COMMON Medical term: Autism/Global Dev Delay/Seizures/Cerebral Palsy/Down's Syndrome

[Angelmum]

Scroll down to read individual postings related to: COMMON Medical term: Autism/Global Dev Delay/Seizures/Cerebral Palsy/Down's Syndrome


Global Developmental Delay (GDD clickable)

Babies are usually born programmed to learn important skills such as speaking, socialising or walking in predictable sequences of stages, with the help of encouragement, teaching and support as they grow up. These skills usually develop in predictable sequences and at predictable times. There are well-established average ages for when these stages of skill development occur, although they are all affected by familial factors (children in some families talk later than in others, walk later, or become dry at night later), racial factors (Black children by and large sit up, crawl and walk earlier than White children do) and social factors (children in homes with lots of books and opportunities to read and where reading is a valued and a frequent pastime will read earlier and better than others). All the above stages of skill development are known as developmental milestones and there are a number of these within recognised areas of development (developmental domains).

A child with Developmental Delay has delayed achievement of one or more developmental milestones in one or more developmental domains. A child with Global Developmental Delay (GDD clickable) is one who is delayed in achieving milestones within most, if not all, of these development domains. The prevalence of GDD is estimated to be 5-10 percent of the childhood population, and most children with GDD have impairment of all domains.

These domains of development can be summarized as follows:

* Motor skills (milestones in this domain include, gross motor skills such as sitting up or rolling over and fine motor skills such as picking up small objects);

* Speech and language (which also includes babbling, imitating speech, identifying sounds, communicating using non-verbal means such as gesture, facial expression, eye contact and posture, and understanding what others are trying to communicate to you – comprehension or “receptive language”);

* Cognitive skills (the ability to learn new things, filter and process information, remember and recall, and to reason);

* Social and emotional skills (interacting with others and development of personal traits and feelings).

Parents will often be the first to worry that their child has delays in one or more developmental domains. However children develop at notoriously different rates and the age at which a particular child reaches a specific developmental milestone can vary substantially. In fact, some children who do not reach developmental milestones on time may catch up later, sometimes with and sometimes without extra support, have no permanent problems and go on to develop normally.

[Angelmum]

Autism Spectrum Disorder

The fastest growing diagnosis within the disability of Pervasive Developmental Disorders is Autism Spectrum Disorder.

Children diagnosed with Autism Spectrum Disorder are from all socioeconomic groups, as well as cultural, racial, and ethnic populations. More students with Autism Spectrum Disorder will be found in every community and neighborhood due to the increased identification of the disorder.

There are five related developmental disorders placed under the umbrella category of Pervasive Developmental Disorders. They include:

1. Autism Spectrum Disorder
2. Asperger’s Syndrome
3. Childhood Disintegrative Disorder
4. Rett’s
5. Pervasive Developmental Disorder – Not Otherwise Specified

Specific Aspects of Autism Spectrum Disorder

• Autism Spectrum Disorder affects the neurodevelopment system. The results are distinct learning and behavior characteristics
• Autism Spectrum Disorder has an underlying biological/genetic cause that produces organic and/or physical changes during brain development. This results in atypical cognitive and social development and behaviors
• Autism Spectrum Disorder affects individuals uniquely
• Autism Spectrum Disorder does not result from poor parenting
• Autism Spectrum Disorder affects the individual’s ability to integrate sensory information and regulate their emotions

There are five deficit areas to consider as diagnostic criteria for identifying individuals with Autism Spectrum Disorder, they are:

1. Communication
2. Socialization/Social skills
3. Restricted interests
4. Sensory integration
5. Behavior

Individuals diagnosed with Autism Spectrum Disorder exhibit varying degrees of difficulties in these five areas.

Recent research shows students with Autism Spectrum Disorder exhibit the same early symptoms that include:

• Lack of eye contact
• Lack of joint attention (attention to the same item or topic as another person)
• Atypical sensory/motor processing

Goals and Objectives for Students with Autism Spectrum Disorder

The general education teacher must ensure that students with Autism Spectrum Disorder have goals and objectives designed to promote the development of independent living, academic skills, and appropriate social behaviors and skills.

