Electrical activity is happening in our brain all the time. A seizure happens when there is a sudden burst of intense electrical activity in the brain. This is often referred to as epileptic activity. The epileptic activity causes a temporary disruption to the way the brain normally works, so the brain’s messages become mixed up. The brain is responsible for all the functions of your body. What happens to you during a seizure will depend on where in your brain the epileptic activity begins, and how widely and quickly it spreads. For this reason, there are many different types of seizures, and each person will experience epilepsy in a way that is unique to them
There are many types of epilepsy. Some types start when you are very young, and some in later life. Some types last for a short time and other types can last for the whole of your life.
Sometimes the reason epilepsy develops is clear. It could be because of brain damage caused by a difficult birth, a severe blow to the head, a stroke, or an infection of the brain such as meningitis. Very occasionally the cause is a brain tumour. In around six out of ten (60%) people, doctors don’t know the cause of epilepsy. For many of these people, it is just part of how they are made that makes them more likely to have a seizure.
There isn’t a test that can prove that you do or you don’t have epilepsy. Tests such as the electroencephalogram (EEG) – which records brainwave patterns – and MRI of the brain can give doctors useful information. A diagnosis of epilepsy should be made by a doctor with specialist training in epilepsy.
To make a diagnosis, an epilepsy specialist will use their expert knowledge and look at the information from different tests. They will ask you what happens before, during and after your seizures. They might also want to speak to someone who has seen your seizures.
Epilepsy is currently defined as the tendency to have recurrent seizures. It is unusual to be diagnosed with epilepsy after only one seizure. Around five people in every 100 will have an epileptic seizure at some time in their life. Out of these five people, around four will go on to develop epilepsy.
Epilepsy is usually treated with epilepsy medicines. You may also hear these referred to as anti-epileptic drugs (AEDs). Epilepsy medicines act on the brain, trying to reduce seizures or stop seizures from happening. Lots of people with epilepsy find that when they have the right medicine, they have fewer or no seizures. 70 per cent (seven out of ten) of people with epilepsy could be seizure free with the right treatment.
The person goes stiff, loses consciousness and then falls to the ground. This is followed by jerking movements. A blue tinge around the mouth is likely. This is due to irregular breathing. Loss of bladder and/or bowel control may happen. After a minute or two the jerking movements should stop and consciousness may slowly return.
Sometimes the person may not be aware of their surroundings or what they are doing. They may pluck at their clothes, smack their lips, swallow repeatedly, and wander around
Cerebral palsy (CP) is a term used to describe a disorder affecting body movement and muscle coordination. It is caused by damage to one of the parts of the developing brain which controls and organizes a person’s movement and posture. Because of this messages between the body and brain are ‘scrambled’
No two people with CP will be affected in the same way. For some people the effects will be very mild. For others they can be severe or profound with many variations in between.
The damage to the developing brain can happen before, during or after birth and is usually diagnosed before the age of three. Almost 50% of children with CP are born early. Small preterm (early) babies have vulnerable brains which may haemorrhage (bleed heavily). This is because of the immaturity of the developing brain and the vulnerability of the tissue in the brain.Other causes include:
It is often not possible for doctors to give an exact reason why part of the baby’s brain has been injured or failed to develop, as there may be no obvious single reason why a child has cerebral palsy.
CP can happen in any family. It affects both sexes, although slightly more males than females have CP. Some risk factors are well-known, such as extreme prematurity, low birth weight and multiple births. The risk of CP is 5 times greater with twins and 18 times greater with triplets. However, it is not usually possible to say which children are most likely to have CP.
CP affects approximately 1 in every 400 children. Over the last few years the number of people with CP who have profound and multiple difficulties has increased.
There are three different systems within the brain involved in controlling movement. Impairment can happen in one or more of these areas. The type of CP which results depends on which area of the brain is most affected.
There are three types of CP:
Spastic cerebral palsy (spasticity)
Present in 75% to 88% of people with CP, which makes it the most common form of the condition. “Spastic” means “stiff” and people with this type of CP have tightness or stiffness and weakness in some muscles. This causes degrees of difficulty in moving the body, which may be mild or severe. People with spastic CP have a tendency to remain in certain positions and also to develop shortening of some muscles. This can sometimes limit the movement of joints.
Dyskinetic cerebral palsy (dyskinesia)
Sometimes referred to as dystonic, athetoid or choreoathetoid CP. Present in about 15% of people with CP. People with dyskinetic cerebral palsy experience uncontrolled, involuntary sustained or intermittent muscle contractions as the tone of the muscle can change from floppy and loose (hypotonia) to tight with slow, rhythmic twisting movements. The whole body can be affected resulting in difficulties maintaining an upright position. Speech can be hard to understand as there may be difficulty controlling the tongue, breathing and vocal cords.
