Child Development Clinic

Behavioral issues in children can lead to stress and frustration for the entire family. In young children, these issues may not yet be categorized as a specific diagnosis, but a child with significant behavioral issues may exhibit signs of:

* Anxiety

Having frequent and severe tantrums

Being manipulative

Being repetitively defiant towards those in authority.

Often their teachers, peers, and parents label these children as disruptive, frustrating, mean, or even “bad”.

It is important to speak directly with your Doctor concerning the presence or confirmation of any diagnosis of a spectrum disorder.

Sometimes children who demonstrate significant behavioral issues are given a formal diagnosis of oppositional defiant disorder. Often behavioral issues are identified along with another diagnosis like ADHD or Asperger’s (now considered a part of ASD). In many cases, behavioral issues never receive a formal diagnosis but nonetheless are a major issue in a child’s ability to make and keep friends or succeed in school. They often require intervention due to the impact on family life and disruption to everyday activities.

Symptoms of Oppositional Defiant Disorder (ODD) :-

* Signs of oppositional defiant disorder in children are usually apparent before the age eight. Behaviors may occur most with people the child knows well, such as family members or care providers. These behaviors are frequent, not age appropriate, and cause significant issues at school, at home, and/or with peers. Signs of ODD include (1)Losing one’s temper often.

Frequent arguing with adults or refusing to comply with adults’ rules or requests.

Often getting angry or being resentful or vindictive.

Deliberately annoying others; easily becoming annoyed with others.

Often blaming other people for one’s own mistakes or misbehavior.

It is defined as an intellectual functioning level (as measured by standard tests for intelligence quotient) well below average and significant limitations in daily living skills (adaptive functioning).

Description of MR

According to the ‘Centre for Disease Control and Prevention’, in the 1990s, mental retardation occured in 2.5 to 3 percent of the general population. Mental retardation begins in childhood or adolescence before the age of 18.

It persists throughout adulthood. Intellectual functioning level is defined by standardized tests (Weschsler-Intelligence Scales) that measure the ability to reason in terms of mental age (intelligence quotient or IQ). Diagnosis of mental retardation is made if an individual has an intellectual functioning level well below average and significant limitations in two or more adaptive skill areas.

Mental retardation is defined as IQ score below 70 to 75.

Adaptive skills are the skills needed for daily life. Such skills include the ability to produce and understand language (communication); home-living skills; use of community resources; health, safety, leisure, self-care, and social skills; self-direction; functional academic skills (reading, writing, and arithmetic); and work skills.

In general, mentally retarded children reach developmental milestones such as walking and talking much later than the general population.

Symptoms of mental retardation may appear at birth or later in childhood. Time of onset depends on the suspected cause of the disability.

Some cases of mild mental retardation are not diagnosed before the child enters pre-school.

These children typically have difficulties with social, communication, and functional academic skills.

Children who have a neurological disorder or illness such as encephalitis or meningitis may suddenly show signs of cognitive impairment and adaptive difficulties.

Categories of mental retardation

Mild Mental Retardation

Approximately 85 percent of the mentally retarded population is in the mildly retarded category. Their IQ score ranges from 50 to 75 and they can often acquire academic skills up to the sixth grade level. They can become fairly self-sufficient and in some cases live independently, with community and social support.

Moderate Mental Retardation

About 10 percent of the mentally retarded population is considered moderately retarded. Moderately retarded individuals have IQ scores ranging from 35 to 55. They can carry out work and self-care tasks with moderate supervision. They typically acquire communication skills in childhood and are able to live and function successfully within the community in a supervised environment such as a group home.

Severe Mental Retardation

About 3 to 4 percent of the mentally retarded population is severely retarded. Severely retarded individuals have IQ scores of 20 to 40. They may master very basic self-care skills and some communication skills. Many severely retarded individuals are able to live in a group home.

Profound Mental Retardation

Only 1 to 2 percent of the mentally retarded population is classified as profoundly retarded. Profoundly retarded individuals have IQ scores under 20 to 25. They may be able to develop basic self-care and communication skills with appropriate support and training. Their retardation is often caused by an accompanying neurological disorder. The profoundly retarded need a high level of structure and supervision

Epilepsy is a neurological condition (affecting the brain and nervous system) where a person has a tendency to have seizures that start in the brain.

