to another
Cant hold her head steadily,
Seems floppy, cant sit down
on her own
Speech Babbling conversations with
you
Does not express eagerness
Vision Can see full colour. Can track
objects moving far away
Focuses on specific toys
only like spinning wheels
Does not make an eye
contact while speaking
Auditory Responds to name call
Able to distinguish familiar
and unfamiliar voices.
Able to track sound
Does not respond to name
call

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Motor skill Can crawl quite fast.
Can bring toys closer to him
Can lift small objects using two
fingers
Makes gestures like “yes” “no” to
express himself. tries to copy
elders like drinking from cup,
combing hair,
Does not crawl
Cant stand with support
Cannot hold toys
Does not use gestures
like yes, no
Speech Babbling continues, able to speak
small sentences like amma, appa,
papa,
Vision Listens to and sees your lips
while speaking

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Social and emotional Is shy meeting strangers
Cries when mother or father
leaves
Shows fear in situations like
lights turned off in a room
Does not react when
parents leave. Does not
respond to name calls
Language Points to pictures when its
named
Says several single words and
makes short sentences
Follows instructions
Cannot speak small
sentences.
Does not follow simple
instructions
Cannot walk by 18
months
Cognitive milestone Begins to sort by shape and
colour
Demonstrates independence
Cannot push wheeled
toys

Development Disabilities an overview
Development
Disabilities
Specific
disability
Speech and
language
disorder
Reading
disorder/
Spelling
disorder
Mathematical
disorder
Motor Disorder
Gross motor
disorder (CP)
Fine motor
disorder
Global
intellectual
disbility
Attention
deficit hyper
activity
disorder
Autism
spectrum
disorder
BROAD CLASSIFICATION OF DISORDERS
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Learning disabilities terms and Definitions (1/2)
⚫APD : Auditory processing disorder. Inability to
distinguish subtle differences in sound example
belt/built; three/free
⚫LPD: Language processing disorder, A part of APD
where the child is not able to co-relate an object for a
given sound.
⚫Dyscalculia: Difficulties in mathematics
⚫Dysgraphia: Handwriting difficulties
⚫Dyslexia: Reading and language based processing
skills
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Terms and definitions (2/2)
⚫Non verbal learning disabilities : Discrepancy
between higher verbal skills and weaker motor or
visual-spatial and social skills
⚫Visual Motor defect: Difficulties to draw or copy
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Non learning disorders. Terms and Definitions
⚫ADHD (Secondary disorder) Attention deficiency
and hyperactivity. Unable to pay attention and
difficulty in controlling behaviour
⚫Autism Spectrum disorder
⚫Dyspraxia: Difficulty in motor control normally co-
exist with Dyslexia or Dyscalculia or ADHD
⚫Executive functioning: Inefficiency of cognitive
management like planning, remembering details,
paying attention
⚫Memory : Deficiencies in short term, working or long
term memory
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Approach in identifying childhood disabilities
⚫ Disorders can affect a child from 1 to 22 years.
⚫ Many a times a incorrect medical condition can be
mistaken for a disorder. Example if a child is very tired,
always gazing out of the window, there is a possibility of
mistaking it for ADHD where as it could be a simple case
of anemia
⚫ Dispassionate observation: A good teacher is one who
knows what is in the mind of the last bench students
⚫ Screen the professional
⚫ Create an individualized learning plan for special
children.
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Auditory processing disorder
and Language processing disorder
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⚫ Difficulty hearing in noisy situations
⚫ Difficulty following long conversations
⚫ Difficulty remembering spoken
information (i.e., auditory memory
deficits)
⚫ Difficulty taking notes
⚫ Difficulty with reading and/or spelling
⚫ Difficulty processing nonverbal
information (e.g., lack of music
appreciation)
⚫ Poor spellings bad at dictations
ADHD AND APD PRESENTS SIMILAR SYMPTOMS

APD/LPD Presentation and Intervention
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⚫ Changing the learning environment (Less noisy)
⚫ Use of electronic devices for aiding learning
⚫ Consult a speech therapist and/or audiologist
⚫ For Language processing disability : Use the following technique See 🡪 Say
🡪 Do
⚫ Example If the student needs to write the word Bag the teacher says Bag,
Bag (two times) student repeats Bag, Bag (two times) and then student
writes it once
Short video demonstration

