Saturday, September 23, 2023

Using Alexa app for speech therapy assistance : blueprint


Using Alexa for speech assistance and training
Use of voice for listening, understanding, copying, voice commands and voice modulations , kids stories, pronounciation, vocabulary and information, knowlege and importantly how to section all helps parents to use the device for kids learning vocabulary in Hindi and English both.
In addition, there is a secret option in alexa which can be used for information added by you for training your kid in your own way or judiciously adjusted for individual child's use.
This option in alexa is called alexa my questions. This option is hidden in alexa blueprint section, which can be modulated from your Using Alexa App and if the same account is for any alexa , your my questions will work for same alexa.
In this my questions section you can add your answers with questions changes in 3 different formats. So even if u change the format of the question, it may give same planned answer. You as parent can create such hundreds of answers like the one in rapidex English speaking course book available online for free. A child or caretaker can be trained to sue my questions app to bombard variety of information to the kid, a type of semidynamic interactive content for interactive langauge learning.
The kid has to be made auditory receptive before we assume that auditory vocal  signals will help initiate language. It can be done with help of medical support as needed. The more u make a child listen, the more the child will be Auditory learner.
Remember, in a child with speech delay, adding music (entertainment) in early years of life will only serve for rhythm and entertainment, which will make the child only entertained and that will be an escape from langauge or meaning of the vocals. Had the time used for music and nonvocal sound given to child ear been utilised for vocal inputs.. child will be learning the vocal inputs faster. 
*Stay away from screen (visual) learning, stay away from music based learning, insist for vocal based (Auditory) learning, insist for meaning based learning* Radio is a mode of passive audio input with dynamic and rich content. But prefer chanels with less music and more words like say bibidhbharti or akashwani.*
Dr Kondekar


Friday, September 15, 2023

constipation in autism kids

It's not uncommon to have constipation in kids with autism. It's seen in around 70% cases.
It is hypothesised to be due to lack of sensing the gut distention for evacuation and child starts reatining motions /stools inside.
In most kids it's not per se constipation to hard stools. But if the child has 5o strain, it's better to call it constipation and manage as early as possible.
A child refusingt I sit for potty or doingw eird gestures at potty time or making legs curved or not sitting properly or had pain or discomfort is likely to have indigestion which eventually causes constipation. 
The gut is 18 feet long and if the child passes less than 4 inches motion block at a time, it's likely 5o be constipation.
It's again constipation if the child passes very smal pellet like stool balls or smelly or gassy stools mean the child is retaining a lot and most potty is getting fermented and smelly.

Why do we need to know about constipation in autism kids? 
It's mainly because it adds to restless irritability crankiness indigestion reduced appetite poor weight gain and reduced water intake. Remember crankiness of constipated Amitabh Bacchan in movie Piku.
Eating less and drinking less is not a reason for constipation but it happens due to constipation.
Commonest constipation diet is hard food like high protein diet, dry fruits, milk, hard daals and pomegranate .
Soft foods like rice and potato being easy to digest cannot cause constipation.
Constipation is also possible due to some nutrients like fish omega or calcium or phosphate containing tablets.
Best way to treat constipation is not by giving extra water or adding fibre or dry fruits or fruits vegetables .
Best way to treat constipation is by using stool softeners, non absorbable sugar syrups and avoiding constipationg 4d diet as mentioned above. Google for *4d minus diet* for same.

It's common to have indigestion or not passing motions or reduced intake or crankyness with constipation.
There are some probiotic and enzyme supplements that help in constipation.
Constipation with blood ina tools and constipation with daily vomiting will need tests to rule out medical serious emergencies like intussusception, intestinal obstruction or pseudoobstruction or tuberculosis
********
Standard sampleof advice given by a dr in a case of hard stools:in a 2 year old kid
In such situations

Syr gutclear / dofotil 10 ml 3 times a day for 3 days

If no relief double the dose for next 3 days

If no relief
Maintain 10ml 3 times a day and 
Add rectal suppository hallens glycerine  2gmsuppository or dulcolax suppository or babie less than 2 year age u can use neotonic enema.
Above medicines donot get absorbed in blood but just pull the potty out of body, meaning usually simple extra dose is harmless.
If loose motions, stop all of them.
Aristozyme drops 1 ml daily for 1 month, can be increased.

Can be continued long term. It doesn't cause habit.

Dofotil/gutclear/duphalac/laxolite/peg clear/evaq /move out etc all are same and dose is no limit when it's blocked gut.
For vomiting give domstal baby drops 1ml 3 times a day as needed


Tuesday, July 25, 2023

Speech Delay and Autism

 

http://pedneuro.weebly.com/ for downloading resources pdf files videos talks and general information related to autism

http://autismdrmumbai.com  For clinic address

http://autismdr.weebly.com for basic protocol 

https://pedneuromumbai.blogspot.com/2020/05/pediatric-learning-disability-autism.html?m=1 for appointment procedure

Preferably watch these 3 short videos before appointment  

https://youtu.be/FVr4f6Tetsw


https://youtu.be/b7Lkwr5HtHk

https://youtu.be/VIJMz9KMP9Y



*********

Speech is a form of expression that is not just a function or mouth and lips or vocal apparatus. 

Apart from above following are more common causes 

A child who cannot hear.. deafness 

A child who can hear but cannot listen, attention deficit 

A child who gives attention but cannot understand, cognition deficit 

A child who can understand but cannot express, apraxia/aphasia 

Apraxia of speech: non verbal Communication deficit 

Aphasia of speech: verbal communication deficit 

Often if the child has behaviour issues in addition, there is also likely hood or poor understanding and possibility of autism. 

