Premature babies run the risk of cerebral palsy: Dr.Anjana Thadhani

Pediatrician, Dr.Anjana Thadhani, is the founder and director of Niramay Guidance Clinics. They are centers for assessment of behavioral, educational and psychological problems of children.

Her field of activities includes diagnosis and rehabilitation of children with growth delays, physical disabilities, dyslexia, autism, cerebral palsy, mental retardation, behavioral and academic problems and other related issues.

Dr.Thadhani answered Sify readers’ queries related to the above in an exclusive chat. Read the transcript below.

what is right age for admission in school ???
A child usually goes to nursery at 3yrs and 1st standard by 6 yrs. However most of the schools would have their age cut-off for admission.

How to recognize children who is suffering from Autism
The children with AUTISM would have problem in speech development, poor eye contact, isolated play, poor group participation, rocking spinning behaviours, inappropriate attachment to toys and other objects, difficulty in understanding instructions and learning.

How do I handle an hyperactive kid? mine is 5 year old girl. she never sit at one place
Please provide her with lots of activities to do at home. Take her to the garden and play area everyday and let her play for atleast an hour. Please cut down on chocolates and colas and other processed foods.

My child 2yrs she had a tumour in brain and removed successfully and had a vp shunt in her head she is very admant she does not listen to me. can you explain which is the best hospital in India for treatment for hydrocephalus
The best hospital for neurosurgical care would be AIMS Delhi.

What steps can be taken by ‘to be mothers’ to avoid any kind of physical or psychological disorders in their children?
The mother needs to have good nutrition, adequate rest, and reduced mental stress besides the medical support by a good gynaecologist.

How can cerebral palsy be prevented in children?
Good antenatal, natal and neonatal care could help.

How responsible are gene abnormalities for cerebral palsy?
In a very small percentage the genetic conditions may have symptoms similar to cerebral palsy.

Is it true that premature babies run the risk of cerebral palsy?
Yes the risk is there but with early intervention and appropriate care the disability can be minimised.

What are the symptoms of cerebral palsy?
Delay in physical milestones like head holding, sitting, standing, walking, etc.

Stammering in a child is physical or mental illness?
Its usually mental and the child needs to be seen by both a speech therapist and a counsellor.

My daughter aged 12 yrs is very stubborn doctor. She over reacts to situations now a days. Also has started breaking things and screaming when angry. Is this normal?
It is not normal. Consult an expert.

Is it normal if a 4 month old cries a lot while sleeping?
Usually a child will cry if he is wet or hungry. It is not usually normal for a child to cry while sleeping.

What should be the ideal weight of a 4 month old child Doctor?
Depends on the birth weight . Your child should double the birth weight by 5 months.

Any guidance on the use of baby products available in market today?
Please use home based diet for the baby and mild soaps for the child. Fancy products should be avoided.

Any foods that I should avoid till I breastfeed my child?
Some medicines are contraindicated and avoid eating outside and food which cause acidity for you.

I have a 4 month old baby. How can I boost his his mental and physical development?
Please read out to your child and give some visual and auditory stimulation. Be with the child and show concern as it is very important for bonding.

Also please give some tips that can help my newborn sleep better at night.
Some children may show rhythm disturbances, Its better to let the child grow out of it naturally. Most of them usually would settle within 6 months of age.

What things should be kept in mind before vaccinating a child?
The child should not be sick or have high fever before vaccination.

Are all vaccines safe Madam for a child?
Yes as they undergo proper trials. Please consult your Doctor before going newer vaccines.

What should I look for in a good pediatrician?
Doctor should be caring and updated with the latest knowledge.

What is the right age to start disciplining a child?
You can start it as soon as the child is born but definitely after he is one year old.

Can some vaccinations help a child avoid psychological problems that he might develop later?

Doctor what kind of vaccinations can help a newborn to grow healthy?
Consult your paediatrician and follow the recommended schedule. Diet would help the child to grow healthy and not only vaccination.

What are the most common behavioral problems found in children today?
Aggression and hyperactivity are commonly seen. We also see a lot of children with learning.

I am 43 yrs. Hoping to get a child soon. Is it true that children born to older mother will have some kind of behavioral and psychological problems?
Please consult your Gynaecologist and do the screen for down syndrome. All the children may not necessarily have the same problem.

I am 40 yrs male. I want to sponsor and take care of one of the mentally retarded child in an orphange. pls advise as a pediatrician.
Please get the child assessed to know the functional level of the child. After that appropriate vocational guidance and training could be started if the child is old enough. For a small child special education and other therapies would help.