Why Say – Say Do is important
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APD screening technique
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⚫Fishers_auditory_checklist
⚫Childrens_performance_scale
⚫SIFTER
⚫Its important that the teacher fills in this checklist
along with each parent

Dyscalculia : Mathematics
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⚫ Can occur any time from childhood until the teen ages
⚫ No feel for numbers, No sense of numbers
⚫ Numbers not connected with a Magnitude
⚫ 4 + ---- = 9
⚫ Counting for any calculations
⚫ Trouble with sequencing
⚫ Unable to memorise tables
⚫ Tendency not to notice patterns
⚫ Left right confusion
⚫ Difficulty in reading the clock, Money
⚫ Gradually reduce number counting and make them
realise the magnitude
⚫ Difficulty in seeing the time
Note its quite tough to identify Dyscalculia
LOOK FOR SIGNS WHO ARE IN CLASS 5 AND ABOVE

Dysgraphia – handwriting difficulties
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⚫ Handwriting is illegible
⚫ Missing words and letters incomplete sentences
⚫ Awkward pencil grip , several spelling mistakes
⚫ Says words aloud while writing
⚫ Most of the times does not complete notes
CAN TAKE LONG TIME TO CURE SOMETIMES DISAPPEARS WITH AGE

Example
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UNPLANNED CANNOT WRITE ON PLAIN PAPER MIXING CASE

Dyslexia – Reading and writing
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⚫ Affects 3-7% of the population
⚫ Generally very clever child but has difficulty in reading,
writing or spellings
⚫ Talented in art, drama sports or music
⚫ Seems to day dream
⚫ Has extended hearing – hears things that are not said
example understands and reads “Enabled” as “Disabled”
⚫ Putting letters and figures the wrong way round – such
as writing "6" instead "9", or "b" instead of "d"
⚫ Answering questions well orally, but having difficulty
writing down the answer

Dyslexia simulation
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⚫Read the following passage and answer the following
questions – Time allotted 2 minutes
⚫What other roles does the disability advisor at
UMIST have ?

Dyslexia original text
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Secondary disorders
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⚫ Attention deficiency-Hyperactivity disorder
⚫ Most common childhood disorder can continue during
adulthood. It is mainly composed of three broad types
⚫ Predominantly hyperactive-impulsive:
⚪ Fidgeting hands
⚪ Unable to sit in a place for a while
⚪ Dash around and touch or play with everything around.
⚪ Difficulty in doing a focussed task like assembling a lego toy
⚪ Talks Non stop
⚪ Be in constant motion, very impatient, difficulty in waiting for their
turn
⚪ Poor in academics
FEELING LEFT OUT !

ADHD Continued
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⚫Predominantly inattention :
⚪ Be easily distracted, miss details, forget things, and frequently switch
from one activity to another
⚪ Become bored with a task after only a few minutes, unless they are
doing something enjoyable
⚪ Daydream, become easily confused, and move slowly
⚪ Struggle to follow instructions.
⚪ Have trouble completing or turning in homework assignments, often
losing things (e.g., pencils, toys, assignments) needed to complete
tasks or activities
⚪ Poor in academics
⚫ Combined hyperactive-impulsive and inattentive
– A mix of both
CAN BE EASILY CONFUSED WITH BIPOLAR DISORDER !!

ADHD continued
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⚫Causes : Not clearly identified yet.
⚫Average age of Onset is 7 years can occur later as well
⚫It can be contained using medication and proper
therapy. The disorder can be contained if identified
early

Identification techniques
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⚫ No single test can diagnose a child as having ADHD.
⚫ Most children get distracted, act impulsively, and struggle to
concentrate at one time or another. Sometimes, these normal
factors may be mistaken for ADHD
⚫ Often, teachers notice the symptoms first, when a child has
trouble following rules, or frequently "spaces out" in the
classroom or on the playground
⚫ Some children with ADHD also have other illnesses or
conditions
⚪ A learning disability
⚪ Oppositional defiant disorder : Very stubborn children who argue
with parents very often
⚪ Conduct disorder: Telling lies, stealing, fighting or bullying
⚪ Bipolar disorder: Extreme mood swings
⚪ Tourette syndrome: Or nervous Tics
TOUGH TO DETECT AND CANNOT BE FULLY CURED

Autism Spectrum Disorder
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⚫Persistent deficits in social communication and
social interaction across multiple contexts;
⚫Restricted, repetitive patterns of behaviour,
interests, or activities;
⚫Symptoms cause clinically significant impairment in
social, occupational, or other important areas of
current functioning.
⚫The term “spectrum” refers to the wide range of
symptoms, skills, and levels of impairment or
disability that children with ASD can have.

