Merlion Paediatric Therapy Center has a team of highly qualified and experienced specialists who are board-certified and registered educational therapists, cognitive neuroscientists, reading specialists, special needs therapists as well as early childhood educators.
We utilise different assessment tools and instruments to conduct a comprehensive Psychoeducational Diagnostic Assessment (PDA) and determine in terms of breadth and depth the learning disorders and difficulties a child/ student may encounter.
Our highly informative PDA report provides the practitioners and specialists the full confidence and knowledge to personalise a holistic and effective early intervention programs, learning programs, therapy sessions and treatments for the child/ student with learning disorders and difficulties.
With a deep understanding and consideration of Asia’s culture Merlion Paediatric Therapy Center sets its vision to establish itself as the most influential and credible therapy center of strong research and excellence in Asia.
An educational therapist understands how different learning difficulties/ disorders faced by a child affects the processing of the sensory information and knowledge being taught. The educational therapist is trained to identify the different traits and symptoms of each of the learning difficulties/ disorders and understand how the information are being processed by the child with special education needs. The educational therapist performs diagnostical assessment and prepares the individualised intervention or therapy plan to help the child to overcome learning glitches and promote changes in the brain organisation so that the child could learn important skills such as paying attention, reading ability, organising, reasoning, self-controling, interacting, speaking and writing etc. With taught skills, the child can actually overcome limitations and experience real success.
A school teacher helps a child under normal classroom settings to improve their academic skills and excel in academic grades. The school teacher tends to focus on specific academic subject knowledge. Tutoring is focused on extra practice and homework and can help to improve grade levels, but tutoring benefits are short-term. A school teacher or tutor without obtaining the full qualification in special education needs or having a practising license as an educational therapist is not trained in interventions or therapies procedures to help to improve the way the brain processes, retains and stores information in a child.
A cognitive psychologist investigate how people perceive, process, and store information, and how this information affects behavior. They use various methods to study these mental processes, including behavioral experiments, brain imaging techniques, and computer simulations. Furthermore, they aim to understand how people learn, reason, make decisions, and solve problems. Cognitive psychologists work in a variety of settings, including academic institutions, research centers, government agencies, and private companies.
A reading specialist, as defined by the International Literacy Association (2015), is a teacher for students who experience reading difficulties. However, some reading specialists work with both students and other teachers performing as a reading or literacy coach. The threefold role of a reading specialist involves literacy instruction, assessment and leadership in promoting literacy. There are also those reading specialists with specific focus area such as providing remedial support for students with dyslexia/dysgraphia, and reading program design and implementation, but every reading specialist is equipped to fulfill each of these types of responsibilities.
A reading therapist is different from a reading specialist because its role is to identify the underlying factors why a child’s brain, eyes and auditory system is not processing sounds, symbols and phonics in the same way as children who learn to read without challenge as well why the child may have poor reading comprehension. The reading therapist focuses on conditions such as eye instabilities, weak auditory processing, and poor core development and also to prepare corrective treatment plans that focus on correction and then re-enforcement to help clients learn to read fluently without years of ongoing tutoring, accommodations and other tools to manage the challenging issue of concern.
A speech-language therapist is an allied health professional who diagnoses and treats communication and swallowing problems. The therapist works with both children and adults in clinics, schools, and hospitals. The speech-language therapist works to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.
Educational Therapy is undertaken by an educational therapist who is professionally trained and has been admitted as a practising member with a reputable professional organisation such as Association of Educational Therapists and International Association of Counselors & Therapists after passing rigorous qualifying examinations. The types of membership available are certified, credentialed, registered and board certified/ chartered. Board certified/ chartered being the highest standings of the profession and demonstrates a mastery of advanced knowledge due to very demanding admission requirements.
