Is Your Child Naughty or ADHD? Early Signs of Autism & ADHD Every Parent Must Know

Table of Content:

 

• Awareness& Diagnosis
• Source of Concern: Teacher, Parent, or Performance?
• When to Observe and When to Act
• ADHD Labels vs. Parental Support
• Understanding the Spectrum: Severe Autism vs. Manageable ADHD
• Memory, Interest, and Misconceptions
• Naughtiness vs. ADHD: Spotting the Difference
• Early Diagnosis
• Speech Delay: Cause or Choice?
• Parental Role in Autism Care
• Preparing for Adult Life with ADHD
• Do Boys Talk Later? Myth or Fact?
• Role of Society in Autism Care
• Handling Aggression in Autism
• Early Support, Better Outcomes

 

Dr. Hema Sathish:Hello, everyone here we have Dr. Kavita who is accomplished neurologist. The best fit of her introduction is she’s a pediatrician and a neurologist, so who best can answer these questions for us. So I want to know. So we are going to talk about autism and ADHD so well, you also know that everybody, it’s quite interconnected but two parts of the spectrum right. So first I would like to notice like, how many cases do you see in your OPD who have ADHD or diagnosed as autism and Lu come to you?

Dr. Kavita:Well, that’s a wonderful question and I think this is the topic which has to be explained to many of the patterns because the understanding of these diseases is the first step in managing the problem very effectively. So coming to the question the I must say in the OP practice of so many years there has been an exponential increase in the number of cases come.

Dr. Hema Sathish:Is if the numbers are increasing or the awareness is increasing?

Awareness & Diagnosis

Dr. Kavita:I guess both O yeah earlier I can’t even say. Around 10,15 years ago the people started to know and people started to diagnose about diagnoses these conditions like ADHD, autism and then came autistic spectrum disorders and all that. So now the number of children who are getting affected are getting increased and again the awareness is getting increased because again it’s going to be a small family. So the symptoms are being watched even more carefully. I must say I think that’s what I feel because back whom our own professors have told that they have not diagnosed so many children with it was always neuroinfections. Earlier it was always infections, malnutrition, those were the burning problems, what they had faced our senior colleagues. So what we are saying now is this increase in the number which is quite alarming and the reason could be both as you said could be the increased awareness, increased identification of the problem and we also expect a lot from whether there there’s one child or two child in a family. The expectation is more and when it is not matched up to what is being expected, the performance level or academic excellence is not up to the level and they do not know what is the problem.

Dr. Hema Sathish:So when you said the awareness is moved, so do you see the patients coming in or the parents bringing them in because the teacher told them or the performance was bad. Or it’s just that the mother has been so observant and they found it out.

Source of Concern: Teacher, Parent, or Performance?

Dr. Kavita:The majority of the times the teachers are the ones who quite early, Quite early because

Dr. Hema Sathish:I think there’s awareness program for the teachers all to understand this problem. Right

Dr. Kavita:yes. I, that’s good, yes, definitely good because especially the pre-school I mean, the pre KG. LKG and UKG, those teachers and they are having this training to identify and it is very important because that is the exact time if it is pick up quite early and brought it to the notice of the parents when they can get the expert help. The right way of management if started early always has a better efficient management of these problems.

Dr. Hema Sathish:That’s true, so what would you advise a parent to look for him at sometime? You feel that when the awareness is created then the parent gets so jitter over everything they’re saying, oh my God, probably my child has got this. Probably this is it and now it’s like become a fashion statement. Oh, he’s got ADHD. I mean, that’s not true. Right. So what would you say? Like when you should take the action or what the parent can do if they have even saw their. I mean seeing their child have some problem then how to go about it.

When to Observe and When to Act

Dr. Kavita:Yes actually you have rightly mentioned it because it is so fashionable now for everybody to immediately judge the child that telling that Oh, he is having autism and that terminology. Sometimes even before diagnosing that the child children are having autism. ADHD or autistic spectrum disorder, we call it now just wanted to mention that because clinically the neurologist and the child’s eye cattrist would want to mention it as autistic spectrum disorder rather than autism. But the word autism is very common, commonly used, told by any not even a medical person can even tell that the child is having autism because. The child he or she is little mischievous, or they really don’t know which category they belong to are we right in calling those names so many times I have to tell that this is not Autism. That has been many a times,

Dr. Hema Sathish:but that’s such a relief to the mother. Right,

Dr. Kavita:yes, yes. I will say the first thing I would say is no, this is not autism, so this is the domain where the child is having a problem person. Some parents also have a little more as early, but I have to tell them that this is not autism or this is a spectrum which can be managed. So it is very important not to judge right away just with one particular behaviour or one particular problem or just one particular academic skill. The child is week on to call a name or brand the child with a judgment of a lifetime diagnosis.