Autism Spectrum disorder
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⚫Causes : Scientists don't know the exact causes of
autism spectrum disorder (ASD), but research
suggests that both genes and environment play
important roles
⚫Most people who develop ASD have no reported
family history of autism, suggesting that random,
rare, and possibly many gene mutations are likely to
affect a person's risk.

Autism Spectrum Disorder
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⚫Things to look for
⚪ Does not respond to Name Call
⚪ Very interested in wheeled toys
⚪ Focuses on details rather than the big picture
⚪ Does not Fear heights
⚪ Prefers the same type of food every day
⚪ Hyper active does not feel tired until they get fully exhausted
⚪ Lack of sleep
⚪ Can have language disorders or auditory disorders along with
ASD
ASD IS A SPECTRUM DISORDER

Autism Spectrum disorder
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⚫ Repetitive and stereotyped behaviours
⚫ Children with ASD often have repetitive motions or unusual behaviours. These behaviours may
be extreme and very noticeable, or they can be mild and discreet. For example, some children
may repeatedly flap their arms or walk in specific patterns, while others may subtly move their
fingers by their eyes in what looks to be a gesture. These repetitive actions are sometimes called
"stereotypy" or "stereotyped behaviours."
⚫ Children with ASD also tend to have overly focused interests. Children with ASD may become
fascinated with moving objects or parts of objects, like the wheels on a moving car. They might
spend a long time lining up toys in a certain way, rather than playing with them. They may also
become very upset if someone accidentally moves one of the toys. Repetitive behavior can also
take the form of a persistent, intense preoccupation. For example, they might be obsessed with
learning all about vacuum cleaners, train schedules, or lighthouses. Children with ASD often
have great interest in numbers, symbols, or science topics.
⚫ While children with ASD often do best with routine in their daily activities and surroundings,
inflexibility may often be extreme and cause serious difficulties. They may insist on eating the
same exact meals every day or taking the same exact route to school. A slight change in a
specific routine can be extremely upsetting. Some children may even have emotional outbursts,
especially when feeling angry or frustrated or when placed in a new or stimulating environment.
⚫ No two children express exactly the same types and severity of symptoms. In fact, many
typically developing children occasionally display some of the behaviors common to children
with ASD. However, if you notice your child has several ASD-related symptoms, have your child
screened and evaluated by a health professional experienced with ASD.

Early Symptoms
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⚫ Social impairment, including difficulties with social
communication
⚫ Repetitive and stereotyped behaviours.
⚫ Social impairment
⚫ Most children with ASD have trouble engaging in everyday
social interactions. For example, some children with ASD
may:
⚫ Make little eye contact
⚫ Tend to look and listen less to people in their environment or
fail to respond to other people
⚫ Rarely seek to share their enjoyment of toys or activities by
pointing or showing things to others
⚫ Respond unusually when others show anger, distress, or
affection.

Early screening technique
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⚫For Todlers use MCART checklist
⚫For children > 1 year use CARS checklist

Early intervention
⚫Programs are designed children from 0 to 8 years
⚫Aimed at children who are “At-Risk” for or having
development delays
⚫May typically involve the whole family
⚫May include health, educational and therapeutic
services.
⚫The process
⚫Observe 🡪 Screen 🡪 Rule out medical issues 🡪
Refer for intervention 🡪 Follow up
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Assessment report
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⚫Who is being assessed?
⚫Why were they sent for assessment?
⚫Who referred them?
⚫What were the tools used for assessment?
⚫What are the findings?
⚫What are the recommendations?

Source and references
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⚫DIAGNOSTIC AND STATISTICAL MANUAL OF
MENTAL DISORDERS FIFTH EDI T ION
⚪ The bible of mental disorders (P88)

Early childhoodintervension awareness

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