It is essential that these goals be introduced early and addressed annually in the individualized education program. If these goals are not addressed until the child reaches secondary school, there is a higher potential for many students with Autism Spectrum Disorder leaving school not able to live independently, succeed academically or be gainfully employed.

In order to help provide a smooth transition to a normal school setting, the responsibilities of the IEP (individualized education program) team may include:

• Developing goals and short-term objectives that promote self-monitoring and independent living skills

Secondary individualized education program teams have the responsibility to identify the long-term supports these students will require for academic, economic and social independence. They must ensure students with Autism Spectrum Disorder have long-term goals that specify the need for explicit instruction in the essential social skills necessary for all post-secondary academic, social, and/or vocational settings. Students with Autism Spectrum Disorder must be given multiple opportunities in a variety of social, academic, and vocational contexts to practice these skills.

Of highest priority is ensuring that students with Autism Spectrum Disorder acquire the essential social and daily living skills they need for a responsible integration into the community.

[Angelmum]

Fits/Seizures clickable

Seizures are caused by abnormal electrical discharges in the brain. Symptoms may vary depending on the part of the brain that is involved, but seizures often cause unusual sensations, uncontrollable muscle spasms, and loss of consciousness.

Some seizures may be the result of a medical problem. Low blood sugar, infection, a head injury, accidental poisoning, or drug overdose can cause a seizure. A seizure may also be due to a brain tumor or other health problem affecting the brain. In addition, anything that results in a sudden lack of oxygen to the brain can cause a seizure. In some cases, the cause of the seizure is never discovered.

When seizures recur, it may indicate the chronic condition known as epilepsy.

Febrile seizures, relatively common in kids younger than 5 years old, can occur when a child develops a high fever, usually with the temperature rising rapidly to 102° Fahrenheit (38.9° Celsius) or more. While terrifying to parents, these seizures are usually brief and rarely cause any problems, unless the fever is associated with a serious infection, such as meningitis. A child who has a febrile seizure is not more likely to develop epilepsy.

If Your Child Has a Seizure
A child who's having a seizure should be placed on the ground or floor in a safe area. Remove any nearby objects. Loosen any clothing around the head or neck. Do not try to wedge the child's mouth open or place an object between the teeth, and do not attempt to restrain movements. Once the seizure seems to have ended, roll your child onto his or her side.

Call emergency medical services immediately if your child:

* has difficulty breathing
* turns bluish in color
*sustained a head injury
*seems ill
*has a known heart condition
*has never had a seizure before
*might have ingested any poisons, medications, etc

If your child has previously had seizures, call emergency services if the seizure lasts more than 5 minutes, or if the seizure is different or unusual.

If your child is breathing normally and the seizure lasts just a few minutes, you can wait until it has subsided, then call your doctor.

Following the seizure, your child will probably fall into a deep sleep (this is called the postictal period). This is normal, and you should not try to wake your child. Do not attempt to give food or drink until your child is awake and alert.

For a child who has febrile seizures, the doctor may suggest that you give fever-reducing medicine (such as ibuprofen or acetaminophen) to control the fever and prevent seizures from recurring. Your doctor may also recommend sponging your child with lukewarm water to help cool him or her down.


Angelman child has seizures. dear daughter started her 1st seizure at 3 yrs old. She was purplish and fever 39.5-40°C so we rushed her to Kandang Kerbau Hospital. Was told not to worry cos she had no difficulty in breathing. She was jerking but her eyes could track us walking here and there.

The next seizure was triggered due to over-exhaust. She missed her afternoon nap and had done quite a lot of walking. I couldnt bring her stroller cos my sis house wasnt accessible by mrt. It was hard to carry her, a big stroller and a big bag. It was a horrible experience because she was so tired yet she cant control her jerking and trying to get a good sleep. She was crying, jerking and sleep ... in the half sleep half wake condition for 9-10hrs. Was hugging & patting her to sleep + crying! Lucky my son was around to pass me water and food + I need to relieve/bathe. Once I released my hold, she was startled and woke up again (cry).

dear daughter taking Eplim Sodium Valporate 4ml x 2.

[Angelmum]

Down's syndrome or trisomy 21

DSA Singapore clickable
Down syndrome, Down's syndrome, or trisomy 21 is a chromosomal disorder caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British doctor who described the syndrome in 1866.

