Category: Clinical Psychology

In this COVID scenario, most of the parents come to me saying their child has difficulty in understanding spellings, difficulty in reading, writing and calculations.

 Is the concept of Specific Learning Disability (SLD) still an unknown area between the common men?

A child with SLD is portrayed up as a “lazy child” when his school teachers complain about his poor academic performance, or when is found inattentive in class, or reaches in his higher secondary. But does this problem start very late? Can we identify the child’s problem in the preschool level/ in his early schooling itself? The enigma of the child who encounters extraordinary difficulty in learning is not new. Since a child is promoted to next class without the need of minimum passing marks, parents and teachers become unaware and wake up only at secondary levels, and the child’s problem remains unnoticed.  Children face difficulty in learning varying in culture, countries and languages.

What is Specific Learning Disability (SLD)?

”  The main feature of SLD is specific and significant impairment in the development of reading, spelling, writing, or arithmetic skills which is not because of a)mental retardation/ intellectual deficit b)any sensory problems like problem in vision/hearing/writing c)inadequate schooling But has , a)normal intelligence, minimum level of IQ=80 b)performance is minimum of 2 grades below his educational level Some children also do have mixed disorder of scholastic skills which means both arithmetic and reading/ spelling skills are significantly impaired  “

The spectrum of difficulties and their severity makes diagnosis of SLD extremely difficult especially when they are confounded by factors like varying environment and culture. SLD as all other developmental problems is both a health and an educational issue because of which if neglected, leads to child suffer in all walks of life. The total prevalence rates revealed that one in every five school children have SLD. The multilingual system forces children to learn through a medium other than their mother tongue which aggravates the complexity making the diagnosis extremely difficult. This paves the way to understand the importance of the diagnosis of SLD.

The terms learning disorders, learning disability (LD), and learning difficulty are often used interchangeably but differ in many ways.

Alert!!More conditions with SLD

Children with SLD have higher rates of psychological comorbidities. Approximately 30% of children have behavioral and emotional problems. The comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) in children with SLD varies from 10% to 60%. It was seen that 62% of children with SLD have depressive disorder. Diagnosis at an early stage would help in the prevention of many mental illnesses in children.

Undetected and unmanaged SLD

In cases of negligence of the SLD, a child may end up in having chronic scholastic difficulties, dropouts, emotional problems such as depression/anxiety, behavioural problems like conduct issues/anger, substance abuse and poor quality of life in family.

Most of parents have inadequate knowledge and information of SLD, which ends up in delay in recognition of SLD. Most of the parents do not try to pay attention to the child’s problem. They do not focus on remedial intervention. These usually lead to many behavioural and emotional turmoil in children. They are labelled as dull, lazy, mischievous, and so on without knowing the actual reason behind this. Family needs to invest lot of time and energy for these children. Instead of taking SLD as burden and shame it has to be well accepted by the family and support the child to overcome this condition.

Social factors play a very important role in the overall course of illness. Acceptance from friends, and teachers, play very significant role in helping the child with SLD. Lack of information among them, their attitude about the SLD children matters a lot in supporting a child with SLD.

Prevention and Management

Despite the fact that millions of people around the world suffer silently from SLD, there remains widespread confusion and misinformation with regard to identification of and interventions for SLD. Due to this, children do not enjoy their school life and stop going to school. All teachers must be motivated to put extra effort to help these students. Teachers follow different teaching methods and styles from school to school. Few schools focus on teaching phonetics while some adopt the traditional rote learning pattern in which the child learns the alphabets without understanding their formation and sound.  Mugging up learning pattern helps only in temporary satisfaction, ignoring the overall development of the child. Multisensory teaching aids, visual and auditory cues, computer software providing text‑to‑text and speech‑to‑text capabilities, and so on can be provided to improve the quality of teaching practices. Intervention at school including remedial training, and teachers’ training is important.

Building family and social support to these affected children is important. If parents successfully identify their child’s needs that can be integrated in helping the child. Instead of SLD remaining undiagnosed and untreated for a longer period of time, it is the need of the hour to address this issue. Child’s problems aggravate because parents do not bother until the child fails. Having a thorough insight into the overlapping areas, can clear the misconceptions, and shall guide assessment, intervention, and welfare benefits to these children who genuinely deserve them.

If your child has been suffering from SLD, do not ignore the symptoms. Visit us today for the right guidance and treatment.