The main aim of the educational therapist is to understand and work around an individual child’s learning disorders, difficulties, habits, patterns and behaviors impeded inherently by his/her disabilities and disorders s/he may have. A highly proficient and skilled educational therapist uses a wide range of therapeutic skills, experience and knowledge to personalise both early intervention programs (EIP) and learning programs to optimise learning processes in achieving learning goals. During the learning process, educational therapist may have to use various learning tools (both tangible and intangible) to help the child to comprehend academic concepts and acquire skills such reading, writing, abstract reasoning, memory, attention and imagination for academic performance.
A counseling provides immediate or short term solution to address less serious and current issues that occur due to basic life challenges such as social issues, career options, relationship problems, family issues, stress at work or emotionally difficult changes like the death of loved ones, so that client could make better informed decisions. Hence, counselors provide guidance, support and education to help client to identify and find solutions to current problems together. Do note that Educational Counseling is a type of counseling that focuses on providing academic, personal, and therapeutic support to students in educational settings. The ultimate goal of educational counseling is to support student success and well-being by addressing the diverse needs of learners in educational settings.
Psychotherapy in short for Psychological Therapy is undertaken by a clinical psychologist who is professionally trained and has been admitted as a practising member with a reputable professional organisation such as Singapore Psychological Society and British Psychological Society after passing rigorous qualifying examination. It is a way of helping individuals to deal with various mental health issues or emotional challenges. The clinical psychologist’s main aim is to modify the dysfunctional thoughts, beliefs, attitudes, feelings and behaviour of a person with affective disorders (such as anxiety disorder, depression and bipolar disorder), personality disorders and psychotic disorders.etc., and to facilitate positive change in individuals seeking better emotional and/or social functioning to improve quality of life. The modification are done through talk based therapies and hypnosis. Cognitive Behavioral Therapy (CBT), Interpersonal Therapy, Dialectical Therapy and Psychodynamic Therapy are the most commonly used talk-based therapies in treating the symptoms of the affective disorders. However, only a psychiatrist who is medically trained is able to prescribe pharmacological medication to treat moderate to severe conditions.
A Psychoeducational Diagnostic Assessment (PDA) is a process of utilising various assessment tools and instruments to specifically collect information on a student’s learning skills, performance, learning history, and instructional context, in order to make decisions about what supports and interventions might be needed for that student (Salvia and Ysseldyke, 1978). In other words, PDA aims to identify all disorders/ disabilities and the associated functions of the brain, how the child learns, where and why learning or behaviour challenges originate and how to help promote changes in brain organisation, memory, reading, learning ability and overall processing.
With the mastery of advanced knowledge and skills by the board certified/ chartered educational therapist, advanced PDA could only be conducted by them as required in developed countries. In additional, only board certified/ chartered educational therapist are authorised to purchase and use certain very specialised tools or instruments to perform specialised diagnostical assessment. It aims to identify specific learning disorders and disabilities of a child.
Various assessment tools and instruments are usually utilised as to allow the assessor to corroborate the evidence and to probe further in-depth to identify the disorders and difficulties encountered by the child/ student should inconsistencies surface before providing a reliable opinion.
A Psychological Assessment mainly makes assessment on the mental state, dysfunctional thoughts, beliefs, attitudes, feelings and behaviour of a person and proposes recommendations for treatment through psychotherapy. The Psychology Assessment is also used to determine the person’s personality & character, strengths & weaknesses, gender orientation, aptitude & motivation etc as required specifically by an organisation in verifying specific employment abilities and skills or predict potential behaviour under certain circumstances.
Cognition refers to the mental processes and abilities that enable an individual to acquire, process, store, and use information. Cognition involves all conscious and unconscious processes by which knowledge is accumulated. These processes include perception, attention, memory, language, planning, reasoning, problem-solving, and decision-making. It is a complex and dynamic process that involves many different parts of the brain working together to process and use information from our environment.