What can be the various causes for mental retardation in a child?
As mental retardation is related to mental functioning, any insult to the growing brain during pregnancy or during birth could lead to this condition. Some genetic conditions are associated with mental retardation also.

What kind of support plan is available in today’s time for a mentally retarded child?
It greatly depends on the intellectual capacity of the child. The child can achieve academics through alternative boards like Open schooling and a lot of vocational courses are available for such children.

My son is 9yrs old. His teachers keep complaining that he does not pay attention and has a trouble answering verbally in class. Is this Attention Deficit Disorder?
It could be a problem with attention. However the child needs to be assessed in order to have a diagnosis. Please avoid chocolates and processed food for your child. Medications can also help.

What are the treatment options available today for Dyslexia?
The mainstay of treatment is special education using multi sensory remedial methods to teach the child concepts in a different way. Occupational therapist can help in poor handwriting. Medications for inattention would help the child to concentrate better. Counselling also helps in keeping both the child and parent motivated.

How do I know whether a child has Dyslexia?
A detailed evaluation doing an IQ test as well as detailed educational test would give us the diagnosis of Dyslexia. The symptoms are usually spelling mistakes, poor handwriting, difficulty in Maths and failure in school.

Can one help a child with Dyslexia learn to read? If yes, then how?
It is important to understand the specific process in reading that the child unable to do. Teaching basic letter sound identification and building gradually on the same through remedial methods would help the child.

Hi Doctor, Can you please tell me the symptoms and signs of Dyslexia?
Dyslexia would present with poor school performance. There could be failures in subjects and usually seen around third standard onwards. The children would have spelling mistakes, refusal to write and calculation errors. They are usually bright and able to understand and respond orally better.

Can there also be a connection of somediseases or illnesses with a child’s height growth?
Commonest cause for short stature is malnutrition and other nutritional deficiencies. Endocrine causes like deficiency of growth hormone, thyroid, etc. can also cause the same. Some genetic conditions are associated with short height.

Has the onset of puberty to do anything with a child’s height growth?

Is it true that height growth can be slower in some kids for a few years and can speed up later and get normal after a few years?
It is possible and usually dependent on the onset of puberty in few cases. The pattern could also be familial. However an expert opinion would help to rule out other causes.

Should I visit an expert for my son’s short height?

My son aged 12 yrs is very short for his age. But he is otherwise healthy. What might be the reasons?
For assessment of growth it is important to take the height of both the parents and determine his height potential based on mid parental height. It would be important to follow the growth of the child and see how is he fairing as per expected height charting. A paediatrician could help you to rule out correctable causes of short stature such as anaemia, hypothyroidism, etc.

What about schooling for children who suffer from Autism?
During the initial stages and in mild cases the children can go to a regular school till primary level. Later they may need a special school. I personally know of a autistic child who has completed BCom.

Does autism have a permanent cure?
No as of now we do not have a permanent cure for Autism. However with early and effective intervention the problem behaviour can be minimised and the child could have a good and productive life.

Is there a relation between vaccines and autism?
There has been a lot of concern about MMR ands Measles vaccination causing AUTISM however it has been proven that it is not true. It is mainly the time of presentation of Autism that such associations were made. Any child with Autism needs to have all routine immunisations.

What actually causes autism?
There are multiple hypothesis related to causation of Autism. However it is a developmental disorder and has neuroanatomical and neurochemical basis.

My son is around 6 years old and he tries to withholds his stool. He will stand in corner and will make different types of actions but will avoid to go to bathroom. His underwear is soiled all the time and is smelling.
One important point I want to know is whether this has been happening throughout or has he off late started to soil his clothes. This would require proper investigation. You may need to see a pediatrician and meet a counsellor.

My son is 2 years old.He has been going to a daycare for past 6 months but still he is not used to it.He cries everyday when I go to drop him .He started biting n hitting us.Is this temporary issue or a serious concern?
this could be a severe temper tantrum and if has not settled for 6 months you may require some consultation for the same.

Do all children who cannot speak well and clear suffer from Autism?
Speech delay is one of the symptoms of autism. The child needs to have other behaviours like poor eye contact, repetitive speech and behaviours like spinning, rocking, hand flapping, etc. for him to be diagnosed as Autism.

My nephew is 4yrs. He cannot speak full words. But understands everything. He even dances very well. What is your advise?
This could be a case of pure speech delay… but since he has reached an age where he has not naturally learnt the language I suggest that you show him to a speech therapist and may require speech therapy for 3-6 months. We can review the case after 6 months.