Severity of impairment is very much dependent on the degree of intellectual disability and whether there are additional medical conditions present Children with Down syndrome have a higher risk for the following conditions:

congenital heart defects
-leukemia
-hearing loss
-eye disease
-cataracts
-refractive errors
-hip dislocation
--sleep apnea
-thyroid disease
However, many of the conditions mentioned can be improved with early intervention.


Maternal Serum Screening Test is a voluntary blood test conducted between 15 and 20 weeks of pregnancy to aid in the risk assessment of Down Syndrome, a congenital disease caused by a defect in the chromosomes.

The Maternal Serum Screening test is used to identify pregnancies in which the risk of Down Syndrome is significant enough to justify considering an amniocentesis.

Conducted between 15 to 20 weeks of pregnancy, the test measures the amount of AFP (alpha-fetoprotein) and hCG (human chorionic gonadotrophin). These substances are produced by the foetus and the placenta, and can be detected in the mother's blood.



What Is Mosaic Down Syndrome?

Mosaic Down syndrome is a developmental disability caused by an extra chromosome. The difference is the same as in Down syndrome, except that individuals with Mosaic Down syndrome do not have the extra chromosome on every cell. They have a "mosaic" of affected and uneffected cells. Children with Mosaic Down syndrome may have higher IQs than those with Down syndrome, but many of the health and development issues are the same.

Children with mosaic Down syndrome have two distinct cell groupings. In some cells there is a total of 46 chromosomes, which is the “typical” group. In other cells there is an extra copy of the chromosome #21, making 47 cells total for this group.

[Angelmum]

Cerebral Palsy (CP)

A group of disorders characterised by loss of motor functions or any other nerve functions. These disorders are caused by brain damage that occurs during foetal development or near the time of birth.

Symptoms
The symptoms of CP vary from just mild clumsiness to extensive uncontrolled muscle spasticity. Many with cerebral palsy have other disabilities as well, such as seizures, an inability to see, hear, speak or learn as others do, or psychological or behavioural problems. Not everyone with CP is retarded, some are of average intelligence. While some people with CP have learning disabilities many others with CP do not.

Early signs would appear before the age of 3. Babies with CP are usually slow to reach developmental milestones. Abilities like learning to roll over, sit, crawl, smile or walk are not well developed. The motor abilities will often seem unusual and strange.

There are four types of CP:
Spastic CP, the most common type, is a disorder in which certain muscles are stiff and weak.
Athetoid (dyskinetic, hypotonic, dystonia) CP involuntary movements are present.
Ataxic CP occurs when the Cerebellum has been damaged, thus causing lack of coordination and jerky movements. This form of CP have staggered or fragmented movements often involving tremors or exaggerated posturing (athetosis) and bizarre twisting motions.
Mixed CP is when two or more types of CP are present in the same person.


Treatment
CP is a lifelong condition that cannot be cured. The treatment is aimed at maintaining or improving the quality of life, providing the sufferer with tools to enjoy a near-normal life. There are basically three types of treatment for Cerebral Palsy:

Surgery can be used to correct muscle contractures - removal of tight contractures that inhibits proper movement of the limbs.

Drugs such as clonazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic medications can help to control abnormal movements. Alcohol or botulinum toxin type A (Botox) injections into muscle may be used to reduce spasticity for a short time so health care providers can work to lengthen a muscle.

Adjunctive therapies include
Physical Therapy, the most common treatment for cerebral palsy, consists of special exercises designed to increase and improve the range of movement and strength of the muscle groups, is aimed at strengthening and stretching muscles and preventing spasticity as well as increasing muscle control.
Occupational therapy is designed to help the child develop the fine motor skills needed to function day-to-day at home and school.

Speech therapy will also help the child develop communication skills.

[elantranine]

Anyone has a child with autism?

[Angelmum]

Originally Posted by elantranine Anyone has a child with autism?

erhmm, this Special Needs forum still new so autism parents hvnt reported in. you got a child with autism or suspect to be?

[elantranine]

Yeah...I got a mild ASD boy diagnosed when he was 3yrs old.
To date he is already 5 yrs old. He has been doing well and most of his ASD traits have disappear....thnx to early intervention center he is attending to and of cos support from his teachers there in at PCF center too. He attends both school daily. Now I am planning ahead for his future as in which primary school he should attend in another 1 1/2yrs ? So i'm awaiting parents who do have children with ASD and attending mainstream school , to share their experiences.