Ataxic cerebral palsy (ataxia)
Present in about 4% of people with CP. They can experience problems with balance and coordination. This is due to difficulty in controlling movements of the trunk, head, legs and arms. Ataxia affects the whole body and when walking, they will probably be very unsteady on their feet. People with ataxic CP are likely to have shaky hand movements and jerky speech.
Sometimes it may be difficult to know what kind of cerebral palsy a person has, as it can be a mixture of the above three, if more than one of the movement systems is impaired.
There are three commonly used descriptions of ways cerebral palsy affects different parts of the body:
As stated earlier, no two people will be affected in exactly the same way. This is because the effects of CP vary according to how much damage has been done to the developing brain. People with CP have difficulty controlling some or all of their movements. In some people this is hardly noticeable, while others might have difficulty talking, walking or using their hands. Some people will be unable to sit up without support and will need help to do most everyday tasks.
A person with cerebral palsy may have some or most of the following features, to a greater or less extent:
The results of these difficulties may mean a delay in achieving the “milestones of development”. In other words a child may be slower than average in acquiring physical skills such as hand control or learning to walk. Some people who are severely affected may never develop the most complex of these skills. However, it can be difficult for a doctor to predict accurately how a young child with cerebral palsy will be affected as they grow older. Good therapy, support and education of parents to know how to assist their child, can help progress in early years.
Depending on the severity of the condition, the person with CP might get treatment from different therapists. The three most common for people with CP are:
Some people with CP may need no or little treatment
The damage to the brain does not worsen as an individual gets older. However, over time certain of the physical effects, such as muscles tightening and shortening, can produce other problems such as joint stiffness. This can cause discomfort and hinder a person’s activity, if ignored.
Certain difficulties are more common in people with CP:
The most common visual impairment is a squint, which may need correction with glasses or an operation. More serious visual impairments are much less common. Visual field defects are sometimes present and should be tested for. This means that the part of the brain that is responsible for understanding the images the person sees is not working properly. The eyes may look healthy when examined, but the person will not be able to see normally.
A small number of people with CP have hearing impairments which cause difficulties with speech and language. Some children with CP develop “glue ear” or other ear infections. This can cause a hearing impairment, which, in turn, can make learning to speak more difficult until it is treated.
Some people with CP have difficulty in perceiving space and relating it to their own bodies (for example, they cannot judge distances) or thinking spatially (eg visualising a three-dimensional building, being able to tell right from left, understanding the concepts of “in”, “on”, ” under “, etc). It may affect people’s ability to do things like dressing or making it more difficult to learn maths, reading and writing. This is caused by an abnormality in the part of the brain and is not related to intelligence.
Speech and Language
Some people with CP have no speech. Others have difficulty speaking. Some have difficulty controlling movement, which means that the muscles in the mouth, tongue, palate and voice box are affected. This can make speech sound unclear. However, many children with CP learn some kind of verbal communication.
Chewing and Swallowing
Sometimes chewing and swallowing is difficult because of problems controlling the mouth muscles, lips and tongue. An early sign may be difficulty with sucking. Eating is sometimes difficult for people with CP. This can be called dysphagia. They may also have reflux (food or drink flowing back up to the throat).
Around one in three people with CP have epilepsy. It is impossible to predict whether or when a child may develop seizures (fits). Some children start to have them when they are very young, others in adult life. Epilepsy can often be well controlled with medication.
Some children have difficulty planning motor movements or doing apparently simple tasks like dressing. This is due to difficulties in parts of the brain which organize movement and spatial awareness. These children may be labelled “clumsy” or have learning difficulties at school, particularly relating to maths. Activities like skipping, running or climbing (known as gross motor activities) are very difficult. These children can walk quite well but will often trip or fall. Special therapy programs can help children with dyspraxia with their motor organization and teach them to dress themselves. These programs can supplement learning programs at school.
Other physical difficulties
Some people with CP may have some other difficulties. These could include:
In most cases these difficulties can be reduced or overcome.
It is often assumed that people with CP who are unable to talk, or have difficulty controlling their movements, have a learning disability. This is not always the case and should never be assumed. CP does not necessarily affect intelligence, though some people might have a learning disability. The degree of speech and movement a person has does not indicate their level of intelligence.
Specific Learning Difficulties
Some people have difficulty learning to read, draw, or do arithmetic. This is because a particular part of the brain is affected. If the problem is out of proportion to a person’s general intelligence, it is called a specific learning difficulty.
We don’t know enough yet about how and why CP happens to cure or prevent it. However, because of improvements in medical care before and during birth, fewer babies have been born with certain types of CP. In term babies with Hypoxic ischemic encephalopathy (HIE) ‘cooling therapy’ has shown very encouraging results. Ongoing research, particularly around prematurity where the incidence of CP is high, is helping to reduce the level of brain and lung damage and visual impairment.