Dr. Hema Sathish:True, true, very true, and you, its so. And then they glorify it also. And then they say No, no, he’s got ADHD. So it’s fine, he cannot do this. But is it that acceptable? I mean, or the parent can work on the child and make sure that the child can come at least near normal or something.

ADHD Labels vs. Parental Support

Dr. Kavita:It’s actually maybe to explain this. I would want to elaborate like what exactly is the problem, the autistic spectrum disorder, the ADHD. The learning disability is, it’s not an abnormal brain. So because again the question would be like Will my child become normal? So answer,

Dr. Hema Sathish:that’s so nice to know. No, that is’ not an abnormal brain. So the parent has to understand that the brain is not abnormally, they absolutely fine and a little bit of tweaking, probably right.

Dr. Kavita:Yes, it is again the understanding of this problem. Is very important and that is the first step of the management or the

Dr. Hema Sathish:especially if it is ADHD then you can really take care of it really well and a period of time they’ll be absolutely normal right

Dr. Kavita:yes exactly. So coming back to the point it is not the abnormal brain, rather the certain parts of the brain, certain parts of the circuitsWithin the brain they work differently or they are developed in a different way like I can say like a computer which works with the different software, not with the usual software. We can maybe understand that way better. So if we understand this way we can, we need not expect like when will my child become normal. So it is very important when we classify these children having an autistic spectrum disorder where there is a level one level to level three or it is an ADHD. So even in these two spectrums they can coexist. And there can be only certain problems and they can be exceptionally talented in one field, so they may not fall into the mainstream of the so-called educational mark gaining system. But they can be exceptionally talented in one field, which we do not approve as a real professional.

Dr. Hema Sathish:Also, that’s something really sad, because I think our education system is also set in such a way that it has to be the mark which has been scored which identifies the child as an intelligent child or not so smart, or not a very intelligent kid. But that’s one way sad also, but one way I think. It makes life easier for many of the parents because than they assess so that’s the only assessment over here in India we have.

Dr. Kavita:But I say we are in the crossroads madam like towards the thing because we are also having schools where they have a separate section where they identify these kids and then they are given more time in performing the examinations and they are also into the mainstream of education that normal school. But still they have special educators who take extra care in exact domains where they are me and all that because some people some children may fare little less marks and max they will be very good in art.

Dr. Hema Sathish:Yeah, true.

Dr. Kavita:So I think the schools are now changing. I think we are at the cross probably will really be

Dr. Hema Sathish:still developing so we should be there soon. Well when you say autism. Autism is at the extreme end of the spectrum of autism, it’s quite a challenge for the parent or for anybody even for the child right. But when we talk about ADHD it can be graded into several grades rate and then that can be handled also in a different way and the person can become normal over a period of time. Yes so those things can you describe a little more on that, so which you would call the extreme spectrum where they really need professional help and then the spectrum where it becomes a little lesser, lesser.

Understanding the Spectrum: Severe Autism vs. Manageable ADHD

Dr. Kavita:Again in Autistic Spectrum Disorder. Also we have level one, level two, level three so depending on the support they need like level three would be. The most severe form where even for their daily activities they would require help even for their own routine daily act. That’s a very severe form of autism and there are the level One level Two where at earlier age if we are going to intervene and then we are going to change the path where they have to travel or how to cope with, there are certain mechanisms where it’s going to be a team effort, maybe we’ll discover the management part little more elaborately and coming to ADHDs you rightly said their performance. Maybe there is also we commonly call them as highperforming ADHD so those people they will have the problems in advancing in their own life or what they want to do. Will be sometimes like aggressive behaviour, so certain symptoms in these problems, the severity of those symptoms may require professional help like for hyperactivity per se. So in that case the therapy alone may not be sufficient for them. So it’s very important that there should be a team which is going to diagnose these children who is going to approach these children who is going to plan a treatment pattern for at least a year or two during the initial phase. The developing phase. Because catching them early, we can definitely make them come to that near normal or at least normal from what they were before. So at least that we can, if not, there is a normalcy at least from the comparison could be made like how these children were before a year earlier and how they now. So that definitely we can achieve.

