Disorganized Children

A Guide for Parents and Professionals

Samuel Stein, Uttom Chowdhury

• Publisher: Jessica Kingsley Publishers
• Year: 2006
• ISBN:
  9781846424960
• Topic: Didattica
• Subtopic: Difficoltà di apprendimento

Disorganized children' may display a range of behaviours symptomatic of, for example, ADHD, autism and conduct disorders, but they often fail to meet all the criteria for a clear diagnosis.

In this book, psychiatrists, speech, family and occupational therapists and neurodevelopment specialists present a range of behavioural and psychological strategies to help disorganized children improve concentration and performance in the classroom and deal with a variety of behaviour and social interaction difficulties. The authors also provide information and interventions for dyslexia, dyspraxia, OCD and schizophrenia, among others.

The combination of information, exercises and case studies makes this a valuable tool for use by parents, health care and teaching professionals, and the authors provide an insight into the mind of disorganized children and practical guidance on how best to help them achieve their full potential.

Part 1

Child Development

Chapter 1

From 0 to 5 years

Uttom Chowdhury and Samuel M. Stein

From earliest infancy through to young adulthood, children and adolescents grow and develop according to their age and ability. This developmental pathway is influenced by a wide range of factors, and even ‘normal’ child development varies enormously. Some parents may report that their child is walking at 10 months, whereas others may report their child as walking from 17 months. While most children will crawl before walking, some will crawl ‘commando-style’ and others will ‘bottom-shuffle’. On the whole, girls tend to develop earlier, particularly with regard to social and communication skills. Yet, all of these changes fall well within anticipated growth and development. However, although the rate of change may differ, it is important to recognize that there is an overall consistency to the pattern of developmental progress over time.

The two main factors which may actively affect development, either positively or negatively, are genetic influences and environmental influences. Genetic factors represent the inherent biological potential of the child, while environmental factors will influence the extent to which the child may achieve this potential. Genetic factors include intelligence, temperament and sex while environmental factors include nutrition, warmth, affection, role models and the opportunity to play. For optimal development to take place, the environment must meet the child’s inbuilt physical and psychological needs.

As children can only be fully understood within this fluid context of genetic predisposition and environmental influences, it is essential to understand something about normal development before considering the potential physical and psychological problems which may present during childhood and adolescence. This chapter therefore aims to provide a basic overview of growth and change between birth and 5 years of age. A simple outline of normal development is described for each specific age group including motor function, vision, hearing, speech and social function. Any gross deviation from these milestones may require more detailed reading, discussion with appropriate professionals or further investigation.

THE NEWBORN BABY

•Motor: At birth, both arms and legs are usually stiff while the trunk and neck are floppy. The head therefore needs to be supported when the infant is picked up. A number of primitive reflexes are still present, such as the Moro reflex, which involves a sudden outward movement of the arms and an opening of the hands in response to an unexpected loud noise or a rapid lowering of the head or body. Within moments, the baby’s arms come together again, simulating an embrace. This reflex, as with other ‘survival reflexes’, will fade after a few months.

•Vision: Infants are able to turn their head towards diffuse light, and close their eyes in response to sudden bright light. However, they cannot focus effectively until 3 months of age. The parent’s face must therefore be brought to within 30 centimetres of the baby’s face to gain his or her attention.

•Hearing: A startle reaction to loud noises is present from birth.

•Social/play: Within a few days, babies will make eye contact with their parents and interact with facial gestures.

AT 1 MONTH

•Motor: Both arms and legs are now active. Infants are able to open their hands, but these are generally closed. However, fingers and toes will fan out when limbs are extended. If their cheek is touched, babies will move towards the stimulus in an attempt to suckle (rooting reflex). When held standing up, babies will attempt to make ‘walking’ movements and touching the sole of their foot against a solid surface will produce a ‘stepping’ reflex. Pressure placed on their palm will initiate a ‘grasping’ reflex in which the fingers curl and grip.

•Vision: Babies’ pupils will constrict if stimulated by light and their eyes will shut tightly if any direct light shines into them. They will gaze at toys moved towards and away from their face, and will start to watch familiar faces more closely. From about 3 weeks of age, infants are increasingly alert visually.

•Hearing: Infants will be startled by sudden noises, and may appear to ‘freeze’ momentarily when a small bell is rung. If crying, they may stop suddenly when gentle noises are made.

•Speech: At this age, babies may utter some sounds when content. They will ‘coo’ in response to their parent’s voice from about 5 to 6 weeks, and will cry when hungry or uncomfortable.

•Social/play: A social smile develops from about 6 weeks onwards, and the baby will stop crying when picked up.

AT 3 MONTHS

•Motor: Infants’ legs now kick out and, when lying on their front, they will try to lift their head using their forearms for support. When pulled to sit up, there is no longer any head lag and they may hold a rattle for a few seconds.

•Vision: There is greater preoccupation with the parent’s face. Babies will move their head to gaze at objects, and will follow the movement of a dangling toy. They will also watch their own hand movements.

•Hearing: Loud noises continue to produce blinking, crying and distress. They will turn their head towards a nearby voice.

•Speech: Babies will make some sounds when spoken to, and ‘gurgle’ and ‘coo’ with pleasure.

•Social/play: Infants will fix their eyes on the parent’s face. They will start to smile, and respond to being tickled or played with. Excited arm and leg movements may occur when they see food or preparation for bathtime. While friendly with adults, they know who their main carer is.

