Category: Parenting

Selina Ding Wai Eng   Educational and Clinical Psychologist, Ding Child Psychology Centre

Selina Ding reads dyslexia better than most, as she is one of the few child development specialists in this country who are heavily invested in developing programmes for dyslexic children.

Dyslexia: what is it?

“Dyslexia is more than just a reading problem,” explains Selina. “It is actually a layman term used to describe a specific learning disorder.” She goes on to explain that there are three types of learning disorders – impairment in reading, spelling and mathematics. Dyslexia generally refers to impairment in both reading and spelling, while dyscalculia refers to the impairment in counting and solving mathematical problems.

“Some children may suffer from all three disorders,” she explains, “while others may only have reading and writing issues.” Some children may be able to read like normal children, but they cannot write like normal children. Selina considers these children dyslexic as well.

At a glance

It is a neurological disorder, a condition that affects the brain or the connecting nerves. According to Selina, we do not know yet for sure how dyslexia comes about. “Some say it can be caused by a genetic predisposition – which is to say, a child has a higher chance of developing dyslexia if there is a family history – but there is also evidence that it can occur in a child even without family history,” she adds.

Dyslexics are not stupid. “The first criteria in the diagnosis of dyslexia,” explains Selina, “is that the child shows intelligence within the normal range, while his or her academic achievements are lower than those of his or her peers.”

Dyslexia cannot be cured. It is a lifelong condition and the tendency to make dyslexic mistakes will always be there. However, intervention helps the dyslexic child to read and write to the best of his or her abilities, by teaching the child how to adapt to the condition.

Diagnosing dyslexia

While there are many free “self-test” services available online, a clinical or educational psychologist is the most qualified person to diagnose whether someone is dyslexic. Another advantage of consulting a psychologist over using an online checklist is that the psychologist will be able to tailor a suitable programme for your child.   

Should the parent be concerned? According to Selina, parents may consider sending their child for an evaluation by a clinical or educational psychologist if the child has received ample educational exposure for someone his or her age, but the child’s performance is not at the same level as their peers.

Even if the child may not be dyslexic, the evaluation can help identify other problems that may be present.

Should the parent wait until the child is older? Some parents may want to wait until the child is older, often in the hope that the child will overcome his or her learning difficulties eventually. However, Selina points out that earlier is actually better. If the child is diagnosed and receives help before he or she starts primary school, for example, the child will be in a better position to fit in with the class and catch up with his or her studies.

What is the diagnosis process like?

1. Getting to know the child’s background. Selina explains that, when a child is sent for evaluation, the first step is a thorough evaluation of the child’s developmental history, family history and schooling history. The child’s school books, report cards, teacher’s referral (if any) and such can also be evaluated to determine whether the child’s academic performance is within the normal level of children of his age.
2. Testing for dyslexia. In the next session, the parents will bring the child for a series of assessments. The session may take a few hours. The child will be tested on his or her IQ as well as his or her ability to read, write, do maths, speak and comprehend what he or she is reading. These tests are all based on international standards, and have been used to successfully diagnose children with dyslexia and other learning problems. Some parents may be surprised at how thorough the tests can be. This thoroughness is necessary to rule out other possible reasons for the child’s apparent learning difficulties. 
3. Is there a problem? The psychologist would analyze the results of these tests as well as the child’s background to determine whether the child has dyslexia. Once there is an official diagnosis, the parents can then choose to send the child to an intervention programme that will help the child continue to still learn and thrive despite his or her dyslexia.

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Most clinical and educational psychologists who can diagnose dyslexia often offer programmes to help children cope with this condition. Such programmes may differ slightly depending on the centre, says Selina Ding, so it is up to the parents to pick a programme that the child is most comfortable and happy with.

