Thursday, November 26, 2015
Saturday, October 10, 2015
Monday, September 14, 2015
HELPING A HYPERKINETIC CHILD TO STUDY
Getting a child with attention deficit hyperactivity disorder to study is a challenge in the home and school.
I am copying down some points mentioned in Dr Malvika Kapur's book, which will give parents an idea about how go about organising their studies.
1. Reduce distractions in study area ( Study area should be in a quiet place, no TV/ Music/ mobile phones to be allowed), clear the study table and remove distracting posters and displays
पढ़ने के स्थान पर ऐसी कोई वस्तु नहीं होनी चाहिए जिससे बच्चे का ध्यान बटेगा. उदहारण के तौर पर- मैज पे राखी चीजे, दीवारों पर चित्र, या कमरे में टी व्ही, सेल फोन, इत्यादि का होना.
2. Structure the task- breal down the study in logical small bits- so it is possible to proceed in a step by step way
पढाई के छोटी खंड बनाये ताकि बच्चा एक- एक कदम पढाई कर पाए
3. Set short term goals. Means give one bit of the task (Write one answer/ do 2 sums, etc)
पढाई का एक- एक खंड बच्चे को समाप्त करने दे, उसके बाद आगे बढे
4. Break long assignments into small parts so the child can see an end to the work
बच्चे को पढाई के नियोजन के बारे में बताये ताकि वोह समझ सके की पढाई कब ख़त्म होगी
5. Seat the child near a good role model or 'study buddy'
बच्चे को अच्छे छात्र के बगल में बिठाये ताकि वह उसका अनुकरण कर सके
I am copying down some points mentioned in Dr Malvika Kapur's book, which will give parents an idea about how go about organising their studies.
चंचल बच्चों की पढाई का नियोजन करते समय
निम्नलिखित मुद्दों का ध्यान रखें. ये मुद्दे घर और पाठशाला दोनों जगहों के लिए
हैं. ये मुद्दे डॉ मालविका कपूर, बेंगलोर, इनकी किताबसे है.
पढ़ने के स्थान पर ऐसी कोई वस्तु नहीं होनी चाहिए जिससे बच्चे का ध्यान बटेगा. उदहारण के तौर पर- मैज पे राखी चीजे, दीवारों पर चित्र, या कमरे में टी व्ही, सेल फोन, इत्यादि का होना.
२.
2. Structure the task- breal down the study in logical small bits- so it is possible to proceed in a step by step way
पढाई के छोटी खंड बनाये ताकि बच्चा एक- एक कदम पढाई कर पाए
3. Set short term goals. Means give one bit of the task (Write one answer/ do 2 sums, etc)
पढाई का एक- एक खंड बच्चे को समाप्त करने दे, उसके बाद आगे बढे
4. Break long assignments into small parts so the child can see an end to the work
बच्चे को पढाई के नियोजन के बारे में बताये ताकि वोह समझ सके की पढाई कब ख़त्म होगी
5. Seat the child near a good role model or 'study buddy'
बच्चे को अच्छे छात्र के बगल में बिठाये ताकि वह उसका अनुकरण कर सके
6. Use some physical contact with the child, such as hand on the shoulder, or directing arm and hand movements
स्पर्श द्वारा बच्चे को प्रोत्साहित करे- जैसे की सर पे या पीठ पे हाथ रखने, उसका हाथ पुस्तक की ओर बढ़ाना, इत्यादि
7. Avoid teaching at frustration level. Teach at a level that the child can cope with, and at a level that is mildly challenging to the child
बच्चे की क्षमता के मुताबिक ही उसे सिखाये. पाठ न बहुत कठिन ना बहुत आसान होना चाहिए.
8. Be sure the child understands what is being taught
ये निश्चित करे की जो पाठ पढ़ा रहे है, वह बच्चा समझ रहा है
9. teach only when the child is motivated and ready to work and not when child is tired, irritable or wishes to do something else
बच्चा जब पढाई की ओर अभिप्रेरित हो और उसका दिमाग ताज़ा हो, तभी उसकी पढाई ले. जब बच्चा थका हुवा, चिडचिडा हो तब उसकी पढाई न कराये.
