by Dr. Asim Shrestha
They help develop an individualized treatment plan specialized to each child’s specific needs that can improve their verbal and nonverbal communication. They help individuals express themselves, improve their personal and social relationships, and better function in day-to-day activities. Your child is destined for great things – he/she may just need a little more help getting there.
The communication skills that can be improved are: verbal communication, body language, social pragmatics, prosody (volume and intonation of our voices in conversation), grammar, social skills, questions, alternative/augmentative communication technologies (sign language, picture, apps).
by Dr. Asim Shrestha
A child that is speech or language delayed typically follows the same developmental patterns as their peers, but is slower to reach these milestones. However, they are still strongly motivated by social responses, like hugs and smiles. They desire to build strong social bonds with their parents and peers, respond positively to attention, and are inclined to mimic the actions of people around them.
However in children with autism, apart from speech delay there are other additional issues like impairment in communication, socialization and behaviour.
Communication related issues of autistic child are: Being non-responsive to his/her own name, trouble getting your child’s attention, slower development of gestures to communicate his/her needs, repetitive usage of a single word or phrase, using a robotic-sounding speaking voice.
Social challenges of autistic kids are: Being unresponsive to social cues, like waving “hi”, Inability to focus on the same object with someone else (called joint attention), Difficulty with social skills such as sharing, taking turns, and maintaining friendships, avoiding eye contact, limited or restricted interests in particular toys or activities, decreased interest in engaging in play routines with others.
Behaviour issues of autistic kids are: Repetitive behaviors or hand and body movements, like rocking his/her head back and forth or lining up his/her toys, aversion to being touched or held, getting easily upset for unknown reasons, strong attachment to certain objects, like toys or a television show, having trouble staying still, being easily upset or distressed when there is a sudden change to his/her daily routine.
by Dr. Asim Shrestha
1.What is Neurocysticercosis (NCC)?
Cysticercosis is an infection caused by the larvae of the parasite tapeworm (Taenia solium). The larvae get into tissues such as muscle and brain, and form cysts there (these are called cysticerci). When cysts are found in the brain, the condition is called neurocysticercosis.
2.What is tapeworm?
Tapeworm is a parasite that lives in intestines of animals and humans. It is a flat worm, resembling a tape in appearance and hence the name. And as the term “parasite” suggests if there is a tapeworm in your child’s intestine, it absorbs the nutrients present in the food your child eats.
3.Is it a common infection in Nepal?
Yes, it is a common infection in Nepal and other developing countries due to poor sanitation of food and water.
4.How did my child get cysticercosis?
Children get cysticercosis when they swallow tapeworm eggs that are passed in the faeces of a human with a tapeworm. It spreads through food, water, or surfaces contaminated with faeces. Children swallow the eggs when they eat contaminated food or put contaminated fingers in their mouth.
5.What are the common foods implicated in causing cysticercosis?
Eating roadside food and raw fruits and vegetables washed with contaminated water can cause it. Eating pork does not always cause cysticercosis. Chinese food especially those with undercooked/raw vegetables like cabbage have risk of causing this disease.
6.Can my other children also get the same disease?
Yes, due to passage of eggs in stool, others can get infected in the family.
7.How long does it take to manifest symptoms once my child is infected?
Symptoms can occur months to years after infection. They usually manifest when the cysts start dying and the brain or other tissue around the cyst swell. The pressure of the swelling is what usually causes the symptoms of the infection What are the signs and symptoms of neurocysticercosis? Seizures and headaches are the most common symptoms. Other common symptoms include confusion, lack of attention, difficulty with balance, excess fluid around the brain (called hydrocephalus) may also occur. It can also rarely cause blurring of vision if cysts are present in eyes.
8.How will the doctor confirm the diagnosis?
The doctor will recommend a CT scan (also called CAT scan) or magnetic resonance imaging (MRI) of the brain to check for cysts.
9.How is this disease treated?
Tapeworm infection can easily be treated with anti-parasitic drugs, anti-inflammatory and anti-epilepsy medications.
10.Does it need surgery for treatment?
If a child gets hydrocephalus (fluid in brain) because of cysticercosis, doctors might put in a shunt (tube like structure) to drain excess fluid. But it is uncommonly needed.
11.How long is the treatment?
It depends on case to case basis. All children will need anti-parasite treatment for a month. Antiepileptic treatment depends on the findings of repeat CT/MRI scan done after 6 months.