The Dyslexia Programme in Selina’s private practice, like many programmes out there, is based on the well-known Orton-Gillingham method, an approach well-known for its flexibility and structure as well as its ability to help dyslexic children progress faster in reading, writing and spelling. Its flexibility allows tutors to devise a highly personalized curriculum to meet the child’s specific needs. Such curriculum exposes the child to learning via a variety of senses (hearing, sight as well as kinaesthetic, which emphasizes touch and movement).

 “Ordinary people can memorize the alphabet easily, but to a dyslexic child, the alphabets are like those Egyptian hieroglyphics – he or she has a hard time recognizing them,” explains Selina.

To improve the child’s ability to recognize and correctly pronounce the letters, Selina incorporates additional kinaesthetic elements into the programme. These elements are especially helpful for dyslexic children who also have problems differentiating sounds.

Kinaesthetic tutoring sees the child tracing a letter of the alphabet often printed on papers with textures or made into moulds. Sometimes the child may be blindfolded to enhance his or her sense of touch. This way, the child can see the ‘movement’ of letters such as D and G. “Such exercises help the brain focus better and improve retention of what the child has learned,” Selina explains.

Dyslexia programmes also usually offer supplemental reading materials for the child as well as advice and tips for the parents on supporting their child’s efforts to learn.

How long is the programme?

According to Selina, most programmes are structured around the child’s needs and schedule. Ideally, she would love if a child can spend an hour with her in the programme each day, but realistically, the child may also have other classes or activities to attend. If the child spends 2 hours each week on the programme, it takes about 2 years to complete.

Should the child still go to kindergarten or school in the meantime?

Yes! Selina strongly encourages this, as school is also a place for the child to develop his or her social skills. Additionally, the child may still pick up important knowledge or apply what they have learned. The parents can help their child by explaining to the child’s teachers about his or her dyslexia.

Does this programme work?

In Selina’s experience, yes. She has seen children change from sullen and difficult students to eager learners who are enthusiastic about going to school and even doing their homework!

What is next after the dyslexia programme?

The programme helps the child read, write and understand words better, but the child may have fallen behind on language skills in the meantime. Often, remedial language classes are the next step.

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All children go through a phase where they just don’t feel like doing their homework, sometimes. So, what can you do to motivate them and make studying a fun experience?

Tip#1:  Take a break and don’t nag

Don’t nag, no matter how much you are tempted to. Some kids are natural rebels, so the more you nag them, the more they will refuse!

Just like how you would like a break after a long day at work, your kids need to wind down too after a long day at school. Allow them to spend a little time (about 20 minutes) to unwind such as playing football or watch a bit of TV. Get your children to set the time when they have to work on their homework and make sure that they stick to it.

Tip#2: Use the word “study”

Instead of guilt-tripping your kids by saying “it’s homework time”, why not say “it’s study time”? “Study time” is broader and can reflect on either studying and/or doing homework. It also gives the impression that they can also use that time to study while doing homework.  

Tip 3#: Get them on a routine

Studying will become a habit once you get your kids to study around the same time. Isn’t it just wonderful to see your kids doing their studies on their own without you telling them to? Have a chat with them and establish a study schedule through which they can determine the time they would like to spend studying. Ensure your child is doing this on a daily basis, and all other activities such as meeting up with friends are listed out too,  so that there will be a healthy balance between study and life. Most importantly, ensure that they follow through what they’ve scheduled for themselves. 

Tip #4: Play a supportive role

As much as you would like to help your children with their homework, remember this, it is their homework. So, let them be responsible for it. The purpose of having homework, in the first place, is to test their understanding of the subject while making use of the knowledge and skills they have learnt. Be a supportive parent and don’t criticize or punish your child. Encourage your child to be independent in getting the homework done.  Understand the problems they face (if there are any) and provide rational solutions.   

Tip#5: Praise and appreciate their effort

Let your kids know that you appreciate the efforts they make in attempting to tackle their homework independently, even if they do not get it all right.  Use encouraging words such as “You have done an amazing job, keep it up!” to induce positivity while providing them the confidence to be more persistent in accepting new challenges. 