Dr. Hema Sathish:Okay. That’s very heartening actually. And then one more thing I always see is when we tell a parent you know, like I have seen some kids. Who come up with this problem and when you tell them that you know the child might have ADHD and you know you have to handle the child with care because they come and complain that the child doesn’t study well and the child that a child is a bit of a differ, that’s very unfair because you know the child is probably a very intelligent child. But there are expertise is not, as you said in the subjects which are taught in school and which are the ones which need to secure marks like a Maths or a science. So they might be having interest in several different things. So at that point of time you have to think about it differently. But there one thing I’ve noticed is they come and say that my child resides very well. The memory of these children are so good actually and then they say, how can the teachers say that the child doesn’t study well anything you say the child remembers and the child will say later also. So my child is not a differ. So another the differentiation of being a child who’s lesser in intelligence and being an attention deficit child. There are two different things right?

Memory, Interest, and Misconceptions

Dr. Kavita:yes, exactly, very rightly pointed out, because the intelligence of the child. Is no way connected to these two problems, or rather the intelligence is not directly proportional to the severity of the problem of lead Autistic Spectrum Disorder or ADHD. Or we have one more category which you have mentioned which is learning disability, whether the Dyslexia dyscalcular. So this part it is important again to identify, because this child, as you told, can be exceptionally intelligent where they can memorize a lot, they can reside, but they cannot write. Yeah, so the writing part so again, the part of the brain which is working on controlling the writing part, what we have learned. So that is where the processing is different for that check. So and I have advised to certain Parents to make the child not read from the books, rather, they can record it or somebody else can read it. They listen to it and then they can write it because without reading, they can understand or take it to their memory better. When yeah,

Dr. Hema Sathish:Their memory is very good. Actually

Dr. Kavita:Many of them have got auditory memory. We call it as verbal memory or auditory memory is way better. For example. I will just elaborate like, for example, the child reads apple. Sometimes the child may not be able to memorize the combination of the words is apple. But when the child see the picture of the apple he or she knows that it’s apple so correlated with that, or sometimes sometimes the letters are not stored as letters. In certain children’s they are stored as a picture in there, so basically there are some kids, even. The so-called the normal kids. We tell the left brain oriented children they are very good with the letters speaking, elocution and the right brain oriented children are very good in art, painting, so they will understand the word A or the word apple or the letter A as a picture. So wherever they see A, they remember of the picture rather than A. So it’s very different. So for these kids, so the way we teach theyis completely different. The way we teach these kids are completely different, so rather than telling that oh this child cannot readappple, so the child is a differ no. So I think that is what has to be understood by the parents as well as the teachers. Also, because they should identify where exactly the domain in the economic skill, there is a deficiency or a difficulty that has to be addressed in their way.Maybe.

Dr. Hema Sathish:So that’s a lot of things to. I think, go through, analyse and then figure out where exactly the childhood fit in. Well, there’s one more thing I always keep seeing is there are naughty children. They have these ideas with sparks in their brain and they just want to run and do something. But there are these ADHD kids also because their mind works in a very different pattern, their thought processes like this. So when that happens, so what is the difference between them? I mean? Is there something which we can differentiate very clearly? Or a teacher should understand that this child is probably ADHD and probably we should do something about it.

Naughtiness vs. ADHD: Spotting the Difference

 Dr. Kavita:Actually this is a very, very important question because it’s a very small line,

Dr. Hema Sathish:a very thin line,

Dr. Kavita:thin line, which says that oh, he is mischievous. No, this is ADHD because once again, the moment we are going to give a diagnosis for the mischief done by a child, it’s going to be a lifelong diagnosis. So for that I would say certain clinical points, we always see certain deviation in their behaviour.

Dr. Hema Sathish:Okay

Dr. Kavita: For example, a child, a naughty boy is always shouting in the class or calling out names or doing. Probably usually this happens in the kindergarten to the first standard kind of so that time that the teacher would definitely find out that mistake. Give a punishment or whatever make him stand outside or just say that no, you are not supposed to. He gets a scolding or something, so that should register the child’s brain. That’s called emotional memory, telling that Oh, this is something wrong. The teacher doesn’t like it. So the teacher has given. Has spoken in a very rough view, or the way which I don’t like. So I must not repeat it. So that’s the normal response for a naughty boy. So the naughtiness may be there next time. The evolution of the development would be. The child may be naughty again, but not when the teacher is around. Oh, okay, that’s so not teacher, the teacher comes, he keeps quiet, so that’s a very normal response. We know so even at home Sometimes the mothers might say that he is mischievous when I’m around, but he’s okay is behaving well,

Dr. Hema Sathish:that’s natural right.

