Behavioural/Learning Disorders: ASD, ADHD, Dyspraxia
Autism Spectrum Disorder (ASD)
Features
Social: Poor eye contact, no interactive play, limited gestures/emotional reciprocity, difficulty understanding social cues
Language: Delayed speech, echolalia, monotone speech, limited conversation skills
Behaviour: Ritualistic routines, repetitive movements (hand-flapping, spinning), restricted play interests
Sensory: Hyper-/hyposensitivity to textures, sounds, pain, bright lights, or crowded environments
Red Flags
No gestures (pointing, waving) by 12 months
No babbling by 12 months or words by 18 months
No two-word phrases by 24 months
Loss of previously acquired social or language skills
Management
Screening: M-CHAT at 16–30 months, early detection improves outcomes
Diagnosis: Paediatric referral, ADOS testing, multidisciplinary assessment
Interventions:
Behavioural therapy: Applied behaviour analysis (ABA), speech and language therapy
Educational support: Individualised learning plans, structured classroom settings
Comorbidities: High prevalence of anxiety, ADHD, sleep disturbances—address accordingly
Attention-Deficit/Hyperactivity Disorder (ADHD)
Features
Symptoms present in at least two settings (home, school) before age 12
Subtypes:
Hyperactive/Impulsive: Fidgeting, interrupts conversations, excessive talking, difficulty waiting turns
Inattentive: Easily distracted, forgetful, poor organisation, loses items, avoids tasks requiring sustained focus
Management
Non-Pharmacological
Behavioural strategies: Routines, visual schedules, positive reinforcement
Environmental modifications: Reduce distractions, provide structured learning settings
Task segmentation: Break tasks into manageable steps
Sleep hygiene: Address sleep disturbances, minimise screen time before bed
Referral: Paediatrician for confirmation, support planning, and further assessment
Pharmacological
First-line stimulant therapy:
Dexamphetamine or methylphenidate (adjusted doses based on response and side effects)
Side effects: Reduced appetite, stomach aches, sleep disturbances, irritability
Non-stimulant options: Atomoxetine for cases where stimulants are not tolerated
Dyspraxia (Developmental Coordination Disorder)
Presentation
Onset in childhood, normal IQ but impaired motor coordination
Motor delays affecting:
Academic: Handwriting, using scissors, difficulty copying from a board
Social: Avoids playground activities, struggles with sports, poor coordination in group activities
Clumsy movement, poor balance, slow motor learning
Struggles with planning and organisation, often misinterpreted as inattentiveness
Management
Physiotherapy: Improves gross motor skills, coordination, and balance
Occupational therapy: Focuses on fine motor skills (e.g., handwriting, buttoning clothes)
School support: Tailored educational strategies, additional time for written tasks, assistive technology if needed
Social and emotional support: Address self-esteem issues due to difficulties in coordination-based tasks
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