Category: Child Psychiatry
Scholastic backwardness
Psychiatry
Scholastic backwardness
Scholastic backwardness
Scholastic backwardness is one of the commonest educational problems encountered in children and consists of the fact that the child’s performance at school falls below the expectations i.e.  according to the level of intelligence.
What are the causes for scholastic backwardness (academic problems)?
The causes for a child being poor in academics are varied and range from physical causes to psychological causes the later being more common.
- Some common reasons for scholastic backwardness are
- Early conditioning and environment
- Environment  not suited for  academics like harsh teacher, demanding parents, overcrowded class rooms, lack of encouragement from school authorities, poor health leading to repeated absence from school, bullying in school, being severely reprimanded at school,
- And separation anxieties are some of the factors for academic decline.
- Intelligence
Children who have intellectual disability can have problems in academics as taught in regular school.Â
On the opposite end of the spectrum children who have very high IQ scores can become bored and feel lack of stimulation in the school curriculum lag behind in academics
A) Attention deficit hyperactive disorder ( ADHD)
- Children suffering from ADHD can suffer from poor academic performance.
B) An unhealthy teacher –pupil relationship often causes scholastic backwardness.
C) Physical handicaps
Auditory and visual disturbances can lead to academic backwardness which at times can be difficult to spot in the early years of schooling.
D) Frequent physical illnesses leading to frequent absenteeism lead to a fall in academics.
E) Family environment.
- The family environment is one of the most important factor for a child doing well in academics and parents play a very important role. Proper study environment, appropriate encouragement, spending quality time with their children will give the desired result. At times parents can have great expectations from their child and can push the child unnecessarily leading to fall in academic levels.Â
- The above list is not exhaustive and various other factors can play a role in academic backwardness.
How does the mental health worker assess for academic backwardness?
The doctor has an exhaustive interview with the child and parents. He will look at the child’s report cards, books, both text and written books interact with the child at length to find out causes for the academic decline. He might even suggest certain tests and then come to a conclusion. So be prepared with the child’s books, report card, teacher comments and both parents are advised to go to see the doctor. It is a time consuming process but the rewards could be worth the effort.
What is the treatment for academic backwardness?
Depending on the cause the treatment may include talk therapy and medications for certain conditions if needed. The process of treatment can be long and if persisted you may get the desired result.
Medical Specialists
Autism
Psychiatry
Autism
What is autism?
Autism belongs to a group of disorders called pervasive developmental disorders which is of early onset in which the person suffers from abnormalities in the development of social interaction, communication and behavioural issues.
How frequent is autism?
About 4 to 5 children per 10000 suffer from autism. Some research quote higher figures. Â It is seen more in males than females.
What is the cause for Autism?
A lot of research has implicated various reasons for autism
- Genetic factors play a role as shown by twin studies.
- Medical causes : Neurological infections like meningitis ( infection of the covering of the brain) , rubella infections and decreased oxygen to the brain ( perinatal asphyxia) can lead to autism. 35 to 50 % of children with autism suffer from seizures.
What are the symptoms of autism ?
Symptoms of autism are
- Â Impairment in social interactions as indicated by
a. Marked impairment in the use of multiple non verbal behaviours such as eye to eye contact, facial expression, body postures and gestures to regulate social interactions.
b. Failure to develop peer relationship ( friends ) appropriate to developmental level
c. A lack of spontaneous seeking to share enjoyment, interests or achievements with other people.
d. Lack of social or emotional reciprocity
- Â Impairment in communication as indicated by
a. Delay or lack of development of spoken language
b. Marked impairment in the ability to initiate or sustain conversation with others
c. Repeated gestures and actions and repeated use of language
d. Lack of varied spontaneous make believe play or social imitation play appropriate for the developmental level
- Â Restricted repetitive and stereotyped pattern of behaviour or interests and activities as manifested by
a. Hand or finger flapping
b. Persistent preoccupation with parts of objects
c. Having repeated rituals
4. Onset prior to age 3
What is the course of autism?
  Although the outcome of autism is improving, autism is a lifelong disability. About 20 % of autistic individuals become adults and are able to function with independence and self reliance.  New research in autism is being done which may help the individuals in future.
What is the treatment for autism?
  Main treatment for Autism is behaviour therapy.  Parents will also need extensive therapy in order to help the child.
Medications will be prescribed depending upon the problem presented.
Medical Specialists
ADHD
Psychiatry
ADHD (Attention Deficit Hyperactive Disorder )
ADHD
Attention deficit hyperactivity disorder is the most common emotional, cognitive and behavioural disorder treated in youth. . It is associated with higher degree of psychiatric morbidity in adulthood. It affects 4% to 7% of children worldwide. New research indicates that it can persist into adulthood.
What are the symptoms of ADHD?
A. Symptoms of inattention like
- Often fails to give attention to details or makes careless mistakes in school work , work or other activities
- Often has difficulty sustaining attention in tasks or play activities
- Often does not seem to listen to when spoken to directly
- Often does not follow through on instructions
- Fails to finish schoolwork chores or duties in the work place
- Often has difficulty in organizing tasks or activities
- Often avoids , dislikes or is reluctant to engage in tasks that require sustained mental effort
- Often loses things  ( pencils, toys, books etc)
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
B. Symptoms of hyperactivity or impulsivity
- Often fidgety with hands or feet or squirms in seat
- Often leaves seat in classroom or in other situations in which remaining seated is expected
- Often runs about or climbs excessively in situations in which it is inappropriate
Often has difficulty in playing or engaging in leisure activities quietly
Is often on the go or often acts like as if driven by a motor
Often talks excessively
Impulsivity
- Often blurts out answers even before the question is completed
- Often has difficulty awaiting turn
- Often interrupts or intrudes on others
Some of the above symptoms should be present before the age of 7 yrs
Symptoms can be present in home and or in school
Impairment in social, academic or occupational functioning
What are the causes of ADHD?
The cause for ADHD is multifactorial
- Physical conditions; pregnancy and delivery complications, cigarette and alcohol exposure in the womb, lead exposure, medications, neurological conditions can be associated with ADHD
- Family conflict, adverse family environment, decreased family cohesion can predispose to ADHD
- ADHD is highly genetic and can run in the family
Do ADHD symptoms reduce with age?
The earlier literature suggests that the hyperactivity component can reduce with age. New research suggests that the attention deficit part can persist into adulthood leading to impairment in socio occupational function. New research suggests a new terminology called adult ADHD.
Children with ADHD are more prone to suffer from conduct disorder, increased chances of substance use and having attention deficits in adulthood. Hence it is always advisable to seek help from a professional when symptoms of ADHD are noticed.
What is the treatment for ADHD?
ADHD can be treated with medications and Behaviour therapy.
For mild to moderate cases behaviour therapy can be considered. It is to be noticed that behaviour therapy is a long process and the parents should have a lot of motivation and patience to implement the therapy.
For moderate to severe ADHD many medications like stimulants like methyl phenydate are available which can help your child. It is advisable to have a detailed discussion with your doctor about the side effect profile of theses medication and then to take an informed decision.