Dr. Kavita:Yes, yes. So that is the normal deviation with the child. So it’s always only as I told him when again and again he’s repeating the same mistake that the teacher. With all the punishments with all possible. They threaten they make them stand up even with that they’re going to behave in a way, not sitting in one place, disturbing the class offer. I think these are the things that is where the differentiation goes here.

Dr. Hema Sathish:That is when you know that the child is not registering it in your mind. Yes, they already forgotten the punishment, forgotten the punishment, yes, so that’s not normal. For example,

Dr. Kavita:sometimes it’s not even perceived as punishment for them. Oh, it’s another task, it’s like that. So that is yeah,

Dr. Hema Sathish:that also I heard the teacher be actually very angry and punishing, and the childhood act as if and you know that the child is taking it as a jovial thing and laughing over that. Also sudden having fun and actually the teachers get very irritated, very irritatingly retain and then the to the parent. Yes, that when I am angry he’s acting so cheeky, correct. But probably that’s not cheekyiness.

Dr. Kavita:That is definitely not cheekiness, but rather the child is in trouble. So the child means yes. So again the stress becomes anti on the family because it is always. Then it is guilt- shamed on the family, then it is about the parenting all that comes around. But rather that child requires a different kind of

Dr. Hema Sathish:and the child at that age doesn’t have an ego right no. So calling the child cheeky is probably very unfair,

Dr. Kavita:it’s very unfair, it’s very, very unfair actually yes. So understanding them is very difficult. So probably the moment we see the ok case this we here where is not all right? The first thing the teachers they usually do and is inform the parents that I think your child needs some attention or an evaluation some. But it’s up for the parent side most of the times they become very. Sensitive about it, So there comes the acceptance part becomes difficult. Suppose sometimes even one parent accepts it. The other parent gets very, very defensive about like no. No. I was like this when my mother took Kara, why don’t you do it? Does the husband usually tell the mother? No, it is because you are pampering? The wife might tell the husband so it can be like this rather than addressing what exactly the child needs at that.

Dr. Hema Sathish:So it’s not only the child, but the parents also need help. Then they also need the counselling and the handholding which is required to understand such a child and take care of a child like that. So that’s really interesting because that’s something which nobody thinks about right. This is where the whole thing of prevention comes in that we always talk about who is affected and we do not talk about the people around them who are getting affected by the scenario. So Dr. Kavita, the next thing would be. I want to know like how early can the diagnosis we made? Because if a parent is aware that there is a problem, they might come in earlier with the problem. And then the child can be helped quite a bit more because the development itself in a child in the first six years is a lot more than in the later stages of life. So if earlier the diagnosis better the outcome. So for that what would you say?

Early Diagnosis

Dr. Kavita:The earliest, Feature or the earliest sign the parent should be aware of is first to know the normal developmental milestones which are expected in a child right from the baby is born like from the second or third month there should be a social smile. The baby should smile when the mother tries to pacify or should have a proper eye contact with the mother. First is always the mother so the mother, and then subsequently by one year the child should be able to walk without support and by around one and a half years I would say 16 to 18 months to be more specific. So before two years the child should have been able to utter few meaningful words. Not only there’s a problem in that nominee.

Dr. Hema Sathish:I think we should can we talk about it now or should we take it later? I do not know I’ll just tell you this because what is happening is you. They have children a little later in life.

Dr. Kavita:Oh yeah,

Dr. Hema Sathish:yeah. And then what happens? The pampering is very higher ye, so they don’t even put the child down. Many times I have seen that. You know the normals are not happening only and the child doesn’t roll over. And then you have this thing. If my child crawls, it might get dirty. It’s starting surface stretching dirty too. So. These parents they don’t allow the child to crawl at all so this child starts walking. Directly directly so so I mean it’s not like a milestone isn’t missed right,

Dr. Kavita:yeah, actually skipping milestone is again a problem they don’t understand skipping a milestone. Usually they always say No, no, my. I never crawled directly sat on the high chair and directly started walking

Dr. Hema Sathish:is becoming very stylish. Privilege child.