The brain is made up of millions of nerve cells that use electrical signals to control the body’s functions, senses and thoughts. If the signals are disrupted, the person may have an epileptic seizure (sometimes called a ‘fit’ or ‘attack’).

Not all seizures are epileptic.Other conditions that can look like epilepsy include fainting (syncope) due to a drop in blood pressure, and febrile convulsions due to a sudden rise in body temperature when a young child is ill. These are not epileptic seizures because they are not caused by disrupted brain activity.

What happens during a seizure?
There are many different types of epileptic seizure.The type of epileptic seizure a child has depends on which area of their brain is affected.

There are two main types of seizure:
focal seizures (sometimes called partial seizures) and generalised seizures. Focal seizures affect only one side of the brain and generalised seizures affect both sides of the brain. Generally, adults and children have the same types of seizure, although some may be more common in childhood than adulthood. For example, absence seizures which can be very brief and are often mistaken for ‘daydreaming’ or not paying attention.

Different seizures include:


jerking of the body (convulsions)
repetitive movements
unusual sensations such as a strange taste in the mouth or a strange smell, or a rising feeling in the stomach.
In some types of seizure, a child may be aware of what is happening. In other types, a child will be unconscious and have no memory of the seizure afterwards.
Some children may have seizures when they are sleeping (sometimes called ‘asleep’ or ‘nocturnal’ seizures). Seizures during sleep can affect sleep patterns and may leave a child feeling tired and confused the next day.

Neurodevelopmental treatment (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists . NDT was developed to enhance the function of adults and children who have difficulty controlling movement as a result of neurological challenges, such as cerebral palsy, stroke, milestone, athetoide and head injury.

This therapy uses guided or facilitated movements as a treatment strategy to ensure correlation of input from tactile, vestibular, and somatosensory receptors within the body.

NDT was developed with the understanding that patients with brain injuries have a limited repertoire of movement patterns. During treatment interventions, repeated experience in movement ensures that a particular pattern is readily accessible for motor performance. The more a patient performs certain movements, the easier these movements becomes. Without NDT interventions, the patient likely will develop a limited set of movement patterns that he or she will apply to nearly all tasks. NDT should begin before such generalized movement synergies become hard-wired in the patient’s brain.
NDT-trained therapists work collaboratively with patients, their families and caregivers, physicians, and other members of the rehabilitation team to develop and implement a comprehensive treatment program for each person that is based on scientific principles and current research.

Brain Gym, Educational Kinesiology or Movement Therapy is a series of movements, done with intention and designed to ‘wake-up’ the brain or to stimulate brain function. Its focus is improved learning and mental organisation. The idea is that these are simple exercises that anyone can do at home or at work or at school and they are often used with children who have special needs or need to improve their learning ability. They are designed to strengthen the relationship between body and mind and so are particularly interesting in this time when so many of our activities are cerebral.

*Brain Gym or Movement Therapy is often used by therapists or in school classrooms with a reported increase in concentration and reading and listening skills.

* Brain Gym exercises are used to improve focus; children (or adults) repeat the exercises regularly and slowly. In children using these exercises there is often a noticeable improvement in memory, concentration, relationships and communication, and physical coordination. Though it is not 100% clear how and why this happens the thinking is that it exercises areas of the brain and strengthens neurological pathways that may not be well used otherwise. It allows participants to practice and strengthen physical coordination pathways and used to support children having developmental issues in this area. The therapy also requires them to be focused and present (i.e. mindful) during the exercises, supporting a habit of focus and single-mindedness. The exercises stimulate particular areas of the brain to improve its function, improve the integration between brain parts and links between the two hemispheres.

*  A lot of Brain gym exercises are designed to cross over from one side to the other – for example making sideways figure eights or putting an elbow to the opposite knee. The aim is to strengthen the connections between left and right brain activity, strengthen neural pathways and improve coordination. When our brains work better our whole body works better and we have an increased sense of well being.

* They are a great accompaniment to life and learning.

Autism spectrum disorder (ASD) is a developmental disability  that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

Signs and Symptoms:

People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.