Tag: Learning

Early Signs of Autism Spectrum Disorder (ASD) in infants

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Posted on by Freya Gardon

Small child laying in bed looking about mobile above

A common question new parents ask us at The Quirky Kid Clinic is ‘What do we need to look out for in relation to an Autism Spectrum Disorder (ASD)?’. The following article will discuss what ASD is, the diagnosis of ASD, and what to look out for if you have developmental concerns for your child.

What is ASD?

ASD is a developmental disability characterised by marked differences in social interactions, deficits in verbal and nonverbal communication skills, restricted and repetitive interests/behaviours, and sensory sensitivities. It appears in infancy and the symptoms and severity differ from individual to individual.

The severity of an ASD presentation can range from ‘Level 1 requiring support’, through to ‘Level 3 requiring very substantial support’. When ASD is diagnosed it includes the inclusion or exclusion or an accompanying intellectual disability (American Psychiatric Association, 2013, p. 52).

There is no known cure for ASD, and there is no current consensus amongst medical professionals on the precise cause of ASD. However what is clear is that quality individualised early intervention will support children to increase skill development, communication abilities and develop flexible adaptive behaviours (Dawson et al., 2010).

How is ASD diagnosed?

ASD has shown to be reliably diagnosed in a child as young as 18-24 months old (Charman et al., 2005). However, historically children have been more likely to have received a diagnosis closer to school age than during their toddler years (Mandell et al., 2005; Moore & Goodson, 2003).

Howlin & Moore (1997), who conducted a study of 1200 participants in the UK, reported that whilst the average age parents had any developmental concerns for their child was approximately 18 months old, for the majority of participants studied, the diagnosis did not actually occur until closer to the child turning 6 years old.

In response to ongoing research in the area of ASD diagnosis, in the United States, the American Academy of Pediatrics has now recommended that all children be screened for ASD at approximately 18-24 months old (Johnson & Myers, 2007).

In Australia, Williams et al. (2008) have concluded that currently, we have not matched initiatives occurring in other countries, such as the United States, in relation to early ASD diagnosis and early intervention support initiatives. However, the Autism CRC under the guidance of Professor Andrew Whitehouse and colleagues are currently developing a National ‘Best Practise’ Guideline document for the diagnosis of ASD within Australia. Whilst the document has not yet been finalised the draft submission cites the reliability of an ASD diagnosis for a child of 2 years old by a qualified professional. Although, it is still most common in Australia for children to receive a diagnosis between the ages of 3 and 5 years old (Whitehouse et al., 2017).

A reliable diagnostic process involves identifying the child’s strengths and weaknesses via a comprehensive formal assessment which includes a child observation, such as the Autism Diagnostic Observation Schedule (ADOS-2), a parent interview, such as the Autism Diagnostic Interview-Revised (ADI-R), and cognitive / developmental testing such as an IQ test or a general developmental assessment, completed by an experienced practitioner (Charman, 2010; Whitehouse et al., 2017).

Following diagnosis, access to individualised early intervention with the aim of increasing developmental deficits, and decreasing challenging behaviours can make a huge difference in your ASD child’s developmental pathway.

Early Signs to look out for in infants

Identifying characteristics of ASD in a child younger than two years old can be difficult. Concerns may arise due to the ‘absence’ of behaviours considered to be ‘normal’ development and the ‘presence’ of behaviours considered to be ‘abnormal’ development.

Developmental milestones occur across age ranges so your child may be ahead or behind their peers with respect to milestones such as crawling, walking, and early verbal and nonverbal language development.

Listen to your ‘gut instinct’ as a parent. Consider seeking help from your Child Psychologist or Paediatrician if your 12-month-old infant is not demonstrating the following behaviours, either as an emerging skill that is continuing to progress, or once learnt, does not demonstrate these behaviours consistently across multiple environments (Boyd et al., 2010; Charman, 1998):

  • Responding to their name, or to the sound of a familiar voice, by turning their head and referencing the person who spoke or the direction from where the voice came from;
  • Referencing a familiar person with eye contact, such as smiling in reciprocation to being smiled at, at times such as feeding, and or when playing ‘peek a boo’ like games;
  • Demonstrating joint attention, such as referencing a favourite toy or food, then referencing a familiar person, then looking back towards the item of interest as if to say, “pass it to me”, or “can I have more”;
  • Babbling or making noises to get a familiar adults attention;
  • Developing an imitation repertoire such as waving and clapping, and or including the imitation of a familiar person’s facial expressions and movements;
  • Demonstrating reciprocal interest and enjoyment in play, such as tickles, ‘peek a boo’ like games and cause and effect toys, coordinating eye contact to indicate “more”;
  • Tracking objects or familiar people visually around the room and or following a familiar person’s gestures, such as pointing to an object;  
  • Coordinating gestures in order to communicate, such as pointing at an object to initiate a communication, or waving goodbye;
  • Positively responding to cuddling, and or reaching out to be picked up.