Dr. Kavita:it’s not. And then actually in this I would like to think is we have to completely avoid having the child in a walker. We have all sizes of walker where the gate becomes a little problem. We strongly. I mean tell that not to use it at least with the wheels on they tend to have even at six months of age. They are very happy that oh the child is moving help of the walker, but that I think has to be avoided. So coming back to this I think this milestone should be normal and we always say a child never learns to work without falling down. True. So now what happens is as you write said they don’t want the child to fall down, but they directly want to walk perfectly

Dr. Hema Sathish:and then crawling is dirty because we also show so much of bacteria. Then child put the hand on the floor, then yes, oh, they’ll touch the bacteria, they’ll get infection and all this

Dr. Kavita:yes, yes, this is also happening. So this normal they actually I always unwary the parents should enjoy this, the milestones, this what they see in a child when they crawl when they have a small fall and they try to get up on their own on his or her own effort. So all this is very, very important in the maturity the child, the baby develops when the brain develops. So the maturity of the circuits, the strengthening of the developmental circuits is happening exactly as you said from. The moment the baby is born up to three. I can say, up to four to five years. Even after that, the prefrontal cortex keeps on developing even during adultolescence. But still this is the rapid. This is the phase where there is a rapid growth grow right from the inuttro face, the faces when the baby is inside the womb and then till. The baby is around three to four years of eight to five years of age. So this is a very important period. So during this developmental milestone when there is an undue delay like so the rough part or broadly, we can say if the child doesn’t walk, there’s a visible part where the mile shown is getting delayed. That would immediately get the attention from to the parents like that. My child has to walk in the first birthday. At least we used to say that the child should stand without a support to cut a cake on the first birthday. That’s true. Remember it very easily one and a half years of age. Before two years of age. The baby. The child should utter few. Meaningful two to three meaningful words if that is not at time, so the language delay is one important earliest sign the parents can identify, and then they can come for a detailed developmental

Dr. Hema Sathish:that there also know when you said language. What I was saying is these younger mums. They give so many gadgets to the children, yes, that they don’t bother to make any noises, and not only that, then they’re pampered so much. There’s a maid standing right next to them. Then the mother is at the disposal because the child is so important, and of course the child becomes a very precious child. Say, especially if they haven’t had a precious child. All the more so what they do is, then the child just has to put the hand out and say. It’s given these children never learn to talk at all. They don’t find the necessity to talk

Dr. Kavita:yes and the worst part as you said it is directly handed over and they come back when they come back to us telling blaming the child he’s always using the mobile. The first question I ask who gave him the mobile. I think that person needs a treatment rather than the child.

Dr. Hema Sathish:That’s so very true that

Dr. Kavita:that is very true because it’s very easy. Oh, it’s very always addicted to mobile very easily. They pit put the blame on the child when we are the ones who have introduced them to

Dr. Hema Sathish:in those children. I have seen that they talk a little delayed yes. I mean is that a specific neurological problem which is causing it or is just that the child doesn’t find it necessary to talk at all.

Speech Delay: Cause or Choice?

Dr. Kavita:Actually, to understand this they even call it as virtual autism and all that yeah, there is, it’s not a scientific term, i would say probably,

Dr. Hema Sathish:But that is by the parent only. Yes, nobody else is do that to blame right because you’re introducing a gadget very early, very early and the child is so clinging on to the gadget and then you’re very happy that the child is occupied with the gadget and the child doesn’t find it necessary to talk to. I think the social communication is a problem or it’s the neurological development which is leading to the problem.

Dr. Kavita:This actually is a very, very interesting part. Many children now they have. It has become very widely happening habit of the mothers or the parents to give them mobile so that their life is peace. At least they are at peace for some time till they are. It is very difficult to keep occupying them for a long time, so that is where this problem arises. They are introduced, but. At 1 point of time when they know that the child is having an odd behaviour where at the age where the child should learn the social interaction. Social communication like Suppose A comes to the house. An example is when they go back they say bye byetata so they understand oh, this gesture is to say by and they have to repeat it again. So this is a learning process during their so is a common thing which occur now we can see when a relative comes to the house. This child is glued to the gadget. They don’t even know who comes who goes when they are going. When they say bye mother will say see uncle is leaving say bye. Will look up like this and then go back