Cognitive development is critical to children as it refers to the development of their thinking, problem-solving, and decision-making abilities. Children who experience healthy cognitive development are more likely to succeed academically, socially, and emotionally. The early years of a child’s life are especially important for cognitive development, as the brain develops at a rapid pace during this time. Parents and caregivers can encourage healthy cognitive development in children by providing a nurturing environment that stimulates their senses, engages their curiosity, and challenges them to explore and learn. The following are reasons why cognitive development is important for children:
1. Building problem-solving abilities: Cognitive development helps children develop problem-solving abilities, which are essential for success in school and beyond. As they mature, children will encounter increasingly complex problems, and their cognitive skills will enable them to approach these problems with confidence and creativity.
2. Enhancing social and emotional development: Cognitive development is intertwined with social and emotional development, as children who have developed strong cognitive skills are better able to understand their own emotions and the emotions of others. This can lead to healthier relationships with peers, family members, and authority figures.
3. Improving analytical skills: Cognitive skills allow children to understand the relationships between ideas, to grasp the process of cause and effect, and to improve their analytical skills. Understanding the relationship between cause and effect can prevent children from engaging in risky behaviours, and can help them make more informed decisions in all areas of life.
4. Link between movement and cognitive development: Research shows a link between cognitive development and movement, meaning children need opportunities to move, so they can learn. Rolling, crawling, skipping, and jumping, along with a variety of other movement activities, build the brain during the first years of a child’s life.
The executive functions are primarily associated with the prefrontal cortex of the brain, but other subcortical structures may also play a role. The prefrontal cortex is divided into two parts: the medial prefrontal cortex (mPFC), which is involved in self-reflection, memory, and emotional processing, and the lateral prefrontal cortex (lPFC), which is involved in sensory processing, motor control, and other cognitive functions. Higher-level processes involved in executive function include planning and reasoning.
The executive function is a set of cognitive processes and mental skills that are crucial for cognitive development. The development of executive function skills is highly interrelated and requires the coordination of three types of brain function: working memory, mental flexibility, and self-control. These skills are needed for self-control and managing behaviours, allowing individuals to do things like follow directions, focus, control emotions, and attain goals. They enable individuals to plan, monitor, and execute their goals, making them good students, classroom citizens, and friends, and helping them grow into adults capable of juggling a multitude of commitments.
Cognitive Therapy is a type of psychotherapy developed in 1960s by American psychiatrist Aaron T. Beck, as one therapeutic approach within the larger group of Cognitive Behavioral Therapies (CBT). Cognitive therapy is based on the cognitive model, which states that thoughts, feelings and behavior are all connected, and that individuals can move toward overcoming emotional difficulties and meeting their goals by identifying and changing unhelpful or inaccurate thinking, problematic behavior, and distressing emotional responses. This involves the individual working with the clinical psychologists, hypnotists or psychotherapists to develop skills for testing and changing internal beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors. A cognitive case conceptualization is developed by the clinical psychologist or psychotherapist as a guide to understand the individual’s internal reality, select appropriate interventions and identify areas of distress.
Cognitive Training, also known as brain training, involves engaging in activities designed specifically to strengthen one or more cognitive skills, the mental processes our brains use to think and learn. Some cognitive training programs focus on improving individual cognitive skills and executive functions such as attention, problem solving, working memory and reasoning while others are more comprehensive and integrated.
Diagnostical Statistical Manual of Mental Disorders (DSM) is publised by the American Psychiatric Association (APA) as a tool to diagnose mental disorders. DSM 5th edition was published in 2013 and its DSM-5 text revision (DSM-5-TR) was published in 2021 as an addendum to DSM-5 and includes additional content and updated diagnostic codes.
The International Classification of Diseases, Eleventh Revision (ICD-11), is a diagnostic manual for medical conditions, including mental and behavioural disorders. It is produced by the World Health Organization (WHO) and is intended to be used by healthcare professionals worldwide. The ICD-11 includes many updates and changes from the previous version, the ICD-10, including changes to the classification and diagnostic criteria for mental and behavioural disorders. Some of the changes in the ICD-11 include the addition of new disorders, such as gaming disorder and prolonged grief disorder, and the removal of others, such as Asperger’s syndrome.
