autism is a disorder, we shall put it in order.

https://youtu.be/10-q08heMuo?si=ulDjAQenlDWMDwK_click here

basics of autism

https://youtube.com/watch?v=8nJLo-dtydI&si=12IB5UUAHN_MKala

click here for video talk on autism basics simplified

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

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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:

1. Fragile x syndrome FMR1

2. Tuberous sclerosis TSC1 TSC2 

3. Rett syndrome MECP2

4. Prader willi syndrome  deletion of paternal allel at 15q11-q13

5. Angelman Syndrome del/mut in maternal UBE3A

6. WilliamsBeuren Syndro,e 7q11.23 del

7. Smith Magenis syndrome 17 p11.2 del

8. velocardiofacial/ Digeorge syndrome  22q11.2 del

9. PhelanMcDermid Syndrome 22q13.3 del

10. Untreated PKU PAH

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

14 wrongly understood and wrongly used terms in autism

 https://m.facebook.com/groups/685590788515887/permalink/1545102012564756/?mibextid=Nif5oz

*feel free to forward.*

*14 wrongly understood and wrongly used terms in autism*

In autism

www.autismdoctor.in

9869405747

Whenever you visit an expert, u ask a question, expert uses some complicated terms which you take it to heart... Keep googling .  Keep worrying... Keep searching... Asking people.

Remember, there is nothing in a new name, as all of them are core features in spectrum kids and by new name we just add worries. Here is list of few names that i try to resolve in simple ways.

1. Genetic : it just means that there is a rare probability of recurrence in next child or having taken from any or both parents.

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2. epigenetic: it means genes are normal, and some unknown cause may be there.

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9869405747

3. lets find out why this happened by EEG MRI TESTS: truly speaking none of these help in management unless child has fits or any other issue than autism.

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9869405747

4. SPD: it just means child is not able to receive your signals or process them

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5. Sensory issues: means child basic and common sense is affected and thastwhy various non-sense issues are happening. Vision and listening are two prime senses for learning. 95% of learning is only through these two.  Only 5 % or less learning is through other senses like touch, proprioception etc . Sadly many therapists spend time only on these 5% neglecting 95%

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9869405747

6. Apraxia: it just means child may know but cannot perform, doesn't add any more to the care plan

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9869405747

7. Slow learner: it just should mean that child has potential to improve speed

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9869405747

6. visual learner: it means we experts are neglecting the listening sense and have taken for granted that he will never use ears. Every autism kid has a right to learn from ears and experts should work for it 

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9869405747

7. Special kid: all kids are special, we need to make them social. By special it means special needs are there for development of the kid.

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9869405747

8. Hyperlexia: it just means that beyond some basic reading, writing skills , other skills are lacking, and should not be neglected 

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9869405747

9. high functioning: this term is given up. It just means that in only some part of knowledge or a thread of a subject, the connections are intact and coordinating in brain and rest is not helping much. It doesn't mean a child is super boy.

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9869405747

10. Low tone: it's normal to have low tone in autism kids. Low tone kids often sit in W fashion. Tone can be best managed by  exercises like statue, sitting properly, hands folded, finger on mouth etc to maintain tone in static  Posture.   Often experts confuse and make parents get confused tone as power. Tone and power are 2 different things. Tone adds to stability, power adds to strength of muscles. Here is what is biggest mistake most parents and experts do. To increase tone, they give physical exercises which helps in increasing strength, not stability. Yoga helps in tone and stability and not strength. We can not build intellectual and social development by increasing physical activities. We need physical stability for learning and posture of attention is needed for learning.

www.autismdoctor.in

9869405747

11. Hyper / behaviour : often parents and many experts take this wrong and may call same. To make it simple, hyper means unnecessary and unusual  increased physical movements that may be due to and may cause both inattention and distractability.

Behaviour is just child's response to a given environment/ stimulus/person, the way the child may sense on his or her own as per level of understanding and iq. Immature brains give excited behaviour of global loud response, partly mature brains learn to trick and show manipulating behaviour. Fully mature and cultured and disciplined Brains will show disciplined behaviour. Unusual and unnecessary physical activity if neglected, will eventually get physically restrained by parents or other people which will make one person being needed all the time for holding the child ( thus making a jail for child and jail for jailor too) or is handled by physical means by hitting hurting punishing, if not by parents but any one around, which will strike aggression and violent behaviour. This is best tackled by medicines. Behaviour therapy and counselling was first line therapy for this 25 years ago. In present Century, medicines is key and first line care and cure for these issues.

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12. No cure, nothing can be done, hopes are miniscule: it just means the person you are dealing with is not optimistic. The person has not seen these kids developing and actually improving for the enablement of schooling and independent daily leaving or independent survival.

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9869405747

13. Inclusive or mainstreaming: it's often used restricted in the context of schooling only. Remember, schooling is not the only important thing in life. What is most important is to have the child as inclusive or mainstream member of the family. Mainstreaming of behaviour and communication along with relationship development for family structure  is most important than mainstreaming or inclusive ness of education. There is no point in teaching academics - numbers and letters if we are not helping the child to be a cultured, mannered and disciplined family member.

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14. Mild moderate severe autism: remember this terminology is given up in 2013. Now we use the term 

level 1 independent autism, often doesn't reach dr

 level 2 dependent autism, can perform day to day basic living, often needs therapies and meds

 level 3 fully dependent autism, often needs institutional care

Now practically speaking, any child less than 7 year age is actually partly dependent, whether autism or not. So it doesn't matter what we call as and pacify ourselves. What is most imp to know that, these scores are based on how one answers questions and how the expert interprets it. What a parent should remember is that what ever it is... The ground rule is severity or dependency can be changed with medicines and therapies towards enablement and mainstreaming. So what a parent should better remember is

 what the child is doing what the child is not supposed to do?

What better child can do what we want to do?

How early we can plan, and how we can plan small goals towards next step of age appropriate development.

www autismdrmumbai.com

autism: Free help for parents of kids with speech and behaviour issues.

 Autism and hyperactivity at times go hand in hand adding difficulty in learning .

In autism child is not able to SENSE the environment and hence sensory issues start coming. Once put the sense in order, all of them shall disappear.

Untreated SENSE, may turn a child cognitively weak and at times adding many neuropsychiatry morbidities like anxiety, fear, depression, hitting hurting, stubbornness, behaviour and sleep issues.

In ADHD, Sense may be normal, but there is unusual unwanted increased physical activity due to inpulsiveness, distractibility and lack of focus. When we tackle these three, kids with ADHD  will be sitting and attending.

Untreated hyperness will eventually be managed by people as physical restrain. More the physical restrain or pampering, more will be likely hood of violent behaviour and or other conduct disorders like lying stealing etc.

It's the job of neurodevelopmental pediatrician to quickly pick these issues and start with early intervention in the form of:

1.counseling: the parents and at times kids to under stand the need of 

2. early intervention: doing something earliest to make the child learnable and improve understanding and vocabulary with

3. treatments and therapies as needed and accordingly

4. Chalking out a plan for further management and periodic modifications to add speed and plan the next level.

www.neuropediatrician.com www.neuropediatrician.com

Remember, if a goal is not planned and revised monthly, we are not working towards a goal 

Any delay will turn into deficit sustaining longer.

Any unwanted thing permitted and promoted with persist.

Read more at www.autismdoctor.in www.autismdoctor.in

To download videos talks PDFs by Dr Kondekar visit www.pedneuro.weebly.com/autism.html www.pedneuro.weebly.com/autism.html