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Jaokar, Shreya Mahesh
- Role of the Caregiver in Sustaining Gains due to Developmental Intervention
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Authors
Affiliations
1 Developmental and Behavioural Paediatrician, New Horizons Child Development Centre, Goregaon East, Mumbai, IN
2 Research Associate, New Horizons Foundation, Mumbai, IN
3 In-Charge, New Horizons Health and Research Foundation, Mumbai, IN
1 Developmental and Behavioural Paediatrician, New Horizons Child Development Centre, Goregaon East, Mumbai, IN
2 Research Associate, New Horizons Foundation, Mumbai, IN
3 In-Charge, New Horizons Health and Research Foundation, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 10 (2021), Pagination: 25-30Abstract
Positive parent-child interactions are critical for effectively navigating the course of a child’s development. In children with developmental and behavioural disorders intervention plan needs to cater to both the child as well as the entire family, to ensure positive changes for both. Due to limited data, time and resource constraints, clinicians in India often are not able to optimally engage and optimize caregiver involvement in the treatment plan. A 2 years and 9-months-old boy presented to a multidisciplinary child development centre due to delayed speech and hyperactivity. In addition, he was found to be fidgety, restless, could not wait for his turn, stubborn, showed head banging when demands were not met and temper tantrums. A battery of developmental assessment led to a diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly hyperactive-impulsive type (DSV-IV-TR). The child received an individualized goal based multi-disciplinary intervention involving parental counselling, occupational therapy and speech and language therapy over a period of 2 years. In addition, parents were actively engaged and coached to implement best practices i.e., reduced screen time, increase play time, home cooked food, sleep hygiene and parent diary. This collaborative approach with parents helped to accelerate and sustain the effectiveness of the multidisciplinary intervention. In a child with ADHD, predominantly hyperactive-impulsive type, caregiver-centred approach plays a vital role in augmenting and sustaining the desired outcomes achieved by a multidisciplinary interventionKeywords
Behavior Therapy, Screen Time, Parent-Child Relationship, Developmental Disabilities, ADHD, Parenting, India.
References
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- Arnold LE, Lofthouse N, Hurt E. Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics. 2012;9(3):599-609.
- Pontifex MB, Saliba BJ, Raine LB, Picchietti DL, Hillman CH. Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. J Pediatr. 2013;162(3):543-551.
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- Multidisciplinary Non-Pharmacological Intervention for a Young Anxious Child : A Case Report
Abstract Views :83 |
PDF Views:0
Authors
Affiliations
1 Developmental and Behavioural Paediatrician, New Horizons Child Development Centre, Saira Mansion, near Pahadi School, Road Number 2,Peru Baug, Jay Prakash Nagar, Goregaon East, Mumbai-400066, IN
2 New Horizons Foundation, Mumbai, IN
3 New Horizons Health and Research Foundation, Mumbai, IN
4 New Horizons Child Development Centre, Mumbai, IN
1 Developmental and Behavioural Paediatrician, New Horizons Child Development Centre, Saira Mansion, near Pahadi School, Road Number 2,Peru Baug, Jay Prakash Nagar, Goregaon East, Mumbai-400066, IN
2 New Horizons Foundation, Mumbai, IN
3 New Horizons Health and Research Foundation, Mumbai, IN
4 New Horizons Child Development Centre, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 8 (2021), Pagination: 37-42Abstract
Although anxiety in children is prevalent in India, evidence regarding their divergent etiopathologies, and holistic intervention approaches are limited. In the present case of a child experiencing acute anxiety the influences of external environment on anxiety-symptomology and a family-centric therapy have been resorted to. The primary concerns of the six-year-old female included obsession over marks on the body, ritualistic behaviours (hand washing), specific fears (ghosts, selective foods and bathing) and situation-based aversions. The Children Apperception Test revealed fears about losing closed ones, injury from non-human forms and perception of environment as ‘anxiety provoking.’ Pre-intervention MR Spectroscopy highlighted slight reduction in N-acetyl aspartate levels which serve as biomarkers for neurological and psychiatric conditions. Parent and child counselling led to reduction of child’s anxiety symptoms and improvements in child-parent interaction. The coping plan developed by the child, parent and psychologist served as a tool to manage her anxiety in social settings other than home. The anxiety episodes completely subsided post intervention. The case report highlights the need to acknowledge and incorporate influences of psychosocial factors and parent-child dyad at all stages of mental health care delivery.Keywords
Anxious Child, Psychosocial, Parent-Child Interaction.References
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- Shimshoni Y, Lebowitz ER, Brotman MA, Pine DS, Leibenluft E, Silverman WK. Anxious-Irritable Children: A distinct subtype of childhood anxiety? Behavior therapy. 2020 Mar 1;51(2):211-22.
- Sette S, Zava F, Baumgartner E, Baiocco R, Coplan RJ. Shyness, unsociability, and socio-emotional functioning at preschool: The protective role of peer acceptance. Journal of Child and Family Studies. 2017 Apr 1;26(4):1196-205.
- Pickard H, Rijsdijk F, Happé F, Mandy W. Are social and communication difficulties a risk factor for the development of social anxiety?. Journal of the American Academy of Child & Adolescent Psychiatry. 2017 Apr 1;56(4):344-51.
- Alfano CA. (Re) conceptualizing sleep among children with anxiety disorders: Where to next?. Clinical child and family psychology review. 2018 Dec 1;21(4):482-99.
- Brown WJ, Wilkerson AK, Boyd SJ, Dewey D, Mesa F, Bunnell BE. A review of sleep disturbance in children and adolescents with anxiety. Journal of sleep research. 2018 Jun;27(3):e12635.
- Ariyannur PS, Arun P, Barry ES, Andrews-Shigaki B, Bosomtwi A, Tang H, Selwyn R, Grunberg NE, Moffett JR, Namboodiri A. Do reductions in brain N-acetylaspartate levels contribute to the etiology of some neuropsychiatric disorders?. Journal of neuroscience research. 2013 Jul 1;91(7):934-42.
- Bellak L, Bellak SS. An introductory note on the Children’s Apperception Test (CAT). Journal of projective techniques. 1950 Jun 1;14(2):173-80.
- Anastasi A, Urbina S. Psychological Testing 7th ed. Prentics-hall International.
- Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics of North America. 2009 Sep 30;32(3):483-524.
- Albanese AM, Russo GR, Geller PA. The role of parental self-efficacy in parent and child well-being: A systematic review of associated outcomes. Child: care, health and development. 2019 May;45(3):333-63.
- Bushnell GA, Compton SN, Dusetzina SB, Gaynes BN, Brookhart MA, Walkup JT, Rynn MA, Stürmer T. Treating pediatric anxiety: Initial use of SSRIs and other anti-anxiety prescription medications. The Journal of clinical psychiatry. 2018 Jan;79(1).