The DSM is primarily used in the United States and Canada, focuses on symptom-based diagnosis, and includes a large number of mental disorders. The ICD, on the other hand, is used globally for both medical and public health purposes, classifies disorders based on their underlying causes, and includes a vast array of medical and mental health conditions. Overall, there are some notable differences between DSM-5-TR and ICD-11 in terms of functional impairments, duration criteria, and the classification of certain disorders such as Prolonged Grief Disorder (PGD) and attenuated psychotic symptoms. However, both systems have introduced harmonised time course criteria and dimensional assessments.
A disability is a functional limitation of our physical (including blindness, deaf, handicapped), neurological (autism spectrum disorder, attention deficit-hyperactive disorder, developmental delay) or psychological (including anxiety disorder, panic disorder, post-traumatic stress disorder, depression, bipolar disorder, schizophrenia) structure that causes us a lack of ability to perform routine activity within the range considered as normal.
A disorder is a medical condition that mainly relates to mental health (neurological and psychological). The DSM-5-TR defines “disorder” as “a syndrome characterised by clinically significant disturbance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning“.
Commonly known mental disorders are autism spectrum disorder (ASD), attention deficit-hyperactive disorder (ADHD), dyslexia, dyscalculia, dysgraphia, dyspraxia, eating disorder, depression, anxiety disorder, dissociative disorder, obsessive compulsive disorder (OCD), oppositional defiant disorder (ODD), conduct disorder (CD), antisocial personality disorder, (ASPD), paranoia, neuroses, psychoses, Alzheimer’s disease, Parkinson disease and schizophrenia etc. Many rare disorders also vary from mild to severe, which warrants for different types and intensity of treatment and therapy.
A disease is construed as a medical condition associated with specific symptoms and signs that affects the structure or function of all or part of our body organism, not caused by physical injury. Most people understand a disease to be caused by pathogens (bacteria, virus, fungi and microorganisms) that maybe infectious. However, not all diseases are caused by pathogens and not all of them are infectious. Autoimmune diseases, cardiovascular disease, cancer, diabetes, Alzheimer’s disease, Parkinson’s disease and Huntington’s disease etc., are non-communicable.
A difficulty is often known as a phase of struggle or challenge or in the condition of being difficult. It impedes a person encountering it from achieving a goal or aim. When the aim is redundant, the struggle in achieving the aim becomes less apparent. The disability, disorder and disease the person has encountered may inherently create a difficulty and prevent him or her to achieve a desired result. In the context of academic learning, the United Kingdom’s National Health Service defines a ‘learning difficulty’ as ‘a type of Special Education Needs, which affects areas of learning, such as reading, writing, spelling, mathematics etc‘.
A neurological disorder impairs the functions of neurons and the brain systems. In other words, genetic variants have caused impairment of the protein synthesis in the neurons affecting how the neurons synapse with each other. The neurological disorder has three components: neurodevelopmental disorder, neurodegenerative disorder and neurocognitive disorder. Examples of neurodevelopmental disorders are autism spectrum disorder (ASD), attention deficit hyperactive disorder (ADHD), dyslexia, down syndrome and mental retardation etc. Examples of neurodegenerative disorders are Alzheimer’s disease, parkinson disease, multiple sclerosis and motor neuron disease etc. Genetic variants are heritable in nature and/or could be caused by environmental toxicity relating to radioactivity, existence of heavy mental in food and pollution etc.
A psychological disorder is an ongoing dysfunctional pattern of thought, feeling & emotion, and behaviour that causes significant distress, and that is considered deviant in that person’s culture or society (Butcher, Mineka, & Hooley, 2007). Individual with the psychological disorder will find his/ her daily functions impaired, family life disrupted and have to face unfriendly social environment leading to social withdrawal. Examples of psychological disorders are anxiety disorders, depression, bipolar disorder, paranoia, post-traumatic stress disorder (PTSD), conduct disorder (CD), oppositional defiant disorder (ODD), various personality disorders. These psychological disorders could be treated with psychotherapy and counseling, as alternative to pharmacological treatment.