Speech delay lasting more than three months is itself a form of disability 

Other speech issues are speech paucity, echolalia, only need based speech, poor vocabulary issues related to sentence formation, issues of syntax and grammer and speech with poor composition and poor comprehension 

Remember unless child hears, listens, understands...child cannot express Initial expression is by eye contact, facial or body language or pointing 

And then only expressing in words Understanding to expression journey is two years with normal brain, needs active inputs of wide vocabulary through stories, essays and compositions. 

Teaching by music, videos, questions and physical activity doesn't help in improving cognition and vocabulary. 

Teaching by asking is like taking exam before the topic is understood. 

For more speech related tips by Dr Kondekar visit Facebook page 

http://facebook.com/speechandsenses

 Each one will have a different way of approach.

Speech delays are very common among children with autism, but they are also common in children without autism. In autism often hearing is normal, but the child doesnt seem to listen.

Speech delay can often be associated with hearing deficit. Hearing deficit can be commonly due to ear infections like ASOM, CSOM, Otitis Externa, Ear wax, damage to auditory labyrinth or cortex of brain following meningitis or antibiotic use and rarely due to congenital otosclerosis,congenital absence of any crucial part of hearing apparatus. 

Speech delays can also be due to speech understanding, processing, formation and expression of speech. Various disorders of speech expression like cortical dysphasia/ aphasia and speech articulation like dysarthria and also various disorders of brain and disorders of speech apparatus manifesting as specific speech types like scanning speech, stacacto speech, explosive speech, slurred speech are also responsible for speech delay.

Communication is a two way reciprocation of interpersonal relationship. It can be non verbal or body language or expressional and verbal that is with use of language of words/ sounds/voices. 


Communication involves understanding and processing of actions/ words i.e. receptive communication and expressing by actions of various types that is expressive communication.In social and communication disorders both these may be affected.


In autism, often the socialization and social communication is primarily affected but in addition to this autism has other key features which are absent in social communication disorder.


Whatever may be the reason for speech delay; following is the course of evaluation and management for speech delay.


1. Confirm hearing is not affected: It can be confirmed by a BERA test. Although clinically many people will be able to tell hearing is affected or not; the tests will help understand severity and level of hearing affection, whether in ear: outer ear canal or middle ear; or inner year or cochlea or nervous system. Test can at times be false; and may need repeat.


2.If hearing is affected; ear examination; ear cleaning and treatment of ear infection may be needed in cases of ear wax, otitis and adenoiditis. significantly affected /damaged ears with speech delay may need hearing aids. If the hearing is affected at cochlea or at Central nervous system the child may be considered for cochlear implant or devices like hearing aid.


3. Those cases who have no major hearing deficit; and good receptive speech and understanding of speech and have difficulty in talking; these kids will need to be started with speech therapy earliest for modulations of speech apparatus.


4. Children who hear but may not listen; children who may not understand or follow speech or have central speech affection or have difficulty having age appropriate eye contact and response to commands are often likely to be autism; in which only speech therapy may get a very slow or delayed response; unless the prime symptoms of autism are tackled with medicines and occupational therapy.


At our center, most kids establish eye contact and response to commands in 1-3 months

whatsapp 91- 9869405747 for further details. 

Common Genetic Syndromes of AutIsm:

Friday, June 23, 2023

Ten commandments: Dr Kondekar's Key Principles in Autism Reversal

 Key principles in Autism reversal: 

for details and downloading learning pdf and talks click here

Dr Kondekar's ten commandments on Autism reversal: 

GOAL DIRECTED COGNITIVE APPROACH

1.Dont be Special, turn into social 

2.To make social, switch from object world based teaching to people and action based teaching 

3.To develop communication; switch from screen based learning to body language based learning 

4.To develop language, switch from seeing-doing activities to listening talking activities 

5.Sitting tolerance increases by sitting activities with sensory breaks as per childs requirement. Making a child continuously jump and run will make him expert in jumping and running 

6.Constant hugging kissing and carrying skin to skin, make the child get physically pampered and stubborn. keeping your child 2 feet away face to face helps develop eye contact and social communication

7. If you dont make rules for child behaviour, child will start ruling you and throw tantrums to change your behaviour. 

8.Children copy what they see, hear and feel. Dont let them see ,hear and feel what u dont want them to learn, for example saying no or physically handling the child or shouting to grab attention. 

9.Dont teach letters and alphabets,or what is this type of teaching; they are for picture recognitions. Teach in sentences, it means language. Dont ask questions, just go on narrating. 

10.Music/rhymes is good only for momentary solo pleasure. Switch to lyrics and language if you wish the time to be utilized for learning and communication. 

Dr Kondekars ten commandments on Autism reversal



14 point protocol for weekly update of autism kids follow up

Format for giving information or follow up of your kid across whatsapp to Dr Kondekar

copy paste the following with answers

Name of child

Date of birth

City

Payment date and time and mode

See weekly symptom monitoring diary at http://bit.ly/monitoringautism

************


List changes as per--

Comparing now with two week back.. and send me pl

1. Eye to eye connection--

2.Concentration-

3-Obeying commands-

4.Response to sounds -

5. Unnecessary Jumping or running -

6.Biting mouthing throwing hitting hurting :

7.Sleep-

8.Constipation-

9.pointing, gripping, imitation, Writing -

10.Sounds from mouth-

11.Speech-

12. Pretend play, role play, Comprehension and Stories listening skills, sequential

13. Other (sensory issues/ school issues/behaviours)-

14. Mixing with peers in sitting games, group work

**********

List as gains and goals, rather than writing positives or negatives


List any medicine doses changed recently.


List any medicine couldn't be taken with number of days couldn't be taken. Read more at www.autismmumbai.com



Using Alexa app for speech therapy assistance : blueprint

Using Alexa for speech assistance and training Use of voice for listening, understanding, copying, voice commands and voice modulations , ki...