Saturday, November 18

train eyes and ears to sense humans.. not training the skin for objects..

When eyes and ears
Add 90% SENSE to life,
Have your 90% sensory activities 
With eyes and ears..
And not 90% sensory with
Skin touch texture pressure.
www.autismdoctor.in

Sensory issues is about not having sense of the world..
Add sense .. add life.

Thursday, November 16

Therapy in autism should be sequential

Development is a sequential process .. so should therapy be 

If your therapist or your home therapy expert is using the same toys puzzles acitivities for your kid more than 3 months, you are wasting time.

After birth, kids learns to recognise mother first.
Recognising humans and eye contact with humans shall be the first stage of development and so for therapies..
So prime Goal is connect with humans... And not with objects, letters and numbers.

One who is not connecting with humans and u r trying to teach through objects letters numbers.. u r taking the kid away from communication.

DR Kondekar 

Wednesday, November 15

autism reversal principle 3

https://youtu.be/VuS5zPcEpOk?si=6JMehD8qe02rdJPt

Autism reversal commandment number 3 click the link above
To develop communication, switch to action and language based learning from object, picture and screen based learning.


Monday, November 13

autism: changing perspective

Learning occurs through sensory sensing.
95% learning occurs through sensing by ears...
And  focussed observing by eyes....
Only 5 % learning occurs through other "sensory"
Like touch,smell, pressure, joint, position sense etc
" It's unwise to spend 95% of therapy inputs on this 5%, when prime goal of child is Sit,look,listen & focus."
Have 99% of your efforts towards learning through major senses ears and eyes.
Ear is most powerful sensory organ as it makes u listen langauge with its power of adding tenses- past tense, future tense, imagination, adjectives and advanced vocabulary which helps us understand stories.
Learning through eyes is limited unless you teach kids to learn and read books, picture story books.
Learning the receptive communication and receptive socialiisation is the  most priority in autistic kids.
Don't waste your time on object identification and identifying pictures of letters and numbers as it's Not the priority ahead of human identification.
WORK HARD ON EYE TO EYE CONNECTION WITH HUMANS TO LEARN TO LISTEN.. HELP EVERY CHILD BECOME AN AUDITORY LEARNER.
ask me how... Dr Kondekar 9869405747 www.autismdoctor.in

Thursday, October 26

3 ways to use mobile for helping autism kids

Autistic kids will go away from learning language and understanding if we increase screen time with YouTube or videos or repititive content. Music rhymes and videos only help in entertainment if child is not receptive for understanding।
Using mobile phones for selfie helps develop eye contact -connection।
Using mobile phones for video calls helps one socialise and develop understanding of social communication।
Using mobile phones for listening recorded call records will help kid understanding conversations।
But if u are using for showing videos to kid or for rhymes or repititive content, u r wasting time and life।

Remember learning abcd or 1234 or counting or animal or repititive content recognition is not important in life। Before teaching ato z alphabets, teach the kid ato z relatives by picture face video call and names।

www.autismdoctor.in

Monday, October 2

online self screening of kids for autism (less than 3 year of age) mCHAT(R) A FREE

https://www.autismspeaks.org/screen-your-child https://www.autismspeaks.org/screen-your-child   

Click on above link and fil the form. Share the result across whatsapp 

The M-CHAT-R/F is designed to be used with the M-CHAT-R; the M-CHAT-R is valid for screening toddlers between 16 and 30 months of age, to assess risk for autism spectrum disorder (ASD).
Repeatedly abnormal mCHAT score with gap of 1 month will require extensive evaluation.
Irrespective of the results, no therapy or treatment should be stopped or postponed pending any test results.
For DSM 4 AND DSM 5 ASSESMENT FORMS check the link at www.autismdoctor.in

Saturday, September 23

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

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

****

For constipation/indigestion:
Stop milk,dry fruits, toor daals , daanewale fruits like pomegranate and guava.
Add syr laxolite or gutclear or dofotil 10 ml 2 times a day till stools are not regular. Can givetill next consultation or meeting 

1. Some medicines like fish oil and tablets can at times cause constipation when water intake is not enough to wash it off. Stopping them is not a solution because it will halt development. 
2. No constipation medicines are habit forming or addictive and most of them donot get into blood or body and stay in pipe and are extremely safe even in over doses. Doses need to change as per needs and can be easily doubled, they rarely cause loose motions and if they do u can just skip them for one day or reduce to 1ml
3. Syrups like laxolite, laxopeg, peg clear in doses 10 ml 1 to 3 times a day is preferred. Powder forms need more water which kids don't drink easily. 
4. Other levels of syrups that work are, syr dofotil, gutclear, lax or duphalac etc again dose needs to be doubled for results. 
5. Not treating it fully makes the kid cranky irritable and crying. So much so that commonest cause of crying in autism kid is indigestion. 
6. In autism kids, rarely a kid may need syr albendazole 400 mg single dose for deworming or antifungal like tab flucon 50 mg single dose
7. Adding digestive enzymes like tummysoft, aristozyme drops , pro CN drops in doses 1ml to 3ml daily helps like breaking the hard stools motions in gut. 
8. A child going to washroom many times doesn't mean he has loose motions. It can be constipation. 
9. Read more about constipation at https://kondekar.weebly.com/constipation-in-children.html
Whatspp 9869405747


Tuesday, July 25

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

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.

www.autismdoctor.in

9869405747


  

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


www.autismdoctor.in

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.

www.autismdoctor.in

9869405747



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

www.autismdoctor.in

9869405747



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%


www.autismdoctor.in

9869405747


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


www.autismdoctor.in

9869405747



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


www.autismdoctor.in

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 


www.autismdoctor.in

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.


www.autismdoctor.in

9869405747


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


www.autismdoctor.in

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.


www.autismdoctor.in

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.


www.autismdoctor.in

9869405747


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.


www.autismdoctor.in

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.

www.autismdoctor.in

9869405747

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




Friday, June 16

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

What to look for best autism adhd doctor in mumbai?

Dr Kondekar;s blog on best practices in autism adhd, best sensory and speech therapist and role of medicines. Goal directed cognitive approach focussing om eye contact, sitting tolerance, listening and understanding skills and verbal communication by improving connection with the child. Connection and communication is possible between only 2 living beings. Teaching with non living objects keeps u away from primary need of connection with living beings. In autism sensing the world and words is the primary issue, work on that instead of seeing and doing things. In ADHD steadyness of mind and body is main issue, so work on that instead of giving movements. we need attention of eyes and ears for listening so that quality learning develops by focus. Movement / activity breaks are needed for kids without these issues. As these kids are always on the run, they dont need movement based activities and learning ahead of human to human listening based verbal understanding.

story making story telling and picture reading skills in autism kids , for parents

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