Dr. Hema Sathish:and I don’t think the parents insist. Also they say my child is like this acceptance about the child. Whatever is that

Dr. Kavita:in fact, they put the blame on the child like. Oh, he’s like this. We are trying hard to change, but he’s not changing. This is what is happening, so this is a normal thing. So again I wouldn’t say this particular behaviour is autism yet because this can be changed now because you’re again going to be a little assertive in telling that no, this is not the time for your gadget and then it is a time to interact with the relative or the friend of the family. Then it is going to change. But what happens in certain children because basically now there are many researchers have told this autism spectrum disorder ADHD is all because of the epigenetic factors. The genetic factors play a major role. So there are genes which can be dormant in a child which. Can be activated by this extended screen hours so that is the concept behinders are not. All children may develop just because they glue to the thing. It is bad, i don’t want to normalize it all, so I want to take it with caution big, bad. But still we don’t know which child is going to develop that autism or lose the social interactive skill the social communicative skill the child should have attained at that part. Because of this, extended clean hours are glued to the gadget. So that is where. So generally, it is absolutely better to avoid the gadgets at very young age, so that we do not know whether the child is going to develop. We are going to hazen the process or we’re going to make sure that the child is definitely going to get autisms. So there are children who are not genetically prone to develop autism, they can be brought back to their. Or the normal social adaptive behaviour can be caught up way better if the children are not prone to develop that

Dr. Hema Sathish:Ok, so it is always better that’s so hardening right, yes, to know, because then that can change the world so much for everybody, for the child, for the family around them, and for the society around them. Also, yes, well, when talking about all these things. I was just thinking that you what can a mother or a parent or a relative or whoever is there do for the child to make sure that the child development is getting better even if they have autism or autism spectrum disease like the child has been diagnosed with autism or autism spectrum disease because I want to just addresses as a whole, and if that is done, and then I want to know what a mother should do, or a parent or the parents or the family members should do to make sure that the child has helped a lot more to come back to normalcy.

Parental Role in Autism Care

Dr. Kavita:Yes. Because it’s very important that first the family, the relatives should help and stop guilty, shaming the parents that it is because you did this the child to God this you did this the first that should not happen within the family, or the relation is the first part. So then the mother and father, the first step is acceptance.

Dr. Hema Sathish:So yes, that’s very difficult not to accept it. Hard,

Dr. Kavita:easy said, than because it’s very, very difficult. It takes a lot of courage. But by the time we make them understand, because it’s very important that they go to the next step true, only they accept. Then they go to the next step even before it’s too late. So. First they have to accept the fact that there is a difference in the way my child is going to process whatever is going to he or she is going to see and learn and then perceived in the Life. Number One. Number Two will be at home. Probably the first thing is as we had already discussed about screen time. The first thing would be to spend time with the child, that’s true, so that’s a very, very important thing, not just spending time and spending time the way, sometimes being instructed or advised by the neurologist, by the child psychiatrist by the therapist, they would have definitely given some information to the parents they have to behave certain way to the child. So to be more specific with the spending time, what they can do is some. I have heard some mother or father telling me that I punished them, so when they do it. I punish them. So then only then he does it like literally. I would say that only if I beat he listens to what I say. That should not be the way these children should be and raised, or the mistakes what they do. The inappropriate behaviour has to be dealt with. Rather, that should be positive reinforcement at home. So I would say like immediately give an applaud, it can be an applaud, just clap your hands. When he does the thing which is expected that small clapping of hand will be registered in the brain much much better than so many scolding’s and. So many beatings all these would be registered in a very negative way. I will say we should not be the one to introduce a violence to a child. So suppose something which something happens, which we don’t like. You can use violence that shouldn’t be the thing what we should teach our child, because when time comes he may use the same strategy’s. So because the problem itself is there do not understand the rules of right and wrong. That is exactly the basic problem. So positive reinforcement like maybe giving a star a place of reward can be kept in their home. A star is given when they have cleaned up after playing. If they have cleaned up, telling an example, they cleaned up the toys and put in safe place. The entire family can applaud give like a standing ovation or an applaud like excellent, very good. All these things go and register very well, then he keeps repeating it and it’s not like bribing. Oh, you do this, i give a chocolate, you do this, i give the build for you to play that shouldn’t be the case. Okay, it should be an emotional reinforcement in a very positive. Way giving a star golden star or you do some mischief. There is always in this teacher training. Also they have this a thing called timeout system where. For a moment the mother of father say I don’t play with you because you have done this mischief, you’re not supposed to do this, you behave. Certainly I wouldn’t talk to you or I wouldn’t play with you for some time so that a small rejection part will hit them really hard that that might make them understand that. Oh, this is not the right way to behave. So that is called not a negative reinforcement the timeout system. Instead of punishing them we can tell that no, this is not. If you behave this way we are not going to spend time with you because this child is going to really relish the time they’re going to spend with the parents because that is the more predictable, very safe environment rather than in a school or outside or in a therapist place as well. So I think that’s a very important first step to be done by the parents at home to raise this children.

