Neurodevelopmental and Mental Disorders Classroom Management Dr Newton

Neuro-developmental and Mental Disorders: Classroom Management Dr Newton Luiz Dhanya Mission Hospital, Potta, Kerala Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Teacher Special Educator Academic Underachiever School Psychologist Doctor The Doctor frequently plays a minor role in these disorders, compared to the Teacher, the Special Educator and the Psychologist. Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Neuro-developmental disorders • • Intellectual Disability (“MR”) Specific Learning Disability Attention Deficit Hyperactivity Disorder (ADHD) Autism Spectrum Disorders Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Intellectual Disability ( Mental Retardation) TYPE • Mild M R: Educable and trainable • Moderate M R : Non educable but trainable • Severe M R: Non educable non trainable (depend partially for self help skills) • Profound M R ( Totally dependent) Teachers Self Learning Module 2019 I Q range • 55 -70 • 40– 55 • 25 - 40 • Less than 25 Understanding Adolescence ©Adolescent Health Academy IAP

Intellectual Disability What can we do to help him? Detaining him Scolding him Extra homework Rote learning does not help Special school Vocational training does help Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Specific Learning Disability “An inexplicable discrepancy between a child’s IQ and his scholastic performance” Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Specific Learning Disability • Reading Disorder ‘Dyslexia’ • Writing Disorder ‘Dysgraphia’ • Mathematics Disorder ‘Dyscalculia’ Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Reading Disorder What Ian’s mother wrote: I AM HOME What Ian read: IAN HOME Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Reading Disorder: Features Ø READS SLOWLY Ø Reads word by word Ø Spells out words Ø Omits words Ø Ignores punctuation Ø Reversals (SAW = WAS) Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Reading Disorder • • • A very slow reader Makes mistakes in reading NEVERTHELESS His vocabulary and grammar are normal His listening comprehension is normal His memory is normal Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Management • • • Early and intensive remedial reading A Flexible System: • oral tests • extra time for assignments • Audio textbooks Avoid courses that require a lot of reading Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Teachers Self Learning Module 2019 Understanding Adolescence 12 ©Adolescent Health Academy IAP

Writing Disorder: Features v WRITES SLOWLY v Illegible letters v Irregular Spacing v Misses/substitutes a letter Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Writing Disorder: a sample Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Maths Disorder (Dyscalculia) 25 + 36 ---511 ---- 19 + 17 ---2 ---- 70 12 ---62 ---- 9 years old Counts on her fingers Confuses + and – and x Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Management of SLD ü ü ü Explain the problem Modify the curriculum Remedy the weakness Strengthen strengths Counselling Medications Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Attention Deficit Hyperactivity Disorder (ADHD) Teachers Self Learning Module 2019 Understanding Adolescence 17 ©Adolescent Health Academy IAP

ADHD: Features Poor Attention • • • Inattentive Distractible Cannot concentrate for long Hyperactive • • Fidgety; leaves seat frequently Always on the go; talks a lot Impulsive • • Teachers Self Learning Module 2019 Blurts out answers Interrupts others Understanding Adolescence ©Adolescent Health Academy IAP

ADHD: what we can do Parents • • Ensure adequate sleep Minimize screen time Encourage physical activity Organize his life for him Teachers • • Teachers Self Learning Module 2019 Give specific and clear instructions Fix specific behavioural goals Monitor him regularly Keep his parents informed Understanding Adolescence ©Adolescent Health Academy IAP

Autism Poor Social Interaction Ø Ø Ø POOR EYE CONTACT Does not respond when called by name DOES NOT POINT TO OBJECTS OF INTEREST Not interested in other people NO MAKE-BELIEVE PLAY Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Autism Poor Communication v Does not communicate adequately by speech or even gestures v Not interested in speaking to others v Idiosyncratic language v Repetitive Behaviour Motor mannerisms (e. g. flapping hands) Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Autism: Management v v v Teach the child self-care Teach social skills (how to interact with others, need to obey social rules) Vocational training Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Generalized Anxiety Disorder Teachers Self Learning Module 2019 Understanding Adolescence 23 ©Adolescent Health Academy IAP

Depressive Disorder Teachers Self Learning Module 2019 Understanding Adolescence 24 ©Adolescent Health Academy IAP

Red Flags of Adolescent Depression • • Irritability Low mood Loss of interest in activities previously enjoyed Avoiding company/ staying alone Poor concentration Falling grades Loss of appetite/ weight, sleep or Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Substance Abuse Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Persons with Disability Act 2016 • • Promotes inclusive education for children with disabilities (including neuro-developmental disabilities) Recommends, where appropriate, a scribe, extra time for completing exams, and exemption from second and third language courses. Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Case 1 : What would you do? • • • Vimal, A 9 yr old with ADHD Cheerful and likeable chap Cannot sit still in the class: often leaves his seat, fidgets, talks to or pokes the boys seated nearby. Inattentive and distractible Scholastic performance is below par Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

ADHD: what we can do • • Make him sit in the front row Look at him frequently while teaching Spell out exactly what you want him to do Be firm with him Ensure there is no undue stress at home or in school (bullies) Keep his parents informed regularly of whether his behavior is improving Advise a medical consultation if need be Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Case 2 : What would you do? • • • Raju is 10 years old Smart, knows all the answers An extremely slow reader Makes numerous errors while reading Performs very badly in written exams Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Reading Disorder: what we can do • • • Take an oral exam Extra time for projects Extra time and a scribe for exams Advise remedial reading with a trained educator Keep an eye out for his special abilities and interests Recommend courses that involve less reading Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

To Conclude v v v SLD is a common cause of poor scholastic performance. Other important causes include ADHD, ID, and emotional problems. A cheerful but firm teacher who maintains discipline will always be remembered with great affection. Teachers Self Learning Module 2019 Understanding Adolescence ©Adolescent Health Academy IAP

Thank You ! Teachers Self Learning Module 2019 Understanding Adolescence 33 ©Adolescent Health Academy IAP