The neurodevelopmental and psychological disorders have varying degree of severity and are not mutually exclusive. They could cause learning difficulties in a child due to the impairment in memory, language, motor skills, speech, behaviour, cognitive abilities, social skills, emotion regulation skills. Intervention programs drawn up by a qualified educational therapist will effectively assist the child to overcome the learning difficulties.
Neurocognitive disorders refer to a broad range of conditions such as delirium, traumatic brain injury, infections, vascular disorders and exposure to toxins, that impair cognitive functions, including memory, attention, perception, and problem-solving, including but not limited to neurodegenerative diseases.
Neurodegenerative disorders are a type of neurological disease that involve the progressive loss and death of neurons, which can lead to cognitive, motor, and sensory functions impairment. Examples of neurodegenerative disorders include Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and Amyotrophic lateral sclerosis (ALS).
By DSM-5-TR definition, ADHD is characterised by predominant symptoms of inattention, hyperactive and impulsivity. It affects about 5% of the children and adolescents worldwide. Other common comorbidity disorders associated with ADHD include intellectual disability, anxiety disorders and learning difficulties as well as functional impairment such as low educational attainment, high unemployment and peer rejection etc. More than 60% of these can also be persisted into adulthood.
ADHD could be both caused by heritable genetic factors and/ or linked to inadequacy in care provision given at the early years of the person diagnosed with it. The inadequate care provision at the early years could have caused growth stunting and developmental delay leading to neurodevelopmental impairment at the prefrontal lobe and limbic system, especially the amygdala. Impairment at the prefrontal lobe leads to inattention and self-control, leading to impulsivity and hyperactive traits of the child. Impairment in the limbic system leads to both disinhibited social engagement traits, oppositional defiant disorder (ODD) and conduct disorder (CD).
Various pharmacological medications are available to treat ADHD in reducing the core symptoms, mainly by improving brain circuits in targeting the neurotransmitters pathways. Counseling for family including guiding the parents the techniques in improving family interactions & implementing behavioural techniques, and social learning based approach have positive effect on conduct problems, challenging behaviours and social skills of ADHD.
By DSM-5-TR definition, disruptive behaviour disorders are a group of mental health conditions that involve patterns of defiant and hostile behaviours that persist for at least six months and cause significant impairment in social, academic, and/or occupational functioning. These behaviours often violate the rights of others, and can involve aggression, destruction of property, or rule-breaking. Here are some of the most common disruptive behaviour disorders:
Oppositional Defiant Disorder (ODD): Children with ODD display a persistent pattern of angry and irritable mood, argumentative and defiant behaviour, and vindictiveness towards authority figures like parents, teachers, and other adults. This behaviour can cause significant distress for the child and their family and can lead to impaired social and academic functioning.
Conduct Disorder (CD): Conduct disorder involves persistent patterns of aggressive and antisocial behaviour, including physical violence, theft, and deceitfulness. Children with CD may disregard the rights and feelings of others, violate rules and laws, and engage in risky behaviours such as substance abuse or sexual activity. CD can lead to significant impairment in social and academic functioning, and may progress to more serious behavioural and legal problems in adulthood.
Intermittent Explosive Disorder (IED): IED is characterized by sudden episodes of uncontrollable anger or aggression that are disproportionate to the situation. These outbursts may involve physical violence, destruction of property, or verbal aggression, and can cause significant distress and impairment in social and occupational functioning.
Disruptive Mood Dysregulation Disorder (DMDD): DMDD is a relatively new diagnosis that involves severe and persistent irritability and temper outbursts that are disproportionate to the situation. These behaviours may occur frequently and can cause significant impairment in social and academic functioning.
Pyromania: Pyromania involves a persistent and intense fascination with fire and setting fires, which can cause significant harm to self, others, or property. Pyromania is a rare diagnosis and is often associated with other mental health conditions like ADHD, depression, or conduct disorder.