Dr. Hema Sathish:Well when we spoke about so many things do you think that these children are affected so much that in their adolescence and when they are adults their behaviour has to be channelized in a particular way, because what I have read and about ADHD children is when they grow older Also they have problem handling relationships. I mean there are people who do not settle well with their lives even if their partners, even if they have ADHD. Also it might not be very obvious they might be having a job they might be doing very well and in fact some of them are very, very intelligent and you can call them a little bit eccentric also to that level because they do a little bit of things differently. But the fact remains that they probably do not stick onto one job, they probably jump from one thing to other and the same thing with their relationships also. So what can be done to make sure that this aspect is also handled quite early so that later on in their life they live a full-fledged life like at least a fulfilled life which they wish to live.

Preparing for Adult Life with ADHD

Dr. Kavita:exactly exactly mam actually thanks to addressing that part because. In this spectrum disorder and the developmental disorders the ADHD is one thing which can be overlooked or it can be misdiagnosed so ADHD is one thing which can be misdiagnosed earlier or mistaken for a normal mischief or normally they don’t do well in academics and that can be carried over over a period of time and then during adolescence and then in adulthood this can go and there is this adult ADHD part which is often underdiagnosed or which is left unnoticed which is having a lot of issues in the family as you rightly told it mainly in the relationships especially with husband and wife or in the office at workplace they will be extremely intelligent, they’ll be extremely productive but when it comes to interaction or when it comes to a teamwork they fail miserably and they have a tough time with that, so this has to be addressed to that. This is the very reason we say that this behavioural pattern has to be assisted quite early and has to be addressed. Even in the earlier phase so that even during adolescent and adulthood if this is diagnosed, there is a set of medications which can improve their attention which can improve skill their focus. So these are certain areas in the spectrum disorder where the medications help along with the therapy along with the way their strengths has to be channelized. I think add think to your previous question also the important thing the parents should do even at the earlier thing when they know what is their negative part. These children what they are not good at is also important to identify what are their strengths because they can be exceptionally well, there can be extremely good strengths what they have in certain areas that has to be channelized and nurtured, that can be done even during the adolescent phase. The same thing can help them in their adult life. I will just quote one example, there was a couple who came. The husband brought the wife telling that almost even at the verge of divorce telling that she is taking almost two to two, she’s daydreaming. She’s not taking care of the child. She enters the kitchen. She is taking two and a half hours to make one coffee, coffee, or one hour to make a tea to finish the morning course she’s taking, and the mother-in-law keeps complaining that she’s daydreaming, she is not good for anything. We have married child. A. You have married a girl who’s not good enough. Whos now? We don’t even use that term mentally retardant. We don’t even use that term. That was the term which was told in that was. But then with all the detailed analysis, we found what she had was adult ADHD.

Dr. Hema Sathish:Okay,

Dr. Kavita:just intervening with that, she became completely all right over a few months of time she started. Becoming the wonderful wife, wonderful mother and then the husband came and thanked our team telling that we thought we have to get a complete psychiatric treatment. They were at the verge of going and divorcing her also. So this is one example i would tell that even in adulthood. ADHD is there and those are the people who are also being manipulated sometimes and they are also suffering in there like they don’t get to the right job because a boss should understand their strength and the negative aspect also.

Dr. Hema Sathish:Well, one more myth is They always say that the boy child talks later. How far is true,

Do Boys Talk Later? Myth or Fact?