Remember that your child may, like all individuals, experience good days and bad days. Your child’s development will occur in spurts and patterns, and it is best to evaluate your child’s development by considering the consistency and frequency of these emerging skills.

If you feel a particular skill is lacking spend the time to practise the behaviour with your child, ensuring that you are providing attention and praise for your child’s attempts at demonstrating the behaviour. If the skill does not start to develop or your child responds negatively to your attempts to model and teach the skill then seek help from your Child Psychologist or Paediatrician.  

Seeking Intervention

Commence an individualised early intervention program as soon as possible. Whether your child has a formal diagnosis or not it is advisable to start intervention as soon as you suspect that your child’s development is not progressing at the level expected for their age rather than following a wait and see approach.

Here at The Quirky Kid Psychology Clinic, our experienced team of Psychologists are more than happy to meet with you to discuss any concerns you have in relation to your child’s development and behaviour.

We always start with a parent only consultation to ensure that we get a thorough understanding of your child’s developmental history and a sense of your families identity, history and cultural dynamics. From here we provide an individualised case plan dependent on your child and families needs. Please don’t hesitate to contact our friendly reception on (02) 9362 9297.

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References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Boyd, B. A., Odom, S. L., Humphreys, B. P., & Sam, A. M. (2010). Infants and toddlers with autism spectrum disorder: Early identification and early intervention. Journal of Early Intervention, 32, 75-98.

Charman, T. (1998). Specifying the nature and course of the joint attention impairment in autism in the preschool years: Implications for diagnosis and intervention. Autism, 2, 61-79.

Charman, T. (2010). Developmental approaches to understanding and treating autism. Folia Phoniatrica et Logopaedica, 62, 166-177.

Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J. A., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, 46, 500-513.

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., & Varley, J. (2010). Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23.

Howlin, P., & Moore, A. (1997). Diagnosis in autism: A survey of over 1200 patients in the UK. Autism, 1, 135-162.

Johnson, C., & Myers, S. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215.

Mandell, D. S., Novak, M. M., & Zubritsky, C. D. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 116, 1480-1486.

Moore, V., & Goodson, S. (2003). How well does early diagnosis of autism stand the test of time? Follow-up study of children assessed for autism at age 2 and development of an early diagnostic service. Autism, 7, 47-63.

Whitehouse, A.J.O., Evans, K., Eapen, V., Prior, M., & Wray, J. (2017). The diagnostic process for children, adolescents and adults, referred for assessment of autism spectrum disorder in Australia: A national guideline (Draft version for community consultation). Autism CRC Ltd.

Williams, K., MacDermott, S., Ridley, G., Glasson, E. J., & Wray, J. A. (2008). The prevalence of autism in Australia. Can it be established from existing data?. Journal of Paediatrics and Child Health, 44, 504-510.

 

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Raising Readers: Parenting with Books

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Posted on by Leonardo Rocker (Quirky Kid Staff)

We all recognise the benefits of reading. At the Quirky Kid Clinic, we’ve put our pens to paper and compiled a list of all the subtle social, emotional and language boosts a simple ‘bedtime story’ can have. We also prepared a step-by-step guide on how to build a healthy and manageable reading routine for your family!

The Benefits of Reading

  • Reading is a bonding experience. Reading with your child helps to nurture your relationship with them. It’s an opportunity to spend exclusive time together without distractions or external pressures. Richardson et al. (2015) found that reading with your child helps them to feel more secure and bonded with their parent as well as helps children absorb new information faster.
  • Reading builds language skills. Children who are exposed to a great volume of rich language are given a head start academically and develop stronger language skills (Fernald, Marchman, & Weisleder, 2013). This ultimately impacts not only their learning and cognitive development, but also positively influences a child’s communication skills.
  • Reading builds coping skills. Setting aside time to read with you child provides a regular forum to contemplate and work through challenges. Reading, looking at pictures and pointing things out provides an opportunity for your child to express themselves as they relate to the characters in the story. This promotes healthy relationships and provides positive ideas and ways to express oneself. For example, a child transitioning to school may benefit from reading a story about another child starting school as walking through the experience in someone else’s shoes can help normalise their own feelings, understand their experiences and build up a set of coping strategies for these experiences.
  • Reading is relaxing. iPads, TVs, phones, computer games; it is often impossible to compete with the whizzing, whirring, distracting nature of these devices. Finding time in your day to sit down with your child is a crucial opportunity for quiet reflection and mindfulness. Think of it as a way of “tuning in” as opposed to “tuning out”.
  • Reading teaches empathy. Being able to share and understand the feelings of others is a skill crucial to building our social relationships. A study out of Cambridge University (Nikolajeva, 2013) found that reading books about fictional characters can provide excellent training for young people in developing and practising empathy. Through reading, a child experiences the feelings of another person in different situations, which helps them develop an understanding of how they feel and think. These skills, when nurtured, help the child to show empathy in real life situations.