Tip#6  Set goals and rewards

You can motivate your kids to study by giving out a reward when a goal is achieved. The goal set must, of course, be achievable by your child. It should reflect on their ability in making improvements for the desired goal. The form of reward given can be varied, for instance, it can be a movie trip, an ice-cream, a sleepover, etc.

Tip#7  Minimise surrounding distractions

The TV, mobile phone, computer and hand-held games can be distracting. Limit and control their use. For example, they can only watch the TV when they are done with their homework. If your child likes to listen to music while doing homework, make sure that the music he or she is listening to is not too distracting.

References:

Center for Effective Parenting. Available from www.parenting-ed.org

Today Parents. Available from www.today.com/parents/secrets-getting-kids-do-their-homework-8C11080329

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Prof Hugo Van Bever   Professor in Paediatrics, National University Singapore

“Do you know that in the past, many years ago, when I was young and handsome, they said that having a big head at birth increased your risk of allergy?”

Amused laughter greeted Prof Hugo Van Bever as he took the stage for a talk during the recent  “Gut Microbiata Modulation: From Insights to Clinical Practice” session. Organised by the Obstetrical & Gynaecological Society (OGSM) and the Malaysian Paediatric Association (MPA), the session enabled Prof Hugo to share his insight into the latest approaches adopted by the medical community to address allergies in children, especially food allergy.

Prof Hugo, who is currently a Senior Consultant with the Division of Paediatric Allergy, Immunology & Rheumatology in the National University Singapore, pointed out that the rate of allergy among children has been rising over the last 30 years. While the cases of respiratory allergy (allergic rhinitis) has plateaued (although still high), the last 5 years saw a huge increase in the number of children with food allergy.

Just a little bit

Treatments of allergy can involve the exposure of allergens through carefully controlled doses to the allergic person, until the person’s body becomes accustomed to the exposure and their symptoms eventually get better over time. This process is called desensitisation, and we may apply a similar process to infants so we can reduce their risk of certain food allergies when they are older.

Food that makes little ones go, “Aargh!”

• According to Prof Hugo:
• The most common food allergy in infants and toddlers is egg allergy.
• In pre-schoolers, peanut allergy is the most common.
• Seafood allergy is the most common food allergy among older children.

Prof Hugo brought our attention to the Learning Early About Peanuts (LEAP) study in the UK, in which researchers found that infants who were given peanut-containing foods had as much as 80% lower risk of developing peanut allergy by the time they turned 5. This finding led the American Academy of Physicians (AAP) to recommend offering peanut food products (such as peanut butter) to children who are at risk of peanut allergy from a young age. 

Prof Hugo speculated that, as we continue to conduct research into this area, it is possible that we would one day have nutritional guidelines to help parents minimise their children’s risk of allergies from an early age.

5 tips for parents

• Let the child play outdoors more. Most parents worry that their children would suffer allergic reactions when these children are let loose into the wilderness, but Prof Hugo stated that this is far from the case. Allergens such as house dust mites gather in greater concentration indoors, especially in the bedrooms, so the more time children spend in there, the greater is their exposure to allergens. “The bedroom is the zoo of the house dust mite,” Prof Hugo remarked. “Don’t let your child live in there!”
• Keep clean, but not too clean. Keeping the child’s environment totally sterile actually increases the risk of developing an allergy, Prof Hugo said, as the body never gets a chance to become desensitised to allergens. It may be fine to keep a pet, or to let the house get a little “messy” now and then.
• Breast is best. “Breast milk is a living milk,” Prof Hugo stated. No other milk in nature is as good as a mother’s milk. A mother’s milk is complete when it comes to nutrition, and, unlike any other milk, it contain antibodies from the mother to support an infant’s immune system.
• Keep good bacteria around. “Bacteria are our friends,” Prof Hugo declared, “so don’t kill our friends!” Our gut is the natural home for many types of helpful bacteria that support the immune system. Dosing a child with too many antibiotics at an early age, therefore, may kill these helpful bacteria before they have a chance to settle down in the gut. Prof Hugo recommended prebiotics as a means to help children who may need some extra help in maintaining a healthy population of useful bacteria in the gut.
• Use moisturiser. Research shows that children with eczema face a higher risk of developing food allergy. Moisturising the baby’s skin from birth can reduce this risk by as much as 50%, as the moisturiser can act as an extra barrier of protection. “Any moisturiser will do,” clarified Prof Hugo.

