Tag Archives: parenting

Psych Speak 2011


Tid bits from my take on life in 2011. For the latest, click on the tab above.

06/08/2011 Ramazan Rage and the Money Game

Its the 5th day of Ramazan and already I can sense a strange disquiet on the roads. Nothing new in that, except that the rush, the inching in to get in or out of line, the looks and stares have started earlier than usual this year.

Political observers attribute this as ever to the conditions of the economy and the country in general. Psychologically, only extreme examples of food deprivation come to mind, none of which seem to fit here. Hunger for a limited time, when one knows that there will be an end to it, causes mild irritation for sure if prolonged and with the additional factor of burning heat added, but the reactions we have on the roads are in excess of what is expected. Perhaps another dimension is that over some period of time we have been losing our levels of tolerance. It can be sensed in the way the direct-pick-up-the-mobile instead of calling on landline translates into an incessant honking of the horn outside the gate and the idea that the person wanted inside the house will fly out in a matter of seconds. Another horn happy instance can be seen in a traffic jam where many feel it to be their duty to herd the commuters along. A very young version of me once revelled in the idea of owning Chitty chitty bang bang or Knight rider, only to discover that it was a shared dream with others. Now I shudder. If we Pakistanlings are unable to follow properly demarcated roads then how on earth will we follow aerospace rules?

Ramazan rage and swindling is on the rise this Ramazan.

Another money making scheme was just witnessed on Main Khayaban e Jami, Karachi where a tiny little school van came packed with goodies today. As I write this, this farcical scheme is still going on where a company by the nonexistent name of Aryan Enterprises has supposedly launched a dubious custard packaging with a prize scheme – get a ‘free’ blender, tv, sheraton dinner or Nokia N73 cellphone if the coupon yields that name – all for a paltry 1400 rupees. The catch: the France made blender is actually a ‘Mounelux’ instead of Mouleneux (meet the Bata – Beta version), the cell phone with a sheepish admission when confronted, turns to a made in China cheap revision, the TV suddenly goes from a made in Korea to dubious Malay origins and the men incharge earlier smiling and pleasing, turn into the sheepish, sidelong glances types when charged with fraud.

Full marks for the initiative though. The Phir bhi dil hai Hindustani version of Pakistani money makers. ‘Kabhi nayey packet mein baichain tum ko cheez purani’.

And this is just the beginning of Ramazan. Stay tuned for more from the roads of Karachi. Au revoir.

22/05/2011 Neighbourly batting

Just got a phone call from an irate neighbour questioning my take on child psychology when I don’t return her son’s cricket balls. Now should I really explain the consequences of negative punishment? Well, positive reinforcement and negative reinforcement both having failed, time for the big ‘P’. Thats my take on it for now.

In addition I have been told that the cricket balls WILL continue to fall in my house and I should deal with my negative emotions; and that ofcourse there is a 1 in 100 chance of getting hit by one (it narrowly missed me a few days back), and ofcourse cricket balls are not strong enough to break windows of a car or a house. Im totally re-educated! The icing on the cake: I also learnt that this is how children learn to bat sixers otherwise how else will they learn?! I suddenly have visions of young Afridi in knickers having half the neighbourhood running after him with sticks.

So wherein lies the soloution? It truly is a sad fact that we barely have enough playgrounds for children in the city. Yet, there is one very near my house and there happens to be just that someone who can take this kid out to play there. So, till I find another solution, long live negative punishment. Though in this case after hearing a lot of irrational beliefs, I’d say the mother needs it more than the child.

13/05/2011 Revelation – Personal Eureka on Islamic Practices and Self Healing Practices in the World.

Yesterday night I was hit by a revelation. Today it hit harder as I actually said it in front of a friend.