 

 

Ms. Lakshmi Saranya Marath, Clinical Psychologist

 

“A 9-year-old girl studying in 3^rd standard, born out of non-consanguineous marriage, normal birth, with birth weight of 3.5 kilograms, referred by Pediatrician with chief complaints of overeating (body weight of 61.5 kilograms- diagnosed as obese), poor academic performance, incomplete notes, inattention, and anger outbursts with long standing duration. History revealed that she generally remains away from others in class. Medical investigations revealed her high cholesterol level (350mg/dL).  Psychological evaluations revealed her mental health issues as; Attention Deficit Hyperactive Disorder (Inattention type), low self-esteem and history of being bullied at school. She was psychologically intervened since then and within 2 months she reached to 54.5 kilograms”

Childhood obesity is one of the most serious public health challenges of the 21st century. According to World Health Organization (WHO) survey in 2016, the number of overweight children under the age of five is estimated to be over 41 million. World Health Organization (WHO) describes obesity as the result of a chronic caloric imbalance, with more calories being consumed than burned each day. Obesity among children is on the rise in the world and has become a major issue for health care providers.

While we are well aware of the many health risks associated with obesity, we may not be well aware of the psychological implications of obesity in children. A child being obese creates bidirectional impact – on how a child views himself or herself and how others see him or her. Many children with weight problems develop low self-esteem, which may in turn give way to emotional and behavioral problems. For a child with weight problems, being unable to be as mobile as that of others can become a big hurdle to overcome and many fail in it. And most of them feel unskilled, unpopular and slow.

Most obese adults were obese as adolescents and most obese adolescents were overweight or obese as children. The consequences of childhood and adolescent obesity not only include health-related physical outcomes, such as high blood pressure, high cholesterol, metabolic syndrome, diabetes, orthopedic problems, sleep apnea, asthma and fatty liver disease, but also psychological, social, and behavioral consequences, such as risk for problems related to body image, self-esteem, social isolation, discrimination, depression, and reduced quality of life.

There are different factors which contribute to child obesity. Although there are some genetic or hormonal causes of childhood obesity, in most cases overeating and under-exercising results in excess weight.   Environmental factors, psychological factors, lifestyle preferences, and cultural environment play significant roles in the rising prevalence of obesity worldwide. Some children have excessive food as a coping mechanism for dealing with problems or negative emotions like stress, anxiety, or boredom. Family characteristics like the parenting style, parents’ lifestyles and their socioeconomic status also determines child’s food intake pattern. Environmental factors such as demographics, and parents’ work-related demands further influence eating and activity behaviors^.

The obese child can become the victim of bullying and this can then lead to loss of his self-esteem and can cause feelings of hopelessness, which in turn paves its way to depression. Obesity can also result in increased anxiety and poor social skills. The child is often seen as disruptive or acting out in class. This can also lead to conditions of externalizing and internalizing disorders in them. Younger children aswell as adolescents who are obese are often more isolated and peripheral to social networks both in school and the community. Therefore it is essential that the health care provider should delve into the psychological well-being of the obese child by assessing his behavioral issues, school performance, and social wellbeing.

Prevention and treatment of childhood obesity depends on child’s early life and must take place at multisystem levels. This could be at individual level, family level, school level and community level. A child can be motivated to develop self control in eating habits, and increase the activity level. Parental involvement in childhood obesity treatment is crucial as parents can profoundly influence the child’s dietary behaviors and levels of physical activity. Family-based treatment (FBT) is the current gold-standard intervention for pediatric obesity. Parents can promote and expose the child to healthy food options, encourage regular physical activity, limit sedentary time, and serve as role models for healthy eating and active lifestyles. At school level, along with the importance of academic performance, each child should be motivated to participate in physical activity and should be educated about the richness of each food they eat. Effective policies and tools to guide healthy eating and active living could be the main targets achievable at the community level.

The growing issue of childhood obesity can be slowed, if one focuses on the causes. There are many components to be considered in childhood obesity, some being more crucial than others. A combined diet and physical activity intervention conducted in the multisystem level can be more effective at preventing or treating obesity. Moreover, if parents enforce a healthier lifestyle at home, many obesity problems could be avoided. What children learn at home about eating healthy, exercising and making the right nutritional choices will eventually spill over into other aspects of their life. Working on the causes will decrease childhood obesity and lead to a healthier society as a whole.

If your child has been suffering from childhood obesity, do not ignore the symptoms. Visit us today for the right guidance and treatment.

Ms. Lakshmi Saranya marath

Clinical Psychologist