[Angelmum]

Helping Special Students Integrate Better into Society :

http://www.schoolbag.sg/archives/200...ents_integ.php
(Pathlight School was the first school to offer mainstream education for children with specific special educational needs who have IQ's above 75. It caters for children cognitively able to cope with the mainstream syllabus yet unable to cope socially and emotionally in mainstream school. Students are provided with autism friendly facilities, small class sizes and qualified teaching staff in the field of autism)

Originally Posted by elantranine support from his teachers there in at PCF center too. He attends both school daily. Now I am planning ahead for his future

it is good to interact with normal kids. Nice to find such childcare ctr ....although not specialised with special needs, they dont mind let a special child enrol. Know some mummies who benefited from such arrangement.

[E-mum]

Hi, I am grateful to see this forum for parents with special needs kids.

Anyone has a child with Dyspraxia?

My son is 5, diagnosed with GDD and is currently in the EIPIC programme in Rainbow Margaret Drive. He didn't walk till he was 17 months and for initially, speech came really slow. He could only go "babababa..." and finally at 2.5 years, he could call me mama.
His body is low tone and lots of exercises are hard to achieve for him.

When we had our OT (it was limited sessions) at CDU, the therapist said possibly Dyspraxia, so little is known of this that he is not labelled as so. I read up and it seems that he fits.

Other than a hearing test, and assessment for enrolment for Rainbow School. I didn't send him to any further tests.

Should I have done so? If yes, what tests should I send him for? A brain scan?
Is it important to know the cause? Or should I just focus on helping him in whatever ways I can from now on.

Also, anyone deliberately delay their child from entering mainstream primary school for one year? What to make such a decision? I am hesitating to be do this. Wish to discuss with parents with similar situation.

Thanks!

[Angelmum]

Originally Posted by E-mum My son is 5, diagnosed with GDD and is currently in the EIPIC programme in Rainbow Margaret Drive. He didn't walk till he was 17 months and for initially, speech came really slow. He could only go "babababa..." and finally at 2.5 years, he could call me mama. His body is low tone and lots of exercises are hard to achieve for him. When we had our OT (it was limited sessions) at CDU, the therapist said possibly Dyspraxia, so little is known of this that he is not labelled as so. I read up and it seems that he fits.

Thanks for joining us.
R you with Kandang Kerbau Hospital's CDU? R you seeing neuro or just paediatrician in Kandang Kerbau Hospital? Did you raised yr questions about yr suspicion of Dyspraxia?

quote: "Dealing With Dyspraxia
The best way to detect dyspraxia is in a child's behaviour. Due to its clinical invisibility, having a child with dyspraxia can be a major blindfold for parents. And since the rate of a child's development really does vary from individual to individual, figuring out if your child has dyspraxia can really be a trying experience. However, there are specific symptoms that make the condition apparent. "

Originally Posted by E-mum Also, anyone deliberately delay their child from entering mainstream primary school for one year? What to make such a decision? I am hesitating to be do this. Wish to discuss with parents with similar situation. Thanks!

R you referring to the same kid? I know of some parents who delayed their children for attending same yr as those born in same yr to accommodate slower learning abilities. Eg should be P3 but attend P2 instead.

[E-mum]

Thanks so much for your prompt reply.

I talked to NUH CDU doctor during review yesterday and to determine whether my son can go primary school, a school readiness test can be done later in the year. He couldn't answer age-appropriate questions by the doctor, so I think very likely he needs to do one more preschool year.

Doctor didn't agree that my son has dyspraxia. He also said that my son should go for more classes on top of EIPIC, in order to learn more curriculum based work.
This would probably mean forgoing the afternoon naps.

I think Singapore really lack the in between schools for children who are delayed, and unable to catch up with normal curriculum. EIPIC teaches a lot of life skills, but not quite academic-oriented. Or anyone knows of a school like that?

[Angelmum]

Mainstream: gREATER Support for STUDENTS WITH Special Needs in SELECTED SCHOOLS IN 2006
This is an old link. Try searching for the updated list.

Special school with mainstream academics: Pathlight