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Dyslexia and allied problems

Dr. Darshana Naik, MD
• Honorary Pediatric neurologist, VS hospital, Ahmedabad • Fellow pediatric neurology, Mumbai. • Fellow Pediatric neurophysiology, London, UK • Diploma Dev. Neurology, CDC Kerala

• How do you come across patients with dyslexia???

My Experience
• 90% presents with mirror writing “q” instead of “p” • 5% presents with poor result bcoz of lacking in one subject • 3% presents with poor marks in writing and excellent result in oral • 2% positive screening for dyslexia

writing (dyagraphia).Learning Disabilities • It means deficits in acquiring expected skills in reading (dyslexia). maths (dyscalculia) • It accounts 4-5% of normal school population • Not lack of intelligence .

Etiology • child takes learning • Social.Following brain injury .Thinking process • Behavioral.Prob with brain arrangement • Cognitive.environment of learning • Biosocial • Emotional • Acquired.

Presentation • • • • • • 13+ gene identified More then 50% F/H positive Boy>Girls Mild to severe Not till 8ys Part of other disease. Asperger . ADHD.Autism.

poor catching ball .General scenario Infants: • Motor/general intelligence-WNL • FM/Speech/Coordination-Del Toddlers: • 50% left handed • Recurrent fall Preschool: • Poor in sports.

35% (business leaders) • <4% gets bachelor degree .Autism (Asperger syndrome) Adolescence: • Dropout.poor in only one subject • Dumb/Failure • Inattentive/disruptive-ADHD • Withdrawn/silent.General scenario School: • Confusion.

Off-ON • Criminal/hacker • Poor relationship • Anxiety/depression/suicide • Obesity/ Anorexia .General scenario Adult: • Left-Right.

taking too much time.How to diagnose in OPD? • Lagging in one particular subject • Better marks in oral then written • Problems in speakingmispronunciation. non sense grammar “ Dyslexia screening test” . confusion in similar words. messy hand writing. non fluent speech (pausing) • Problems in reading.

• Screening test .

Diagnosis • • 1) 2) 3) 4) Screening test: Diagnostic tests: Dyslexia test: Junior/Senior Sensory integration Neurological assessment EQ/SQ .

Definitive diagnosis • • • • • Neurologist Occupational therapist Child psychologist Counselor Government authority .

Management • • 1. 2. 3. Medical management Non medical management Emotional Sensory integration Educational .

post stroke cognitive improvement • Ped: Breath holding spells. Dyslexia .Management.Medical • Piracetam: Nootropic agent means smart drug or cognitive/neuro/intelligence enhancer drug • Adult: Alzheimer. Down.

Piracetam-Mechanism of action • Dyslexia.poor coordination of both hemispheres • NMDA glutamate receptor stabilization contributes to learning and memory function • Effects: Improves activation of corpus callosm fibers which facilitates active communication of both hemisphere hence improve reasoning (RT) and creative thinking (LT) .

J.Supportive studies • J. psychology • 225kids from 6-12yrs having dyslexia given for 36weeks • Effect started from 12weeks and lasted for 36week • Memory improved. child neurology. clinical pharmacology. J.WISC score .

insomnia • Young kids.Sedation • Dose: 10mg/kg/day .Headache.Side effects • Mild. Nausea.

Non medical • Emotional • Sensory integration • Educational .

Fatigue Behavior therapy and counseling by trained therapist .Emotional problems • • • • Lack of confidence Back log of failure Frustration Insensitivity. Bullying.

Sensory integration Occupational therapist • Tactile • Visual • Auditory • Kinesthetic .

SI-Video .

RJ. visionary. actor . secretary 3) Kinesthetic. scientist. Artists.Educational Management • Neuro-linguistic system: 1) Visual.10% Call centre.80% Clerical jobs. doctors 2) Auditory/Acoustic.10% Sports.

sounds Each child needs tailor made program .Classroom Mx • • • • • • • • • Giving more time Listening books Software for dyslexia One to one tuition Sensory and motor skills therapy Reading aloud Phonation/ decoding Relation of letters. words.

Tasks to avoid in Education • Avoid dictation • Avoid board copying • Avoid too much written home work • Avoid fancy fonts .

Counselor • Maharastra dyslexia association • Special jobs .Legal Aspects • Special time in all exams • Certification from educational board. Occupational therapist. Child psychologist.Neurologist.

Naughty child vs ADHD • More then 500 research papers done on prisoners had ADHD and other related psychological disorders in childhood .

ADHD or Naughty??? .

ADHD • Response to punishment and reward is poor • No difference with environment • Child will say I tried but I cant control NAUGHTY • Response to punishment and reward is good • More hyperactive in presence of person who pamper child • Child can control willing fully .

How to pick up in OPD? • Will not sit at one place • Will not play with single toy for more then 1 minute • Ignore your instruction in spite of listening • Forget things in school • Messy in nature • Restless all the time • Lake of sleep .

ADHD screening tests • Conner’s teacher rating scale • Conner’s parent rating scale .

ADHD post treatment .

Autism .

High functioning autism .Triad 1) No social development 2) No speech development 3) Repetitive movements “Barfi”.Low functioning “My Name is Khan”.

Spot diagnosis 1) Does your child remains in his/her own world? 2) No response to name 3) No separation anxiety “ M-CHAT screening test” .

Take home messages • • • Children are like flowers. we should be gentle and patience to them Not diagnosed before 8years and requires team to diagnose NLP is basic fundamental learning system gaining popularity .

Take home messages • 75% are parental related problem • Screening tests are available • Diagnosis is always probable and must be confirmed by clinical psychologist DSM IV and ICD 10 are internationally acceptable criteria used worldwide and available for all behavior problems • Correct diagnosis at correct age and proper intervention cures 90% .

Opp. Ellisbridge.With best compliments from: ASIAN CHILD NEURO CLINIC & CEREBRAL PALSY CENTRE 2nd Floor. Phone: 079-26400640. 9924181291 E-Mail: darshanaben@gmail. Ahmedabad. Park Avenue . Parimal Garden.