1.AUDIOLOGY/SPEECH LANGUAGE PATHOLOGY-Ashi Susan Kuriakose
linguistics online class
humanities student underging online class- vocational hogher secondary- achievemnt of 7 th grade- wrote SSLC WITH THE HELP OF SCRIBE -" wll not live if failed in the exam "-
LD - academic issue - problems in reading writing- maths- ; life skills ok , ignorant of letters , "ka" "ma"-in Malaayalam- confusion with joined letters, symbols - problems with letters in English also-
INTERVENTIONS-
goalsetting important-training in sound production- spelling errors corrected with the help of phonics - exceptions - try seperately-
2.CLINICAL PSYCHOLOGY-Jayasree KG
3.NUROLOGY-Jasni. M P ,
Math Clinic OSERVATIONS-
EVALUATION TOOL USED-games used -tangrams
maths evaluation tool- diagnostic test-5% cut off - test of arithmetic ability-NIMHANS(INDIAN NORMS)
QNS- 1.count the number in each box 2. comparing the number in each box -3.read the numbers and copy it in numerals ( the doc takes the paper back without any courtesy while I was noting down a few ideas -seemed not interested in sharing this information- licensed property)
PATIENT 1
2 1/2 years autistic child - home activities mother - find out what toy he is interested- note the book he is demanding - 1 1/2 minutes provision of preference - find comfortable place - take an appointment on Monday-look for repeated activities- be calm ,slow and clearcut in giving instrucions-shows a board game with colourful icons
IQ test can only be purchased by professionals
PATIENT 2
A GIRL IN 5 STD-english medium school-Parents complains about being agressive -no emotional expressions- rigid attitude - not cryng when pained - not expressing even when hurt-academically brilliant -reads selective books -fictional stories of Sudha Murthi , Anne Frank -spends most of time on TV , mobile, likes foreign culture, western culture , basically luxury loving , does not accept reality .
DOC INTERACTION WITH THE PARENTS with the help of evaluation tool
any friends - no comfort zone - no social mingling- reserved-prefers to sit at home _one of the class toppers- leadership in school activities -draws a bit -COVID induced inactivity-comfrtable at home - does not like sharing-not intereested in class schedule-not attending "Kuran" classes- recently backward in Maths--no doubts-microfamily only recent- thinks expressing emotions something inferior- attentiondeficit-not planning everything- last minute rush-highly skilled- goood orator-parents worried that it seems academic performance apparently going down- says excuses for not doing things on time-intentional or not - can not identify-whether she is lying- gadget friendly-
how long ? screen time toolong - no game - blogging - web series- fictional- not reading now -recent changes for the last 2 1/2 years - pushing by mother- not accepting time schedule for routine - conflict with sibling ( 6years old ) - does not show affinity to the little child - no problem with the cousins - not reaching to the cousins - screaming aloud " Why am I scared ? Who should I fear ? About friends- Nisha is highly selective , every body is rude to me , obsessed , craves for attention , serves friends deliberately,
Doc : stubborn ? likes travels ? luxury foods ? gifts ? likes foods ? living in flat ?
PARENTS : compares herself to cousin WHO IS FINANCIALLY better.- does not help parents- not responding properly-acts smart before visitors- highly eccentric recently-
DOC : analyses : TV PREFERNCE-thyroid issues- pregnancy issues- does not like milk- fits nil- breast feeding - 9 months -feeding pattern -eats a lot foody - attitude -
milestones k ? -conversation / communication issues- relationship with father and mother- do you value her feelings-
Father- "when I am busy , I cannot"
Dislikes physical activity - not much , plays cards with cousin rarely.
finishes schedules but not on time -shouts @ her little brother - a recent dislike for schools - like walks alone - not interested in maths- keeps things safe
ready to do paid services - keeps secrets-afraid of ghost stories- it prolific ?
Doc comments to the parents
Positives - no problem in behaviour - emotional ,highly selective,
Negatives-she can not balance her expressions - may be taxing for mother and father- upskillilng is required- needs interaction with the child - no friends connection- feels attention lack from my mother - now she feels a need but no skill in creating friends - she always waits positive reponses-need not reveal herself easily- need a half day session with the child - restless is not a serious problem -blogging is creativity- she is not able to finish other chores because she is lost in writing -
final observation : must do other tests for evaluation
INTERACTION WITH THE CHILD
-Asks the child many questions about her school- holy angels - CBSE - vanchiyoor-5th grade - asks about the class room- how to reach the class from the office room-( likes books -library- period of reading - like schools - extra curricular / enojys PE / practses DANCE -study related activity / assembly / role in assembly as monitor/ house wise charge / about play ground / about teachers / some of them hard / phy puishment / yes / 4 students in a bench / I like my hindi teacher/ some teachers allow to place the bag on the desks.others dont.she likes her hindi teacher- friend Neelima-enjoyed the trip from the school to magic planet - she liked the shows - describes vividly- mother often intervenes to correct the child- the child likes her cousin because he is protective and sharing-this session ends - There will be a detailed session next Monday
The child leaves with the parents .