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Words by Hannah May-Lee Wong

Farah Putrinegara A. Bahrom
Clinical Psychologist

Bullying is a distinctive pattern of harming or humiliating someone who is perceived as weaker, smaller or more vulnerable. It is often an imbalance of power coupled with aggression, where the weaker person is deliberately attacked on more than one occasion.

According to clinical psychologist Farah Putrinegara, there are two modes of bullying: direct and indirect. Direct bullying is when a person is targeted, and the bullying happens only between the bully and the victim. Indirect bullying involves other people; for example, the bully might harm his victim’s reputation, spread rumours or say something to damage relationships.

There are also different types of bullying:

• Physical bullying consists of harmful actions such as hitting, pushing or damaging property.
• Verbal bullying includes cursing, throwing insults or saying something hurtful (for example, calling someone ugly or fat).
• Relational bullying involves ruining someone’s reputation or spreading rumours that cause others to distance themselves. This type of bullying is often indirect.
• Cyberbullying is bullying using technology. It could be a form of damage to property, like when a bully has information that he uses against the victim. There could be verbal aggression and relational aggression; for example, spreading rumours online. It could also be when the bully contacts the victim online and makes threats.

Victims of bullying are often people who are different from the rest. This could be in the form of having disabilities, looking different or even just being socially awkward. “Children who are timid, have a quiet personality, who do not typically fight back, or those who rarely speak up in class also tend to be the target of bullying,” said Farah.

How do I know if my child is being bullied?

As a parent, you’ll need to be more aware and observant to pick up subtle changes in your child. Here are some signs you should look out for:

• Your child has suspicious and unexplained injuries such as bruises, or their clothes are torn or ragged.
• Losing belongings such as books, stationery, electronics or other valuables.
• Avoiding school, sometimes making up excuses like having a stomach ache or headache.
• Change in eating habits – eating more than usual or having decreased appetite.
• Having nightmares, even becoming too afraid to sleep alone.
• Not wanting to mix with friends or other children they were once close to.
• Make passing remarks like “that girl said she does not like me” or “I don’t like that person” could be a clue that bullying is occurring.
• More seriously, a child might self-harm.

If you spot these signs, don’t ignore them. Investigate the cause and consider seeking help to solve the problem, such as speaking with your child’s teachers or someone from the school.

What are the long-term effects on the victims of bullies?

Constant fear, depression, anxiety, loneliness and low self-esteem are some of the psychological issues that, if not resolved, can carry on into adulthood. In some cases, bullying changes how the victims react to situations and how they interact with other people. If a person accepts being bullied instead of standing up for himself, he may always choose to keep problems to himself and this in turn may become the way he deals with other kinds of conflicts in the future.

Some children may be affected academically; even the brightest students can experience academic decline if they are distressed by bullying. If a child falls behind academically, it will take much effort to play catch up and this may affect his or her future academic opportunities.

What can I do if my child is being bullied?

Firstly, show you care by asking if the child is alright. Use gentle words like “are you OK” or “what’s going on”. Avoid being too forceful and avoid accusing him or her of doing something wrong.

It may not be wise to immediately schedule a meeting with the bully’s parents to confront them. “It’s not a good idea to have a meeting with teachers, parents and the bully together with your child in the same room,” said Farah. “When the bully is present, your child might get scared or be too afraid to tell the truth. Ask the teacher for help but it’s also important to ask your child his or her opinion. Instead of coming up with your own extensive list of solutions as a parent, you need to include your child in a trouble-shooting phase so that the child feels empowered. Meanwhile, you can still give suggestions and come up with ways to solve the problem together.”