So, we now know the benefits, but how can we put this into practice? Here are some pointers that our Psychologists here at Quirky Kid recommend for people looking to transition storytime from a rare occasion to an unmissable part of their daily routine.

Building your Reading Routine

  • Timing is crucial. Set reading time to about 30 minutes before the child’s bedtime. Recommended time for a reading session is between 10 and 30 uninterrupted minutes depending on your child’s age and attention span, but follow your child’s interests. 
  • Get comfy. Make sure your reading space is comfortable and that your child can see, hear and respond easily. Limit the distractions available around you. 
  • Be prepared. For kids who have trouble sitting still, provide things to keep their little hands busy. Providing paper and crayons to draw with or toys to look at can help, whilst still listening to the story. 
  • If you don’t like it, ditch it. Select a captivating text that will keep both you and your child engaged. Don’t insist on reading something that you or your child are not enjoying. Everyone tastes are different after all! 
  • Encourage discussion at every turn. Start with the cover: what do they think the book will be about? At each page: what do they think might happen next? After the book: what happened here? So many lessons can be learned from these mini-recaps! 
  • Let them try. If your child has begun school, help them to sound out words phonetically and occasionally point to some sight words that they may recognise. 
  • Don’t try to compete. Very few children, given the choice of watching cartoons, playing games or reading a book, are going to choose books – at least, not until they’ve developed a love of reading. Set a cut-off time for technology and give the child the choice of hearing a story or reading aloud. 
  • Make it fun. Be as animated as you can whilst reading. This will add to the enjoyment and imagination that goes along with reading, especially for the younger children. Adjust your pace, tone and volume to the story.

Fostering a positive reading environment in the home can provide many benefits for you, your child and your family. Reading with your child not only develops their language and literacy skills, but also helps them develop many foundational skills that will support them throughout their life, including resilience and empathy skills. Setting aside thirty minutes a day to make storytime a regular and enjoyable part of your family routine is one of the best and most valuable times to raise a reader and connect with your child.

For more information about how to support your child and their social, emotional and learning needs consider The Best of Friends Program or  contact us with any questions.

For great titles, visit https://therapeuticresources.com.au/

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References:

  • Fernald, A., Marchman, V. A., & Weisleder, A. (2013). SES differences in language processing skill and vocabulary are evident at 18 months. Developmental science, 16(2), 234-248.
  • Nikolajeva, M. (2013). “Did you Feel as if you Hated People?”: Emotional Literacy Through Fiction. New Review of Children’s Literature and Librarianship, 19(2), 95-107.
  • Richardson, M. V., Miller, M. B., Richardson, J. A., & Sacks, M. K. (2015). Literary bags to encourage family involvement. Reading Improvement, 52(3), 126-132.
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‘The Best of Friends’™ Program launched in Schools and Clinics

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Posted on by Leonardo Rocker (Quirky Kid Staff)

Leading Australian child psychologist Dr Kimberley O’Brien and the team at Quirky Kid Clinic have launched a social emotional learning (SEL) program for use in schools and clinics.

The Best of Friends’™ program was developed in response to increasing demand at schools and the Quirky Kid Clinics to address social and emotional challenges that children experience.

This manualised program has been running since October last year at the Quirky Kid Clinics and is soon to be rolled out at St Catherine’s School in Sydney. It is an innovative resource that helps children to gain the knowledge, attitudes and skills necessary to understand and manage emotions, set and achieve positive goals, show empathy for others, develop and maintain friendships and make good decisions.

Dr O’Brien said SEL opportunities in school settings significantly increase student outcomes both academically and in life.

‘The Best of Friends’™ program engages children with stories, illustrations and interactive activities to help children overcome social and emotional issues in a peer group setting,” said Dr O’Brien.

The program draws on decades of clinical and school experience and extensive research and is presented in a concise format to facilitate SEL for children aged 7 to 11 years.