Gen evaluation by the doctor
- She has not much problems- She articulates well - but there is a need of a detailed evaluation session-
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4.PHYSICAL MEDICINE AND REHABILITATION UNIT-.Preethy.S.L
PAEDETRIC ASSESSMENT
PATIENT 1 : severely spastic - CP-14 years boy- birth complication ,prologed labour-
The doc hands over a copy of the evaluation tools and allows us to ask about the tool-i askked about DTR reflexes - DTR FOR deep tender reflexes-( SPASTIC-EXAGGERATED RELEXES,PLACIDITY-SLUGGISH RELEXES;NORMAL-JERKY RFLEXES)
REHBILITATION PROCESS-
SPASTIC - slow movement , placid -fast movement
PATIENT - 2
A CHILD with no neck and roll movement- CP -no movements
Therapy- Activities
-neck wedge - trunk balance nil-spine strengthening-sitting-bed -pillow-crosslegged position-bog basin sitting-standing exercises-half knee standing (മുട്ടിൽ നിറുത്തുക )
DISCUSSION -GROWTH AND DEVELOPMET-NECK MUSCLES
3-6 MONTHS :critical period
rises neck @ 3 months , neck tightens @4months, turns aound and lies down with face raised within 2-2 1/2 years , rrely before 5 years,
causes of delay : look for Down Syndrome - comorbidities -heart problems
PATIENT : 3
A LEAN girl of 4 1/2 yrs age - one of twins -talkative , meaningful responses -spastic- delay in growth (self note :Spasticity is a condition in which muscles stiffen or tighten, preventing normal fluid movement. The muscles remain contracted and resist being stretched..)- parents being nurses-growth issues identified very early and therapy initiated on time -born early, 33 WEEKS - BW 1.100 kg-memory normal- language normal-uses past tense -slight issue in eye coordination-IQ normal-has disrathria-leg slightly curved
THERAPY ACTIVITIES
-mobilisation and stretching MS,(rhythmic rotation RR,sustained stretchingSS,PNF,),weight bearing WB, activating weak and antagonistic muscles, orthotics and assistive devices ,aquatic therapyAT, teach and prompte proper positioning,practice functional skills,facilitate normal patterns of movement
1.LEFT HAND MS,RR,SS
2.LEFTSHOULDER MS,RR,SS
3.HELPS to turn whole body to right side - a painful monoveure-neck movement not easy-cano sit alone- bowed posture- feels like falling- gives a bog doll( a dog named Kalyani) to hold on -
4.repeats with the right side
5.sits with crossed legs for trunk balance-tries to make her crawl -teaches the sequnec of movements for crawling - reinfocement , a kiss to the doll for each movement
6. make her sit on gym ball-make her lie with face upwards, make her lie with face downwards,makes her look upwards,make her try to stand by herself -holds her hand and compels her to walk - tells mothre to try the same activity again- advises to do the activity at home
7. therapy for scissoring gate ( W sitting )- ball exercises- other activities tol to the mother in earlier sessions-
Discussion- the curved in the leg may become normal after 4 1/ 2 years ...hydro theraly at home will do good - if scissoring gate exisits even after learning to walk , surgery is an option-
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Patient 3 : A kid with emotional outbursts.......3 years 6 months old boy ...referral from CD C, - treatment @ICCONS for 1 years 6 months ....hydrocephalism-ventricles affected-placid muscles-can not walk properly- alernate stepping not possible -can climb starirs up, but panicky while stepping down
THERAPY ACTIVITIES
- keeps him lying back and makes kim kick in the air , make him sit , makes him walk slowly
-rotating movements-practising walking up a ramp, with fans switched off to get maximum resistence -strenthening activities-has wide stepped gait-flat foot -has got training at home to walk in sand - the doc uses loud complimets like "very good" , "good boy"
DOCTOR COMMENTS : Hyposis - protruded abdomen - language delay(making him lie, make him stand)- IQ seems not normal- can imitate- crosslegged position slightly difficult for the child , just for 5-10minutes-the child has just started walking-lingustic training to be intiated soon-
ACTIVITY- MAKES HIM SIT IN CROSSLEGGED POSITION-balanced walking again- MAKES HIM CLAP - helps him step down slowly
5.SPECIAL EDUCATION SCHOOL-Sulochana P.S.-Leader
6.ACADEMIC SESSIONS
A brief discussion on L D
with the help of ppt presentation
-technical issues with screen presention- says technician on leave !-
Discussion- What is a language disorder ---- types of disorders-challenges-samples of writing problems -eg of mirror writing - dysgraphia- association of sound woth letters- proper accomodations -
CLICK HERE FOR THE PPT-LD WHO ?
Reasons for writing disorders ppt
MAIN CHALLENGE :
Reading issues - boys more susceptible- intervention by teachers with compasssion-harassment in many private schools - students who reprt here are mainly from vallakadavu, BEEMAPALLI- DEPENDS on how parents treat their wards- the craze for A+ GRADE disorder -
lack of consensus in the family-eg a mother and the child reprting at the ICCONS- THE Y WANT TO LEARN TO READ -
MOTHER ready to cooperate with the dos and donts -But father not cooperative
Speech and Language Disorders-
.........with the help of ppt .......
SPEECH ASSESSMENT
- Assessment- ALDM-MAIN CAUSES-CP / AUTISM / M.R
BASE LNE PLAN- IEP
TOOLS- ASSESMENT OF LANGAUAGE DEVELOPMENT- PLAN-experienc is most important - autistic students may have talents in other fields- a yoube savvy boy with autism could read a word at accidetal glane- group therapy- no right based approch- no one refered to RPWD ACT 2016-
Registration Process
details- register- form filled- patient taken to varioes departments- spl education -5 years- therapy , date will be given in advance - nuroligy 2 days a week - fee depeds on oncome -ranges from 100-250/-- no NRI FEES NOW - fee for therapy - 40,60,80
no residential classes now.online corses and classes
LANGUAGE AND LINGUISTICS
ABIDAS NOTES
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