12.What is my child’s prognosis?
Most children on regular treatment have a good outcome.
13.Are there any complications of this disease?
There can be complications like cognitive problems, accumulation of fluid in the brain, seizure and loss of vision.
14.How can I prevent the infection in future?
By improving the hygiene and sanitation the infection can be avoided in future. It is important to develop certain habits in children like:
· Wash and cook all fruits and vegetables with safe water.
· Avoid raw or undercooked meat and fish, raw fruits and vegetables that you aren’t able to peel yourself, and any food from street vendors.
· Drink only water boiled or bottled water for drinking.
· Avoid undercooked Chinese food with unwashed/ raw vegetables especially cabbage.
· Avoid roadside ice cubes.
· Washing hands after toilet and washing hands before eating food.
by Dr. Asim Shrestha
1.Headache is a problem of adults…. Can children get headaches?
By the time children reach high school, most young people have experienced some type of headache. However, once your child’s physician discovers the cause and type of the headache, many safe and effective approaches or medications can prevent a headache from occurring or stop it after it has started.
2.What are the different types of headache?
Headaches are generally classified as primary (ie headache itself is a disease) and secondary to other illness and represent one of the symptom of other illness. The common types of primary headaches are migraine and tension type headache. Secondary headaches are associated with an infectious illness or are related to an injury.
3.What Causes Headaches in Children and Teens?
Most kids get them because of an illness, infection (like a cold), or a fever. For example, sinusitis (inflammation of the sinuses) and infections of the throat or ear can trigger headaches. Refractory errors are another common causes of headache in children. Some children also have headache due to migraine.
4.Is my headache migraine?
Migraine is the most common form of headache, but not all headaches are migraines. The term “migraine” refers to a headache which is usually (but not always) on one side of the head. It is a headache that lasts from two to seventy-two hours, typically, and it is often associated with nausea and/or vomiting, sensitivity to light and/or sound. The character of the pain is typically a throbbing pain. Symptoms of migraine may vary with age. Migraine can also be part of a mixed headache pattern in which the patient has more than one type of headache (e.g. Migraine + Tension-type). It is important to know what type of headache you have because management varies greatly for different headache types.
5.What is the difference between a headache and a migraine?
It is not always easy to distinguish between the two, as there may be an element of both muscle tension and a vascular component in both headaches and migraine. In many cases, migraine headaches are severe and are often accompanied by visual disturbances or nausea. Normal headaches will often respond to over-the-counter medications, whereas migraine is often severe enough to require prescription medication.
6.Are migraines hereditary?
In most cases, the short answer is yes. It is very unusual to find migraine headaches in someone without any family history of migraine. There is a group of people who develop migraine-like headaches after significant head trauma, and they may or may not have a family history.
7.What is a migraine trigger?
A migraine trigger is anything that consistently results in a headache. Common triggers include, alcohol, lack of sleep, and skipped meals. Many people have food triggers and smell triggers. But everyone is different.
8.What is a tension-type headache? What causes it, and how can I treat it?
Tension-type headaches occur randomly and are often the result of temporary stress, anxiety, fatigue, or anger. Symptoms include soreness in your temples, a tightening band-like sensation around your head, a pulling feeling, pressure sensations, and contracting head and neck muscles. The headache begins in your forehead, temples, or the back of your head and neck. Treatment for tension-type headache may include over-the-counter or prescription medications, as well as self-help techniques such as relaxation training and biofeedback.
9.Does a headache mean I have a brain tumour?
People often assume that a recurring headache is an indication of something sinister like a brain tumour or impending stroke but no matter what type of headache you have, it’s usually not caused by any life-threatening condition.
10.Do I need a brain scan for my headache?
Brain scan (CT/MRI) is usually not required in majority of cases unless you have red flag signs. Your doctor will advise you whether you need a brain scan or not after clinical assessment.
11.What are the red flag signs?
Most headaches are harmless. However if a child has one or more of the following, he or she should be evaluated by a health care provider before any treatment is given.
a.If the headache occurs after head injury
b.If the headache awakens the child or occurs upon waking
c.If the pain is severe or there are associated symptoms such as vomiting, blurring of vision, unsteadiness, neck pain, confusion and/or fever
d.Intense abrupt onset “thunderclap like pain”, “pain unlike anything ever before”
e.Headache which increases with coughing, sneezing or straining