10. Shorten the study period to coincide with the attention span of the child. A timer can be used to measure
उसी इतनी ही पढाई की अपेक्षा करे, जितना की उसका ध्यान रहे. ये समय जानने के लिए घडी का इस्तेमाल कर सकते है.
11. Instruct the child in self- monitoring
बच्चे को अपने- आप पर ध्यान रखना सिखाये
12. Pair written instructions with oral instructions
बच्चे को लिख कर और बताकर पढाई समझाये.
13. Cue child to stay on tasks- means give him signal to return to task when you see his attention wandering
जब भी बच्चे का ध्यान घुमंते हुए नजर आये तो उसे किसी संकेत से ध्यान फिर से पढाई की ओर लाने की आदत डाले
14. provide ‘seat breaks’, that is, running errands, cleaning blackboard, collect the books, etc
थोड़ी पढाई के बाद रुकने की अनुमति देना, और कोई और छोटे काम जैसे किताबे रखना, फलक साफ़ करना ऐसे काम बताना.
15. allow the child to stand at times while working. This also means to ignore bit fidgetiness, back not straight, little bit of facial movements
अगर बच्चा पढ़ते समय थोडा बहुत खड़ा हो जाये, या मुह बनाये तो उसकी ओर नजरंदाज करना चाहिए
16. use multi sensory teaching approach with specialized teaching materials
विशिष्ठ उपकरानोसे और सीखनेके मध्यमोसे बच्चे को बहु-संवेदिक रूप से सिखाने की कोशिश करें
17. make special effort to keep up their interest and motivation with adequate and immediate reinforcements as they tend to get bored easily
चंचल बच्चे पढाई से जल्दी ऊब जाते है, उनकी दिलचस्पी बनाये रखने के लिए खास प्रयास करना चाहिए. जैसे की- अछे काम की तुरंत प्रशंसा करना
18. give frequent clear feedback about child’s performance (good, keep it up)
बच्चे के काम के बारे में उसे प्रतिपुष्टि दे, और वह अछे शब्दों में दे
19. be firm, do not allow the child to escape a task that you know he is capable of performing
कभी- कभी बच्चा पढाई करने से मुकर जाता है- उस समय दृढ़ता से उसको डेट रहने की सलाह दे ताकी थोड़ी चुनैतिवाला काम भी करने की उसे आदत पड़ेगी
20. be consistent. Do not alternate between giving in to the child and being form about completing a goal
हर बार एक ही तरह का व्यहार करे. कभी बहुत दयालु कभी बहुत ज्यादा सकती, इस तरह से पढाई न ले.
21. ignore minor impulsive behavior
थोडे- बहुत आवेगशील बर्ताव को नजरंदाज करे
22. use time- out for misbehavior
यदि अभद्र व्यवहार करे तो कुछ मिनिटों के लिए उसे कोने में खड़ा करे.
23. acknowledge positive behavior
अछे बर्ताव की प्रशंसा करे
24. help child organize his daily routine
आपने दैनिक काम- काजोंका नियोजन करना उसे सिखाये
25. look for signs of stress build-up and provide encouragement or reduce work load to alleviate pressure and avoid temper outbursts
यदि बच्चा तना हुआ नजर आये तो उसको थोडा आसान काम दे वरना बच्चा बेचैन हो सकता है और उत्तेजित भी हो सकता है.
Saturday, July 25, 2015
Tuesday, July 21, 2015
Monday, June 29, 2015
Friday, June 5, 2015
Wednesday, May 13, 2015
LIMITS OF PSYCHIATRY
“ ……..so doctor, I want my son to learn to swim at any cost.