I was printing out a manual for Reiki level 2 when looking at the hand positions and the conceptual framework I was struck by how close the entire concept is to Islamic Practices of Namaz and Roza, Saum o Salat. The conceptual framework including meditation – relaxation – focussing on the words – placement of the hands … it all falls into place. Reiki linked with places we touch, Yoga linked with how we move and bend, Meditation linked with how we focus on removing external worries while we focus on His names. The list goes on and on. While we are praying it is not for Allah only; it is He who has created this system for us so that we are purified by the process. Reiki may well call it the flow of the eternal life force.

Bottom line – If one can take out time for Reiki, one can take out time to pray. The most natural and best God given gift to Man – provided one focusses, lets go of external stressors while praying and most important of all: ‘believes’! Pure Taqwa.

30/04/2011 Water, water everywhere…

Water. It is not just Man’s basic need but essential to all life on Earth. Imagine if this necessity were to become a luxury…And this is exactly what may happen and soon enough if we are not careful in water conservation – and here by conservation the reference is not just to its use but also its abuse ranging from overuse to the addition of various pollutants.

A case in point is that of Manchhar in our very own country where high levels of pollutants caused avoidable casualties. The current devastation caused by the recent floods (2011) is also a case in point after which the pollution level has increased further. It is said that the Government has undertaken to provide compensation to the families of the victims… Yet the question remains: who are we to blame? The Government, as a convenient target; the industries, for emptying their pollution into the pure Pakistani waters: or ourselves, for sitting and watching…and watching…

28/4/2011 Psychology of Terror

I have just come within inches of a bomb blast today. On my way to work I saw ambulances, sirens blaring rushing past and several police vans. This is the third blast in a bus in 2 days. I don’t know how long this madness will last where innocent people are killed daily and yet fingers point all around. The blame game doesn’t end does it?

Terror comes in various garbs and the one that is most potent is the one that injects fear in the masses. Overdose of fear can at times lead to apathy like the proverbial switch that has become faulty due to overuse. Right now, perhaps apathy is our double edged sword – the defense that keeps us going and the withdrawal in our own shells and little worlds that leads to social ignorance and carelessness.

If this is a war, which side are we on?

 

Early Interventions for Children with Speech and Language Developmental Delays


Diagnosis is a critical element of clinical psychology. Working in a clinical environment day in and out exposes one to a multitude of disorders across all age groups. Quite often in my clinical work I find myself wishing that a certain patient had approached a psychologist for help at an early age so that the problem would not have intensified. Unfortunately in spite of the data available for psychological practice in Pakistan, most parents consider it a huge stigma to bring a child to a psychiatrist or psychologist. Many schedule their visits at times when others are at work or school, especially in a joint family setting and issues are avoided rather than addressed. In short, we relive the vestiges of the ostrich syndrome again and again until the issue at hand becomes severe enough for school authorities to take note and call in the parents. It is at that time that psychologists are frantically urged, pushed and rushed into giving ‘reports’ and providing that elusive diagnosis.

Here, I have outlined some basic points for parents to consider in cases where they either suspect a developmental delay or where their child has been diagnosed with a disorder such as Down’s syndrome, Mental retardation or has Autistic features. It is by no means a complete review and if you want details and help,you will need to contact a qualified psychologist.

UNDERSTANDING THE PROCESS:

In cases where a child shows developmental delay in his speech and motor functions. The early intervention plan formulated for him includes aspects from these areas.

Developmental delay means that a child has not attained developmental milestones expected for the child’s age in one or more of the following areas of development: cognitive, physical (including vision and hearing), communication, social-emotional, or adaptive development.

Clinically, a developmental delay is a delay that has been measured using clinical opinion, appropriate diagnostic procedures, and documented as a 12-month delay in one functional area; or a 33% delay in one functional area or a 25% delay in each of two areas.

As children change from “toddlers” to a “preschoolers,” they are “transitioning” from the early intervention process to a process more suitable for preschoolers and a revision is usually needed as they turn 4 years old and beyond.