AT 6 MONTHS

•Motor: While lying on their back, babies will grab their own feet. If held sitting, they will keep their back straight. When held standing, they will take their own weight on their legs. If lying on their front, they will tend to extend their arms, and they begin to use their hand to hold toys (palmar grasp).

•Vision: They will move their head and eyes when distracted, and visually follow an adult around the room. Their eyes should move together, without any evidence of a squint. By now, they will also show interest in ‘peek-a-boo’ games.

•Hearing: Infants will turn towards familiar voices.

•Speech: They may laugh and chuckle to themselves, but scream when annoyed. They can vocalize using sounds such as ‘goo’, ‘der’ and ‘a-a’. They will also try to attract attention vocally.

•Social/play: At this age, they tend to put everything into their mouths. They will also put their hand on their mother’s breast or a bottle when feeding. They will show delight when engaged in active play. Although they are generally friendly, they start to show some degree of anxiety about strangers from around 7 months onwards. They are excited by familiar toys, and will smile at their own image in a mirror.

AT 9 MONTHS

•Motor: Babies may sit unsupported on the floor, and pull themselves up to stand. They can crawl, roll and wriggle on their front. They also begin to point at objects, and use ‘scissors’ grip (between index finger and thumb) to hold string. Finger feeding and early chewing may be apparent.

•Vision: They are very attentive and will stretch out their hands to take a toy.

•Hearing: They are attentive to everyday sounds.

•Speech: Infants now vocalize as part of communication, and may shout to attract attention. They babble and use syllables such as ‘da-da’, ‘ma-ma’ and ‘aba’.

•Social/play: They can grasp a bell by the handle and ring in imitation of the parent. They can watch while toys are partly hidden and then promptly find them, as well as looking for objects that disappear. They are able to distinguish strangers from familiar adults. They will also throw their body back and stiffen in annoyance, but will stop activities to the command of ‘no’.

AT 12 MONTHS

•Motor: Children can now rise into a sitting position from lying down. They can also crawl on hands and knees, may shuffle on their bottom or ‘bear’ walk on the floor. They are able to walk around furniture and step sideways, especially if one hand is held. They can pick up objects with a pincer grip (between thumb and tip of index finger), as well as pointing with their index finger. They can drop toys deliberately and watch as they fall. They can also hold toy bricks in each hand, and bang them together to make a noise.

•Vision: Children recognize familiar faces from a distance, and may watch people for a prolonged period of time.

•Hearing: They will immediately respond to their own name, as well as recognizing familiar tunes with which they try to join in.

•Speech: This takes the form of babbling loudly. There is some imitation of adult vocalization and attempts to converse.

•Social/play: Children are able to drink from a cup and hold a spoon. They can stretch their arms out for dressing, and may give toys to adults on request. They will place objects into and out of cups, watching while objects are hidden under a cup before reaching to find the toy. They may clap as part of imitation and wave goodbye on request. They can also imitate actions such as using a play telephone or using a cup and spoon. They will shake their head to communicate ‘no’.

AT 15 MONTHS

•Motor: Toddlers may try to start walking on their own for a few paces. They are able to crawl upstairs and slide downstairs backwards, as well as kneeling unaided. They can build a tower of cubes and grasp a crayon with their whole hand to scribble.

•Vision: They will watch activities outside a window for several minutes, and look with interest at picture books.

•Hearing: Children can demonstrate a basic understanding of a small number of words. They can also understand simple instructions such as ‘come here’ or ‘give me the ball’.

•Speech: They make a wide range of speech-like sounds, and can ask for objects by pointing.

•Social/play: Toddlers will attempt to bring a spoon to their mouth, and chew well. They can push large wheeled objects, open cupboards and close doors. They may also throw objects on to the floor as part of play or rejection. They should be very curious, with a desire to explore their environment. They are able to play ‘to and fro’ games with trucks, cars or balls.

AT 18 MONTHS

•Motor: Toddlers can now walk well, and may even start to run. They can climb into adult chairs, and squat to pick up fallen toys. Hand preference begins to show, and they are able to build a tower of three cubes.

•Vision: They can recognize pictures in books, point and turn several pages.

•Hearing: An ability to listen to commands which are addressed to them emerges.

•Speech: They can use 6 to 15 words or more, and make noises to themselves which have emotional inflections. Attempts to sing are evident, and they begin to repeat words overheard in conversation.

•Social/play: Children can obey simple instructions such as ‘shut the door’. They are able to point to their own shoes, nose or head on request. They can hold a cup with both hands, and drink without spilling. They begin to let adults know of toilet needs by restlessness and vocalization. They explore their environment with little sense of danger but still like to be near familiar adults. They also imitate everyday activities such as ‘sweeping’.

AT 2 YEARS

•Motor: By now, children can walk up and down stairs. They may sit and steer a tricycle but cannot yet use the pedals. They will walk into a ball when trying to kick it, but are able to run, both starting and stopping safely. The are able to squat with complete steadiness in order to rest or to play with an object on the ground. Spontaneous circular scribbles should start to emerge and they can build a tower of six or seven cubes.

•Vision: They are able to recognize details within a picture book, and also recognize familiar adults in photographs.

•Hearing: Increasing attention is paid to communications addressed to them.

•Speech: Children should be capable of using about 50 words, while understanding more. They can put words together in phrases, and talk to themselves continuously in long monologues. Echoes of adult speech are evident, with constant asking for the names of objects and people. They enjoy joining in with nursery rhymes and songs. They can also name familiar objects and pictures, and point to their hair on request.

•Social/play: They can put on their hat and shoes, and drink well without spilling. They may also attempt to verbalize toilet needs. They can turn ...