Do anything and reduce his fear of the pool…..” The child in question is 4 years old
“……… we should now ask Psychiatrists to step in and do some
counseling to provide stress management to the Police force so such incidents
do not occur……” response to a recent case of fratricide
“……….this happened because they don’t have regular full-time
counselors and Psychiatrists on campus……” response to the student suicide on
campus of a premier engineering institute
On the one hand, Psychiatrists have to face stigma and
people do not like to take their advice where due. On the other hand are
instances where Psychiatrists are seen as a panacea for all behavioral and
social problems- as the above examples show. Psychiatrists also sometimes get
carried away and try to get involved in things that should do not fall in their
jurisdiction. So it is very important to understand the limits of Psychiatry.
What can Psychiatrists do, actually?
Psychiatrists are trained to treat mental illness. Most
training programs cover only treatment with medications. So strictly
Psychiatrists should restrict to treating only disorders with medications. No
patient ever recovers merely by ‘spending time’ with a Psychiatrist. There are
other people to spend time with, even for a fee.
What do Psychiatrists need, to work?
The other common myth is that Psychiatrists can work in a
vacuum, without any facilities or instruments. But a Psychiatrist needs a
quiet, safe sound proof room to work. Basic instruments like BP instrument,
weighing machine, height measure and basic neurological exam instruments are
needed. Every Psychiatrist needs the assistance of clinical psychologist,
counseling psychologist, social worker, counselor and receptionist. Without the
inputs from these people Psychiatric interventions remain disorganized,
incomplete and become excessively medicalised.
Who should meet a Psychiatrist, really?
I have always felt that people should try to meet their
family doctor or counselor first and then meet the Psychiatrist if recommended.
But in India- the poor training and unscrupulousness of primary health care
workers makes me recommend ‘ when in doubt meet a Psychiatrist’. This is said
with the hope that the Psychiatrist will be well trained and honest. Unless
there is a clear mental disorder or your Psychiatrist is trained in
Psychotherapy- there is no role for Psychiatrist involvement. But Psychiatrists
have one advantage- they are invariably trained in methods of diagnosis and at
least you can find out what is wrong with you.
Social problems and Psychiatrists?
Psychiatrists cannot solve social problems based on their
training and professional degree. The correct scientific method to solve a
social problem is to study it from different angles- find solutions from
different disciplines and then involve Psychiatrists only to treat mental
illnesses.
So to the above 3 vignettes, I will say
‘….whats the hurry to teach him to swim. Let it go, now. Try
again when he grows up. Bring him for treatment when he grows up and realizes
that his anxiety is a problem and he is willing to learn how to deal with it…..”
“ several excellent studies on causes of stress in the
Police force have already been done. I can cite the study done by Dr S K
Chaturvedi of NIMHANS, Bangalore.
So commission a similar study for this particular Police
force. (And please don’t tell Psychiatrists to do this study; better trained
professionals are available). I doubt if
there has ever been an attempt to screen applicants for mental sturdiness
before inducting them into the force.
Find out what stresses the Police. Remove those stresses which are
amenable to removal. And teach stress management for the stress that cannot be
removed. For example- police reforms have been pending for ages. Housing
facilities are pathetic. Solve these
problems. Catching thugs is stressful- teach them to deal with this.
It is ridiculous to believe that Psychiatry should teach
people to perform and stay healthy under inhuman conditions manufactured and
maintained by an insensitive system.”
“…..students are conformists and rebellious at the same
time. I don’t think students are going to accept mental health specialists
telling them what to do. Hostel students’ parents blame the college for causing
stress, whereas colleges blame parents for pressurizing students- eventually troubled
students become nobody’s responsibility. Clear administrative guidelines need
to be formulated to deal with such situations. I don’t believe that a premier
institute with a fully functioning department of humanities cannot put together
such a protocol for their institute. What can a Psychiatrist do when an
underage student comes alone for help? Actually it is illegal to treat a
student without expressed consent of the parent or guardian.”
Friday, May 8, 2015
Sunday, April 26, 2015
Tuesday, April 21, 2015
Monday, April 13, 2015
Wednesday, March 11, 2015
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