The Concept of Reward:

Do you remember your childhood? Do the words, ‘gift’ and ‘surprise’ ring a bell? if they do, and the memory is pleasurable, it is probable that you were rewarded appropriately by your parents and they did not overindulge you. Rewards given appropriately and not as bribes or given far in extnet of the behaviour expected, work. When parents complain about rewards not working I have frequently observed that this is usually due to the fact that the so called reward has no value in child’s eyes – it is something that he can get in anycase if he screams loudly enough, throws a tantrum or if his parents really want him to be quiet. ‘If you listen to me you will get a choclate…. okay … you will get two chocolates… okay three… and finally *slap* and *drag*… parental guilt attack and a few more chocolates later… a heavy sigh with ‘these children are just uncontrollable’ …’.

For a child’s progress it will be necessary to reward him when he manages to perform an activity successfully. For most cases of developmental delay related to speech (if no physical reason is found) such as correctly voicing his needs etc, the procedure of the reward can be as follows:

  1. Select a behavior for which the reward will be given.
  2. Select a suitable rewardsuch as it can be a favorite toy or simply clapping by the parents – anything that makes him happy will do. Keep in mind that the reward needs to be valued by him for any effect to take place and it must be given immediately.
  3. When working towards any goal in your mind, start off with rewarding every single time he makes the slightest push towards the desired behavior, and then later increase the level of response expected by the child before he gets the reward. Make sure that non performance does not get that reward any longer. For e.g. in order to help him get what he needs, for the first four days, reward for a behaviour already being followed so he may be rewarded whenever he points towards an object he wants, then reward for the next four days whenever he makes some articulate sound while pointing (not merely screaming), then for another four days reward when he imitates or makes some attempt to imitate you as you name the object (do not be strict about accent and pronunciation) and so on, until he starts naming the object on his own. After the first four times, vary the reward that is, you do not need to provide the reward each time but instead provide it randomly and eventually stop. You can give a bigger reward as a closure for an older child and tell him that this ‘game’ has now ended.
  4. Patience is the key here and the parents will need to show the child exactly what response will get him the reward several times before he even starts imitating them.

SETTING UP GOALS – THE HOME BASED PROCESS:

As a parent you need to set up both short and long term goals based on an understanding of your child’s needs, strengths and weaknesses. A psychological counselor can help you in this process.

 Long term goals are important as the child nears the preschool or school age. These describe the expected growth in the child’s skills and knowledge over the next year as a result of the special education that he receives. Goals should be positive, measurable and achievable. This will help understand the child’s level of growth from year to year.

 A good goal can be made by asking these four simple questions:

  • WHERE? : The setting or under certain conditions
  • WHAT WILL BE ACHIEVED? : Skill(s) or specific behavior. This part begins by asking yourself what the child can currently do and then making markers based upon achieving a specific skill in a specific period of time.  Be REALISTIC and research well before setting up a goal that involves a child being perfectly potty trained at age 1! You are raising a human being, not a robot. And yes, I have come across people who have expected that.
  • HOW? : To what extent and in what manner?
  • WHEN? : At what point. Specify the time and age level of your child when the aforementioned will be made possible.

N.B: Regularly matching the progress report provided by school teachers with your short and long terms goals worksheet will help you in this process. Six monthly meetings with your child’s teachers are also essential for updating yourself.

 AREAS OF CONCERN:

Information and checklists provided herein are to be used as a guideline and not for final diagnostic evaluation. Interventions are provided at the end and are meant to be used by the parents at home.

Articulation problems: A child may have difficulty in articulation. This is a difficulty with pronouncing sounds to make words. There are many reasons children have difficulty in making sounds. These include hearing problems, poor muscle control, cleft palate and lip or learning problems.

The checklist below shows the age at which native English speaking children use a sound correctly. Marking your child’s age, with a pencil, after every few months in the area on the left, will give you an idea of his progress in his level of articulation.