Research into improving mobility is also being carried out. Although brain damage is not reversible there are many treatments and therapies which can help people with CP. Equipment such as splints to help with walking, special buggies and wheelchairs, seating and standing frames, computers and much more can be provided to build on and support people’s abilities.
Many adults with cerebral palsy lead independent lives, with or without support. Many children with cerebral palsy attend mainstream schools and go on to further and higher education. Attitudes towards disability are changing all the time for the better.
Developmental delay is the term used when a child does not progress as expected. For example, your child’s speech may lag behind other children. Or,your child may have been slow to learn to walk. In some children, developmental delay is suspected soon after birth because of feeding difficulties or unusual muscle tone. In other children, developmental delay is only suspected much later when learning or behavioural difficulties surface at school.
There are many different causes for developmental delay. It is a common condition affecting 1-3% of the population. The delay may be caused by a child’s genetic makeup (eg Down syndrome), by problems during pregnancy (eginfection), around the time of delivery, especially if very premature (eg bleedingin the brain), early infancy (eg meningitis) or later in childhood (eg head injury).
A cause can be found in about half of cases.
There are a number of benefits for you and your child to finding out what might be causing the developmental delay. These include:
A Paediatrician (a child specialist) usually does the assessment of developmental delay. The paediatrician will ask questions about your child’s medical history, examine your child, measure your child’s height, weight and head circumference, and assess your child’s developmental progress. Other professionals may be involved in this assessment and your child may be referred for hearing or visionassessment.
Your child may be offered some tests or further referrals, for example to a Paediatric Neurologist (a specialist who deals with the brain and nervous system) or geneticist (a specialist who deals with a person’s genetic makeup) to try to determine the cause of your child’s developmental delay.
There are many different types of test available. These could include:
Maternal infection tests – these are to check whether a mother had aninfection during her pregnancy that affected her child eg rubella
Chromosome analysis – chromosomes are structures in the body that contain genetic information. A chromosomal disorder can occur spontaneously (a once off occurrence) or it can be inherited from a parent. Looking at the chromosomes can help us identify hundreds of disorders that cause developmental delay
Specific genetic tests – there are thousands of genetic conditions that can cause developmental delay in a child. In order for the paediatrician or geneticist to select the appropriate tests on your child, a brain scan may be necessary
Samples may also be taken from parents to find out whether either parent is a carrier of the genetic disorder.
Not every child with developmental delay will be offered tests. There are many conditions for which there is no genetic test yet.
What if a diagnosis is made?
The Doctor will explain what the diagnosis means for you and your child eg what the common features of the condition are, whether there is any treatment for the condition, whether the condition can be passed from one generation to the next.
What if there is no diagnosis?
In spite of investigations, approximately half of children with developmental delay will not receive a specific name for their condition.
And finally…remember that developmental delay does not stop a child from having a full and rewarding life. Your child’s health and educational professionals aim to help your child have a life as enjoyable and fulfilling as possible.
Reduced sharing of interests
Absence of interest in others
Repetitive vocalizations such as repetitive guttural sounds, intonational noise‐making, unusual squealing, repetitive humming
Stereotyped or repetitive motor movements
Stereotyped or repetitive use of objects
Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms.
The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5) is used by health professionals to help diagnose ADHD. It was released in May 2013 and replaces the previous version, the text revision of the fourth edition (DSM-IV-TR). This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD.
There were some changes in the DSM-5 for the diagnosis of ADHD: symptoms can now occur by age 12 rather than by age 6; several symptoms now need to be present in more than one setting rather than just some impairment in more than one setting; new descriptions were added to show what symptoms might look like at older ages; and for adults and adolescents age 17 or older, only 5 symptoms are needed instead of the 6 needed for younger children.
If a parent or other adult is concerned about a child’s behaviour, it is important to discuss these concerns with the child’s health care provider.
Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level
Please note that the criteria (in shortened form) provided here are just for your information. Only trained health care professionals can diagnose or treat ADHD.
Sensory processing (sometimes called “sensory integration” or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioural responses. Whether you are biting into an apple, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or “sensory integration.”
Sensory Processing Disorder (SPD, formerly known as “sensory integration dysfunction”) is a condition that exists when sensory signals don’t get organized into appropriate responses. Pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioural problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively.
One study (Ahn, Miller, Milberger, McIntosh, 2004) shows that at least 1 in 20 children’s daily lives is affected by SPD.
Another research study by the Sensory Processing Disorder Scientific Work Group (Ben-Sasson, Carter, Briggs-Gowen, 2009) suggests that 1 in every 6 children experiences sensory symptoms that may be significant enough to affect aspects of everyday life functions. Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.
Sensory Processing Disorder can affect people in only one sense–for example, just touch or just sight or just movement or in multiple senses. One person with SPD may over-respond to sensation and find clothing, physical contact, light, sound, food, or other sensory input to be unbearable.
