Questions & Answers
If it is a first seizure, you need to take the child to nearest children’s hospital. The doctor will examine the child, and order necessary investigations to find the cause. If the child is diagnosed to have epilepsy, subsequent seizures are managed as follows.
First thing is you need to be calm. The child should be kept in lateral position, protected from injuries by cushioning their head and loosening any tight clothing. Do not restrain him or put anything in the mouth or try to stop him from moving. Do not give him anything to eat and drink until fully recovered. Stay with him till recovery is complete.
Most seizures terminate by themselves. If they continue beyond 2 minutes, use a nasal buccal spray in doses advised by your doctor. Hospitalization may be needed in f seizures continues after use of spray or if child remains unconscious.
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Recurrent headaches could be due to various reasons like sinusitis, vision related issues, tension headaches or childhood migraine. The best option is to see your pediatrician immediately. He will evaluate the child for routine causes, order necessary investigations and referrals. If he feels the need he may refer you a child neurologist for further testing. Neuroimaging may be needed in some cases.
Migrainous headaches are common during childhood and increase in frequency during adolescence. The first step in evaluation is careful history to identify the pattern of the headache. The next step is a physical and thorough neurologic examination. Neuroimaging is not routinely warranted in the evaluation of childhood headache. Once the headache diagnosis is established, management is based on the frequency and severity of headache and the impact on the patient's lifestyle.
Your child should be walking by 12 to 18 months. If not, you should consult your pediatrician. The cause of delayed walking could be simple like hypocalcemia, vitamin D deficiency, hypothyroidism. It could be more complex like cerebral palsy which occurs due to static perinatal brain injury or some structural brain malformation. Mental retardation due to genetic disorders or metabolic disorders can also present with motor delay, but will have other associated features. Child neurologist or geneticist may be required for diagnosis and a strong neurorehabilitation team is required for further rehabilitation.
Your baby should learn to sit independently between ages 6-8 months. By 9 months they should be able to sit without losing balance for several minutes. Consult your pediatrician if not so. Children born prematurely may not develop muscles at the same rate as others. Other causes may include brain damage before or during birth, spinal defects and defects in muscle co-ordination or structure. It may be a part of other complex neurological and genetic disorders. Child neurologist or geneticist may be required for diagnosis and a strong neurorehabilitation team is required for further rehabilitation.
By 1 year the child should say 1-2 words (like Hi, mama, dada, dog) with meaning. By 2 years they will know a few body parts and can point to them when asked. By 2 years they should start using two words sentences (more biscuit, where mama). By 3 years 3 word sentences and by 4 years they will talk about activities at friend’s home or play school. They should also be able to tell short stories. If you are concerned, talk to your pediatrician. He may refer you to a developmental pediatrician or speech and language therapist for evaluation and management.
Poor eye contact in an infant is the most important sign of autism (Autism Spectrum Disorder) and parents must make all attempts to observe the child carefully and improve communication with their child. The communication in infancy is often nonverbal which forms the basis of verbal communication in future. In fact, verbal communication and language will only develop after nonverbal communication develops. Rarely more complex disorders affecting the vision will lead to poor eye contact. It is important to visit your pediatrician so that he reviews the child and makes further referrals.
A lot of children don’t sit in one place till the age of 2 years. This is physiological, the child is growing and he wants to explore. But as he grows further if he is highly inattentive and hyperactive he may have to be evaluated for autism or attention deficit hyperactivity disorder (ADHD).
Inattention has multiple reasons. It a natural phenomenon if the child is engrossed or preoccupied or unwell. But if it is a persistent inability to pay attention then it may a part of developmental disorder like Autism Spectrum Disorder(ASD), Attention Deficit Hyperactive Disorder(ADHD) Hearing Impairment(HI), Visual Impairment(VI), Intellectual Disorder(ID). The cause and the diagnosis depends on the age of the child. And a thorough evaluation is needed.
There are multiple reasons. He may not be interested, he may not know the answer, he may not read the question properly or he may not understand. He may have learning disorder or attention disorder. A thorough evaluation is needed to find the cause and take appropriate remedial measures.
Some children do not write well. Their IQ is good so they grasp concept well but their ability to reproduce matter what they have studied is not adequate. Therefore, we need to check their mastery on the language. Poor language can be result of language barrier where child studies in language other than mother tongue.
A child’s life could be as stressful as an adult. Academic, peer pressure or home environment could lead to the child withdrawing themselves from social environment. There could be a possibility that the child finds the social interactions stressful. These interactions could make him anxious, thus eliminating the reward aspects of interaction. Many a times a child could also be afraid of their schoolmates based on their experience with them. He will need an interview with the psychologist & sometimes further psychological tests to understand his issues.
The fear of asking a “dumb” question could create an even bigger fear of asking any questions at all. The child might find a subject difficult but may not seek help from anyone, thus increasing his hatred towards that subject. Some children may be slow at grasping what’s being taught in class, making them fall back when compared to their classmates. Children with learning disorders can also have difficulty in second language and may need testing for learning disorders.
Unconscious or conscious favoritism displayed by parents could increase discontent and anger among a child thus making them defy whatever their parents say. Authoritative, over protective, or uninvolved parenting could make the child harbor feelings of resentment towards their parents. This may need help from psychologist to resolve conflict and some parenting counselling.
Stressful or threatening events at school, home or nearby environments could trigger major mood changes in a child. The child may turn overly quite or very noisy. The child may get clingy or easily detached. Observing the child’s mood and body language may provide hints towards what is triggering these changes. There may be child experimenting with something new. If the behavior persists and interferes with learning or day to day social interactions then a psychological consultation or medical consultation may be needed.
Child could be undergoing stressful or upsetting events, which have been reflected in their said behavior. Observe your child’s behavior, check for signs of self-harm and most importantly talk to you child about what is going on in his/her life. Don’t discourage your child. See the positives in your child. Always look for persistence and severity of symptoms. If so it is best to take professional help.
Scolding your child at this point maybe incorrect, as at this point of time your child would be feeling guilty, upset, and as a failure. Scolding him at this point will increase his belief. You will have to ask him about the difficulties that he was facing during his exams and pin point the areas in which he/she is finding difficulties (like reading, writing, arithmetic’s). Ask him the reason for failing. Has he failed only this year or has he been failing always. If there is sudden change in behavior or performance it could mean something important and a sensitive approach by the parent, teacher and sometimes professionals may be needed.