Your child’s age Age Sounds Acquired
3 m,n,h,w,p
4 b,t,d,k,g,f
5—6 v,j,s,1,r
7 z,ch,sh,th

 As a rough guide, a normal child’s speech can be understood by a stranger:

• 25 per cent by age one,

• 50 per cent by age two,

• 75 per cent by age three, and

• 90 per cent or greater by age four.

Interventions for articulation problems:

As children usually respond very well to sounds and music, they can be taught to articulate using a variety of techniques involving visual and auditory stimuli:

  •     Certain toys available in the market produce sounds when buttons are pressed. Your child can be encouraged to play using toys that call out the alphabet phonetically. The parents need to say the letter aloud in the same manner and encourage the child to repeat. Initially this may yield no result but do not give up.
  •   While producing a sound, proceed systematically starting from ‘A’ and going till ‘Z’. Stick to one sound for some days before progressing.
  •   Certain sounds such as ‘o’ involve very obvious lip movements and the child can be taught by making him place his fingers on the parent’s lips and tracing the shape while the sound is being produced.
  •   For sounds such as ‘t’ and ‘d’ or ‘b’ and ‘p’ that have similar lip movements, these should be exaggerated in front of the child to make it easier for him to imitate.
  •   Another idea is to place a mirror in front of the child reflecting both the parents and the child while the sound is being produced.
  •   The correct behavior should be rewarded.
  •   Do not get upset if the sound produced is less than perfect. For most children, articulation becomes better after age 4.

Language problems: In addition to articulation, some children also has difficulty in expressive language skills and show developmental delay. Please bear in mind that a child who has a speech, language, or listening problem upon entering kindergarten will be at a distinct disadvantage for learning and participating in class. In kindergarten, children are expected to follow verbal directions,f ollow stories, learn and remember new concepts,  answer questions, mimic the sounds and words shared in class, and recount information using speech that is understandable to others. Some children may need regular speech therapy in order to be able to follow these basics.

Checklist for early speech and language milestones:

Place a tick mark in front of each statement if true, every 4 months, in order to obtain an idea of how your child is developing.

By age 3 to 4, usually children:

use sentences of 4 to 6 words ____

comprehend and answer simple w – questions (who, what, where, when) ____

show an interest in how and why things happen and how people feel ____

ask questions, usually who or what questions ____

follow concrete, two to three-step directions (e.g., “get your shoes, put them on and then come here”) ____

talk easily about daily activities, especially what they are doing, just did or will just do (e.g., what they did with friends / during the day) ____

talk to themselves and mostly their toys while playing ____

tell a basic story or sing a song ____

give directions like “fix this” ____

Interventions for language problems:

The following can be used to give a child some of the basics and prepare him for all that is to come in the preschool environment.

Book reading:

  •   Indulge in book reading with your child. Make a bedtime story a regular habit before putting him down to sleep. This increases vocabulary and helps with parental bonding. It also reduces the incidence of not wanting to go to sleep with most children falling asleep before half the story is done!
  •   Place him beside you with your face at his eye level and make sure that his attention remains on the book if you are reading from one. Initially, the child may not be able to pay attention for more than 1 minute. Start off with a short 1 -2 minute story and increase the time slowly as he starts responding. Normally, a 3 years old child is able to listen to a story / poetry for approximately 5 minutes.
  •   Go slow and pronounce each word loudly and clearly. Vary your tone where necessary.
  •   When he gets distracted, tap twice on the picture in the book to get his attention towards it.
  •   Make sure books with big pictures are used that are familiar to him.
  •   Point to each picture using the child’s finger(s) / hand and let him trace it as you say out its name.

Talking:

  •   Make a habit of talking to the child, whether it is in the bath, at mealtime or on an outing.
  •   Keep in mind that he will learn more from being talked to directly rather than hearing two people talk to each other as happens in cartoons.
  •   As before, reward him every time he makes an attempt to answer back using sounds. Later he may be rewarded upon imitation of the word spoken by you.

Please note that all the points mentioned above are meant to be used as guidelines only and are not an alternative for proper psychological guidance.