Another might under respond and show little or no reaction to stimulation, even pain or extreme hot and cold. In children whose sensory processing of messages from the muscles and joints is impaired, posture and motor skills can be affected. These are the “floppy babies” who worry new parents and the kids who are clumsy on the playground. Still other children exhibit an appetite for sensation that is in perpetual overdrive.
These kids often are misdiagnosed – and inappropriately medicated – for ADHD.
Sensory Processing Disorder is most commonly diagnosed in children, but people who reach adulthood without treatment also experience symptoms and continue to be affected by their inability to accurately and appropriately interpret sensory messages.
These “sensational adults” may have difficulty performing routines and activities involved in work, close relationships, and recreation. Because adults with SPD have struggled for most of their lives, they may also experience depression, underachievement, social isolation, and/or other secondary effects.
Sadly, misdiagnosis is common because many health care professionals are not trained to recognize sensory issues.
‘What causes Sensory Processing Disorder’ is a pressing question for every parent of a child with SPD. Many worry that they are somehow to blame for their child’s sensory issues.
“Is it something I did?” parents want to know.
Preliminary research suggests that SPD is often inherited. If so, the causes of SPD are coded into the child’s genetic material. Prenatal and birth complications have also been implicated, and environmental factors may be involved.
Of course, as with any developmental and/or behavioural disorder, the causes of SPD are likely to be the result of factors that are both genetic and environmental. Only with more research will it be possible to identify the role of each.
Children with Sensory Processing Disorder often have problems with motor skills and other abilities needed for school success and childhood accomplishments. As a result, they often become socially isolated and suffer from low self-esteem and other social/emotional issues.
These difficulties put children with SPD at high risk for many emotional, social, and educational problems, including the inability to make friends or be a part of a group, poor self-concept, academic failure, and being labelled clumsy, uncooperative, belligerent, disruptive, or “out of control.” Anxiety, depression, aggression, or other behaviour problems can follow.
Parents may be blamed for their children’s behaviour.
Effective treatment for Sensory Processing Disorder is available, but far too many children with sensory symptoms are misdiagnosed and not properly treated. Untreated SPD that persists into adulthood can affect an individual’s ability to succeed in marriage, work, and social environments.
Most children with Sensory Processing Disorder (SPD) are just as intelligent as their peers. Many are intellectually gifted. Their brains are simply wired differently. They need to be taught in ways that are adapted to how they process information, and they need leisure activities that suit their own sensory processing needs.
Once children with Sensory Processing Disorder have been accurately diagnosed, they benefit from a treatment program of occupational therapy (OT) with a sensory integration (SI) approach.
During OT sessions, the therapist guides the child through fun activities that are subtly structured so the child is constantly challenged but always successful.The goal of Occupational Therapy is to foster appropriate responses to sensation in an active, meaningful, and fun way so the child is able to behave in a more functional manner. Over time, the appropriate responses generalize to the environment beyond the clinic including home, school, and the larger community.
Effective occupational therapy thus enables children with SPD to take part in the normal activities of childhood, such as playing with friends, enjoying school, eating, dressing, and sleeping.
The student who struggles with reading and spelling often puzzles teachers and parents. The student receives the same classroom instruction as other students,but continues to struggle with some or all of the many facets of reading and spelling.This student may have dyslexia.
The primary symptoms are:
Dyslexia is not a disease! The word dyslexia comes from the Greek language and means difficulty with words. Individuals with dyslexia have trouble with reading and spelling despite having the ability to learn. Individuals with dyslexia can learn, they just learn in a different way. Often these individuals,who have talented and productive minds, are said to have a language learning difference.
Dyslexia occurs on a continuum from mild to severe and no two are alike. With appropriate correction therapy and instruction aimed towards their learning needs, most children can overcome their literacy difficulties and lead productive lives.
A student with dyslexia will have a particular difficulty with single word reading networks that are brain based (neurological). Dyslexia is not a problem with comprehension. Individuals with dyslexia are able to use higher level language skills to support their reading of connected text (stories) and this ability to ‘compensate’ may mask their underlying difficulties with single word reading (decoding).The central difficulty for a student with dyslexia is to convert letter symbols to their correct sound (decode) and convert sounds to their correct written symbol(spell). Research into dyslexia subtypes indicates that poor visual (i.e., orthographic) coding can also be part of the difficulty.
Research has indicated that we should be wary about automatically assuming that language processing difficulties/differences or cognitive difficulties/differences associated with dyslexia are deficits. Some of the cognitive differences that dyslexic individuals display may actually confer advantages for some kinds of thinking or encourage them to find different paths to learning.The following are some of the strengths that individuals with dyslexia may display:
“Paying attention to empowerment, emotional intelligence and self esteem is vital when it comes to dyslexia and associated reading challenges”. Jodi Clements