ADHD, dyslexia, autism, development

This article was written in collaboration with Dr Tammy Lim and Dr Kang Ying Qi, Consultants at the Child Development Unit, Khoo Teck Puat – National University Children's Medical Institute, National University Hospital.

At some point, you might ask, "How do I know if my child is developing well?" and you may compare your child's physical, intellectual and behavioural development to that of your relative's or neighbour's child of the same age.

What is typical development for a preschooler? 

A preschooler likes to explore the world around him by jumping, running and playing. He/ she learns to do many things on his/ her own, like feeding and dressing himself/ herself, and may prefer to use the toilet alone. In terms of speech and language, he/ she progresses from speaking in single words to complete sentences. Socially, he/ she will be increasingly aware of his environment. and will also learn how to interact with people and establish relationships with family members and peers.

For more information, refer to the 15 to 18 months and 2 to 3 years old Developmental Checklist for parents in the Health Booklet.  

How to support my child's development?

 

  • Ensure your child is safe while he/ she is exploring the world around him/ her
  • Ensure a well-balanced diet, sufficient sleep and physical activity
  • Use screen time only with supervision and interaction with you
  • Involve your child in household chores
  • Set clear and consistent boundaries, and use non-hurtful discipline when your child misbehaves
  • Support your child as he/ she forms and maintains friendships
  • Encourage your child to share and take turns
  • Help your child discover his/ her strengths and interests

What is a developmental delay? 

The term "developmental delay" is used to describe a child who is slower to  achieve developmental milestones than other children at that given age. 

What is a developmental disability? 

Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behaviour areas (Centers for Disease Control and Prevention). These conditions typically arise in the early years of life, and may affect the way a person moves, communicates, thinks, learns and behaves throughout his/ her life. Common developmental disabilities that affect children include autism spectrum disorder, attention deficit hyperactivity disorder (ADHD) and dyslexia. 

It is important for parents understand typical child development, and to flag up any concerns early, so that the child can receive early intervention and maximise his potential in the long run.





  • Autism Spectrum Disorder (ASD)

    Children with autism spectrum disorder (ASD) have difficulties in social communication and have repetitive patterns of behaviour. They may also have unusual interests and may process sensory information (e.g. how things look, smell, taste, sound, feel etc) differently.

    Here are some red flags, which may suggest ASD:

    AgeSymptom
    By 12 monthsDoes not respond to name
    By 14 monthsDoes not point at objects to show interest
    By 18 monthsDoes not pretend play
    General
    • Speech and language delay
    • Avoids eye contact
    • Prefers to be alone
    • Has trouble understanding other people's feelings
    • Has trouble talking about own feelings
    • Repeats words or phrases over and over
    • Gives unrelated answers to questions
    • Gets upset by minor changes
    • Has obsessive interests
    • Makes repetitive movements, eg. flapping hands, rocking, spinning in circles
    • Has unusual reactions to the way things sound, smell, taste, look or feel

    Reference: http://www.cdc.gov/ncbddd/autism/signs.html

    If you have any concerns that your child may have ASD, discuss these with your child's doctor as early intervention is crucial for your child's optimal development.  

    Attention Deficit Hyperactivity Disorder (ADHD) 

    Children with attention deficit hyperactivity disorder may have difficulty paying attention, controlling their impulses, or be overly active, compared to other children their age.

    A child with ADHD may 

    • Have difficulty focussing on the task at hand
    • Seem forgetful
    • Be unable to sit through games, stories, and circle time in school
    • Constantly ask questions but races off before the answer is given 
    • Be unable to wait for his/ her turn, and interrupts others during conversations
    • Be constantly on the go, stopping only to collapse from exhaustion 
    • Knock into objects and people, or climb and jump off furniture
    • Have frequent injuries
    • Fail to meet academic and social expectations in school 
    • Have problems verbalising organised and focused responses to the teacher's questions
    • Misplace his/ her belongings frequently

    Excessive screen time exposure in children and insufficient sleep can result in poor attention, difficulties in controlling impulses and hyperactivity. These symptoms may be similar to those seen in ADHD. Do refer to our Healthhub resources on sleep and screen time exposure in children for more information.

    If despite ensuring healthy screen time exposure and sufficient sleep, your child continues to have above behavioural concerns, discuss these concerns with your child's doctor.




Dyslexia 

Dyslexia, or specific learning disorder with impairment in reading, is a language-based learning disability. Children with dyslexia have difficulties in reading, spelling and writing. There is an unexpected gap between a child's potential for learning and his or her academic achievement. It is not caused by vision problems or intellectual disability.

 

Common symptoms of dyslexia include:

  • Difficulties in acquiring and using language
  • Difficulties in reading, spelling
  • Writing letters in the wrong order
  • Difficulty learning the names of letters or sounds in the alphabet
  • Difficulty in identifying and/or discriminating sounds in words
  • Confusion with similar letters such as "b" and "d", "p" and "q"
  • Confusion of words that look alike such as "on" and "no", "was" and "saw", "there" and "three"
  • Confusion with concepts relating to directions such as "left" and "right", "before" and "after"
  • Difficulty organising spoken and written language

 

If you are concerned that your child may have some symptoms suggestive of dyslexia or other learning difficulties, discuss these concerns with your child's doctor. While a formal dyslexia assessment can only be done after a child is 6-7 years old, younger at-risk children can receive appropriate intervention without the formal diagnosis. 

How to seek help 

You are encouraged to bring your child to your family doctor, doctor at the polyclinic or your child's paediatrician for a developmental assessment.

It will be helpful to speak to your child's other caregivers (if any) and preschool teachers (if your child attends school), to understand your child's behaviours, learning and function in different settings.

The doctor may refer your child to one of the following for further evaluation:

For children who are not yet in primary school

For children in primary school

  • Child Guidance Clinic 
  • Department of Psychological Medicine, NUH
  • Private paediatricians/ child psychiatrists/ psychologists

 

 

Disclaimer: The information provided in this article is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical condition.



   ​