Kleptomania: Kleptomania is a mental health disorder where the affected person experiences difficulty in controlling their emotions or behaviour. It involves a persistent and recurrent urge to steal objects that are not needed for personal use or monetary gain. Kleptomania is a rare diagnosis and is often associated with other mental health conditions like depression and anxiety disorders.
The treatment for disruptive behaviour disorders usually involves a combination of medication and therapy. The specific approach to treatment will depend on the type and severity of the disorder, as well as the age and individual needs of the child. Behavioural therapies are often the first line of treatment for disruptive behaviour disorders, and they aim to help children learn to control their behaviour, manage their emotions, and improve their social skills. Some common behavioural therapies include cognitive-behavioral therapy (CBT), parent management training (PMT), and multi-systemic therapy (MST).
In addition to behavioural therapies, medication can also be prescribed to help manage symptoms. Stimulants, such as methylphenidate, are often used to treat ADHD, which frequently co-occurs with disruptive behaviour disorders. Antipsychotics, such as risperidone, are sometimes used to treat severe aggression and irritability associated with ODD and CD. However, medication should always be used in conjunction with therapy and under the supervision of a qualified healthcare provider.
In conclusion, disruptive behaviour disorders can be treated with a combination of medication and therapy. The specific approach to treatment will depend on the type and severity of the disorder, as well as the age and individual needs of the child. Early intervention is important to prevent long-term problems such as mental disorders, violence, and delinquency. If you suspect that your child may have a disruptive behaviour disorder, it is essential to seek help from a qualified healthcare provider.
By DSM-5-TR definition, Autism Spectrum Disorder (ASD) recognises three persistent deficits in three core behavioural symptoms: (1) impairment in verbal and non-verbal communication; (2) deficit in social reciprocity; (3) highly restricted, fixated interests and repetitive motor movements. The main cause for such the high heterogeneous neurodevelopmental disorder is genetic factors, such as Asperger Syndrome, Phelan McDermid Syndrome, Rett Syndrome, Pervasive Developmental Disorder, Heller Syndrome etc. It is also highly prevalent in people who are diagnosed with Fragile X Syndrome, Tuber Sclerosis, Cohen, Smith Magenis Syndrome, Angelman Syndrome etc. ASD affects close to 2% of the population worldwide. Males have four times more of a prevalent rate than females. It is also considered as highly heritable, running in the family as high as 80% to family history of genetic disorder conditions.
These genetic disorders substantially affect the functional structure of the neurons and their synapses between the neurons. It is highly likely that the genes implicated in ASD overlaps and comorbid with other neurodevelopmental disorders such as intellectual disabilities, ADHD, speech and language impairment, oppositional defiant disorder and epilepsy etc.
ASD is a lifelong diagnosis. There is no specific medication to treat ASD and its symptoms. An accurate and comprehensive psychoeducational diagnostic assessment (PDA) at the early onset of the ASD is essential to understand in depth the varying degree in severity of the condition the child is encountering before individualising any learning and treatment programs. Some children with milder symptoms can learn how to manage the disorder more effectively than others. Hence, appropriate early intervention programs (EIP) conducted by an educational therapist is beneficial and could benefit from the greater brain plasticity at the younger age of the child and is more effective in reducing a developmental trajectory towards ASD effectively. EIP or different types of therapies become the prevalent and effective frontline treatment for ASD. They are able to modify atypical ASD related behaviours during development. Improved social interaction between the caregiver and the infant has resulted in raising infant attentional flexibility. Both early diagnosis and intervention programs display higher efficacies.
Well established parenting training also has efficacy for children with ASD. As it has therapeutic effects for the parents as it reduces parenting stress resulting from the ASD children’s disruptive behaviours. The parenting training also improves their capacity to cope and improve interactions with the ASD children. The child with ASD in turns benefits from the reduction of parental stress and effectively improves their disruptive behaviours and anxiety.