Dr. Kavita:it’s absolutely. Not true, okay. It’s a very common myth and that’s an important reason why the boys are diagnosed very late and they come very late for the treatment also to the expert because of the fact telling that boys always speak late or that’s sometimes the there maybe grandparents. Telling That my son also spoke late, it’s okay. I really don’t know what exactly they mean by that, because I don’t think that can be true anything beyond the two years. If the child doesn’t speak, that has to be dealt with

Dr. Hema Sathish:okay, so you have to handle it and you have to be aware of it. Also, okay, there somewhere know. I feel as a member of the society. If we have to see a child with autism, what can we do as onlookers or people like? I’m not talking as doctors? I’m saying when you are in a public gathering or something know. I have seen sometimes some kid with autism. And then your heart goes out to the mother. But then what can we do

Role of Society in Autism Care

Dr. Kavita:FirstWe also as a society should start being accepting. We should have an acceptable environment immediately telling or that order to take the child away or my child after seeing that child might have a problem all that, even rather the way we are going to accept those children, our children. The next generation also should be raised with the idea that these differences in their development or the deviation of the behaviour also should be accepted as accepted, so that be their problem can be address. So it is not that we have to separate them from a society. Rather, we should also understand and answer. Okay, this is the way they behave in the situation and then maybe keep quiet sometimes or maybe, and also stop advising the mother to do this, do that or be judgmental about who you did this. Because of this, at least we need not do anything either. We accept if you can give some support emotionally or physically when the mother needs a particular, the child is aggressive or something if not better, to keep quiet or not to look very differently in disgust way or something that has to be avoided.

Dr. Hema Sathish:That is something. We all do right as soon as you get a chance. You want to give advice if it’s required, not required. You’re expert, you’re not. Doesn’t matter, yes, advises mandatory. You have to prove yourselves, so please don’t do it henceforth accept the child and it’s not anything keep quiet because the mother or the parent also needs more more help than you can ever imagine. In autism as they grow older especially in the adolescence, their energy levels are very high right generally also, and what happens is they’re very aggressive, and if they hear some loud noise or they can be instigated into doing anything which they don’t realize is good, bad or bad, so can you say something about that? I mean, what can be done in a stage like that

Handling Aggression in Autism

Dr. Kavita:Actually for that it is very important to understand about the treatment which has to be extremely tailormade, customized for the problems these children are facing like there can be overlap of so many features between autistic spectrum disorder and ADHD. As you rightly said they have an excellent stamina, triple times like

Dr. Hema Sathish:They have too much of energy, too much of energy.

Dr. Kavita:The mother becomes started the father because the child keeps running her so that they in fact become and

Dr. Hema Sathish:as they grow older it becomes aggressiveness. Also very alive,

Dr. Kavita:They become aggressive. I always say drain them out physically also because they are the ones who make excellent marathon runners, athletes, so that’s their strengths when their channel is that they become that way also so again that aggressive behaviour. So as I said the treatment should include not only sometimes we tend to think that autism and ADHD can need doesn’t require any medication, it requires only therapy and sometimes. We tend the medications that be given so we will try to manage at home so both the extremes are not correct and some children have these symptoms which require medications and some aspects of the problem has to be addressed by a psychologist has to be addressed by an occupational therapist, by a psychiatrist, by a neurologist so this definitely has to be a teamwork the next for the aggressive behaviour and also the hyperactivity there are there that part has to be dealt by the medications. The right kind of medications has to be given by the neurologist and the psychiatrist so that those medications given right for the right symptom will definitely help controlling the aggression because only then the parents also can deal with the children when they take them around. Suppose they’re going to be aggressive and the behaviour is so inappropriate. Then it is becoming very difficult for the entire family.

Dr. Hema Sathish:Developmental differences are not your fault and you cannot blame it on poor parenting either you know with a lot of support and early diagnosis and intervention, the child will love, grow up well, thrive and survive better. So your job is not to fix the child but to support the child and help the child. And as a neurologist your thought, i mean your one line which you would advise. All the parents, please go ahead. Dr. Kavita.

 Early Support, Better Outcomes

 Dr. Kavita:So the Autistic Spectrum disorder ADHD, the learning disability or all the differences in the development of the brain and the way brain, the difference and the way the brain processes the information, the emotional communication and the skills learned by the child. And these are not the neurological or developmental diseases. They are just the differences which we have to understand with early intervention, the outcomes can be transformed for a better life. For this

Dr. Hema Sathish:Thanks a lot. Dr. Kavita, it was wonderful having you and I hope everybody listening to this has understood quite a lot and we were quite helpful in helping you out help your child.