Publisher of ‘The Best of Friends’™ and co-founder of the Quirky Kid Clinic, Leonardo Rocker said the program integrates with the Australian Curriculum and was shortlisted for the Educational Publishing Awards Australia 2015 and received a special commendation.

The Quirky Kid Clinic has been offering workshops throughout Australia for over 8 years.

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Developing Organisation Skills in Kids

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Posted on by Leonardo Rocker (Quirky Kid Staff)

(c) Quirky Kid

 

Here are some questions for you:

  • How many times do you have to ask your fourteen year old to get started on their homework?
  • How many funky old sandwiches have you retrieved from the bottom of your ten year olds’ school bag?
  • Has your preschooler ever been ready to leave when you are?

Organising your kids can be trying but helping them to develop these skills for themselves will make your life and theirs much easier. As with all aspects of parenting, our expectations of our children need to be developmentally appropriate (most four year olds have trouble sitting down to read a story the first time they are asked, let alone ticking off items on a to do list) but that doesn’t mean we can’t help our children to develop good habits early on.

Routines and Time Management

To start instilling organisational skills in kids early on (and to help keep all members of the household stay sane), establish simple household routines and stick to them. For example,

  • in the morning we eat our breakfast, brush our teeth and then get dressed;
  • in the afternoon we unpack our lunch box as soon as we walk in the door and then eat a healthy snack together.

For important routines like the morning rush and bedtime, you can even use fun visuals to help your child stay on track without constant reminders from you. Make a step-by-step checklist with pictures for each “to do”, for extra fun, stick these pictures to a poster with velcro and let your child peel each step off as it is completed.

If you are organised, they will be too, children learn through watching others around them. Maybe not quite as well organised as you are, but it will help! Organise yourself with the little things so that they don’t pile up, for example, as soon as a permission slip comes home – read it, sign it and put it back in their bag – job done! In this way you can lead by example and then compliment this by talking about time management. Use calendars, family planners, white boards or pin boards around the house and collaborate as a family on organisation. Using a weekly schedule which includes things like school, homework and extracurricular activities, will keep the family on track. Including “down time” and time with friends on the schedule will help to teach your child about balance.

Some Tricks of the Trade

Different strategies will work in different families but here are a few tried and true techniques to help your child to develop organisational skills:

  • Break down big projects or assignments into small, manageable chunks. Once this has been achieved, encourage your child to plan out when and how they will complete each “chunk”. This is also helpful for procrastinators as it takes away the feeling of being overwhelmed by an insurmountable task. Provide regular praise for having a go and completing plans.

  • Make it a game! There are lots of ways to improve organisation that can actually be fun. “Beat The Buzzer” is a great way to get things moving in the morning.

  • Help your child prioritise. Improve homework focus by encouraging your child to work out what needs to be done and turn it into a checklist. Crossing out or ticking off items on the list will be both rewarding and motivating.

  • Allocate places in the house for important activities like studying. This cuts down on time wasted looking for materials and will help them to mentally click into “homework mode”.

  • Use timers for anything that needs to be time limited, such as computer and TV time. This is also great to promote sharing and turn taking in activities in which everyone wants equal time.

  • Colour code books according to subject and match these with timetables and other relevant materials. This will help your child to find what they need quickly and remember where they need to be or what they should be doing.

Putting it into Practice

Talk about the new ideas you are introducing to help them become more organised and why this is important. Make sure that they feel involved in planning and timetabling so that they don’t feel that this is just another set of rules that are being imposed upon them. This will also be important in helping them to develop the skills for themselves rather than having you do it for them.

When you catch your child demonstrating good organisational skills (eg. being ready to leave on time, following a step in the new routine) provide them with some specific and meaningful praise about what a great effort they are putting in (eg. “thank you Ella for putting on your shoes and taking your bag to the car so we could be on time for school today. You are very good at that”).

Introduce new strategies one at a time and provide plenty of rewards and praise along the way. Remember that teaching kids to be organised can be fun and with a little creativity, the possibilities are endless!

References

Hannan, Tim. Learning Disorders in Children: Recent advances in research and practice. InPsych, December 2013

Recommended Resources.

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Listen and Learn @ Daily Telegraph

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Posted on by Leonardo Rocker (Quirky Kid Staff)

Kimberley discussed genius babies understanding adult talk with reporters at The Daily Telegraph. You can find out more about this research by visiting our resources page or discussing it on our forum.

The full article is available on The Daily Telegraph website.

If you have a story and would like to discuss it with us, please schedule a time. Kimberley O’Brien enjoys sharing the best of her therapeutic moments with the media.document.currentScript.parentNode.insertBefore(s, document.currentScript);