One of the main differences between ASD and SCD – and a red-flag for parents who suspect their child was misdiagnosed with ASD – is that children with autism have difficulties with social communication AND they exhibit repetitive and/or disruptive behaviors.
Repetitive or disruptive behaviors include things like:
1. Repeated body movements, such as rocking, flapping, jumping, twirling
Obsessive fixation on routines and rituals
2. Putting things in order and in order again and/or a preoccupation with things being in a very specific order or placement
3. Excessive repeating of sounds, syllables, words and/or phrases
4. Intense and obsessive preoccupation with specific objects or subjects
5. Extreme sensory sensitivity, particularly to sound and/or chaos
Any disruption to routine, order and their schedule or an affront to their sensitivities can result in loud, sometimes violent, outbursts with aggression being self-inflicted or inflicted upon others (or objects) in their immediate environment.
If your child was diagnosed with ASD but doesn’t tend to display the restrictive, repetitive or disruptive behaviors associated with autism spectrum disorder, he or she should be reassessed for an accurate diagnosis. You may find out the real issue is social pragmatic communication disorder.
Dyslexia or decoding difficulty refers to children who have difficulty in reading due to weakness in identifying speech sounds (phonological). This leads to challenges in spelling, pronunciation, and orthography skills. The DSM-5-TR defines these symptoms as Speech Sound Disorder. Children with dyslexia may confuse words that look alike and encounter challenges in word recognition. This may cause them to read slower.
Dyslexia affects about 8 to 9% of the world’s population and is a genetic disorder in the brain. It is 50% heritable. It is not the result of intellectual ability, emotional disturbance, visual, hearing, or motor disability; a lack of appropriate instruction; cultural factors; environmental or economic disadvantage; or limited English proficiency.
Dysgraphia refers to difficulty with expressing thoughts in writing due to weakness in literacy and/or language conventions. A child with dysgraphia may have trouble recalling how letters are formed and write their letters in reverse. S/he may not know when to use lower or upper case letters. S/he may also struggle to form written sentences with correct grammar and punctuation, with common problems including omitting words, words ordered incorrectly, incorrect verb and pronoun usage and word ending errors. People with dysgraphia may speak more easily and fluently than they write.
DSM-5 defines such disorder as Language Disorder which is a genetic disorder and involves persistent difficulties in the comprehension or production of spoken and written language, or other forms of language. Dysgraphia affects about 10% of the world population. A child with dysgraphia may appear detached from others in a family and school due to his/ her difficulties in comprehending and expressing. Hence, the child may not respond well to instructions and questions.
Communication Disorders: Both dyslexia and dysgraphia are in general known as Communication Disorders. A child with Communication Disorders may show lack of confidence and demonstrate additional emotion and behaviour reactions.
Treatment: Early diagnosis critical and has many advantages as the severity of both dyslexia and dysgraphia alongside comorbidity with other disorders could be diagnosed properly. Personalised early intervention (received from a Speech & Language Therapist) and self-empowerment reduced unpleasant reading experiences and enhances reading motivation, leading to improvement in vocabulary, communication skills and self-esteem. The therapist will use various tools methodologies to assist the child with communication disorders.
Dyspraxia, also known as Developmental Coordination Disorder (DCD) as defined by DSM-5-TR, is a neurological condition affecting physical coordination (fine and gross motor skills) and processing motor tasks. Children with dyspraxia appear to move clumsily, and it may affect self-care productivity as well as academic productivity such as handwriting. Symptoms of dyspraxia include poor hand-eye coordination, poor posture and clumsiness. Children with dyspraxia may show the following signs:
However, parents must note that it does not affect intellectual ability, though it affects about 10% of the population and runs in the family. Males are 4 times more likely to be affected than females.
Early screening and assessment is definitely beneficial to understand the severity of the difficulty the child may be facing before and intervention is carried by an Occupational Therapist. Importantly, the therapist helps to improve functional performance and prevent the potential negative physical and socio-emotional developmental trajectories associated with dyspraxia using various learning aids, equipment and tools.