When bullying goes online

Cyberbullying is a relatively new development and can be difficult to detect. How can we know if our child is being cyberbullied and what can we do about it?

Parents can look out for changes in a child’s use of electronic devices, such as:

• A child who likes to go online often suddenly avoids the internet and prefers doing other things like watching television instead.
• Hiding what he/she is doing online by covering the screen, minimizing the window or closing the browser when someone walks into the room.
• Getting jumpy or nervous when he/she gets a message, email or social media notification.
• Deactivating or recreating social media accounts.
• Saying things like “a lot of people don’t like me in school”.

Here are a few things you can do to tackle cyberbullying:

• Investigate the cause of your child’s change in behaviour; don’t ignore signs, subtle though they may seem.
• Ask your child if anything is bothering him/her. Give him or her a chance to express their thoughts before taking matters into your own hands by checking their phones or computers.
• Suggest to your child to tell the bully that “my parents are the administrators of my laptop and they can see what you are sending me” or “my parents check my phone sometimes and they know what you are doing”. If the bully is a child of similar age, chances are he would be scared that Aunty and Uncle might find out, and eventually he may stop bullying.
• If things do not improve, document the cyberbullying and keep records in case you decide to talk to teachers or school authorities.
• Call or meet with teachers to tell them what is going on. If your child’s school fails to stop the bullying or it escalates, you might need to involve law enforcement. In the meantime, remove your child from the situation by switching classes or even switching schools.
• With regards to your child’s emotional wellbeing or mental state, you may want to consider seeking professional help. Sometimes, it’s easier for a child to talk to a third party instead of to you. Look for qualified counsellors or clinical psychologists who have experience in handling children and issues such as bullying.

Why are some children bullies?

“Bullying is not something you are born with, it is something you learn,” stated Farah. “It is more common among neglected children, children of divorced parents or children who lack attention from their family.” Some children whose parents are involved with drugs or alcohol cope by bullying other children. In other cases, children may be bullied at home by their siblings and they try to regain power by bullying their friends to feel better about themselves.

“Sometimes, children may be young and simply can’t tell right from wrong. They just follow what their friends are doing,” Farah explained. “Some kids might say things like “if you don’t join me in doing so-and-so to that kid, then you’re not in our group”. So peer pressure might be a factor.” Another reason could be that some kids are just more assertive or impulsive and do not realize that their behaviour constitutes bullying.

My child is a bully! What should I do?

Bring up the subject by asking your child, “Someone told me you bullied so-and-so. Is that right?” Give him a chance to explain his side of the story before you proceed further. The next step would be to figure out why he did it. For example, a child could have low self-esteem and feel better about himself when he bullies others.

Then, give your child meaningful consequences. For example, if it is cyberbullying, take away his computer. It is important to explain to him why his actions were wrong. Try to get him to understand how the other person feels. After he realizes his wrongdoings, you can teach him ways to make things right again. Farah suggested getting your child to apologize, writing a letter or doing something nice to make it up to the other person. Monitor your child to see if the bullying happens again. It may be good to obtain a third person’s perspective, especially since emotions such as shame or embarrassment may cloud your judgment. If you think you need help, speak with a counsellor or psychologist. Seeking professional help is highly advisable if a child’s aggression becomes unmanageable, for example, if he lashes out physically or gets out of control. The child may have other underlying issues that have yet to be discovered.

What can we do to reduce incidences of bullying?

As with most issues, awareness and education are important. All of us ought to know what constitutes bullying and how to handle it. As parents, we need to be good role models for our children because they will follow closely what we do. “When times are tough and we’ve had a tiring day, we need to remember not to let it out on our kids because they will pick it up and start behaving as such to someone else,” Farah reminded. “Model good behaviour, teach them what it means to be a good person and that our actions have consequences.”

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