Timely Interventions: A Parent's Guide to Help Your Child with Special Needs

By Khadija Khan MD

Children diagnosed with developmental delays have specific medical needs that are often underserved. It is very important for each child to receive appropriate interventions in a timely manner, both environmental and pharmacological.

Dr. Khadija Khan relies on her twenty plus years of experience as a Child and Adolescent Psychiatrist to provide simple guidance and practical resources that helps parents to navigate the complex process of diagnosis and interventions. Dr. Khan provides her insight into various aspects of atypical development and the comorbid emotional and behavioral challenges which are commonly associated with developmental delays. As a Child Psychiatrist she believes in a multidisciplinary approach to maximize the learning potential of each child. She has provided parents with a simple background of medical, neurological and genetic conditions that often surrounds the delays. Parents will feel empowered to learn about the early screening, assessments, pertinent workups and therapeutic interventions.

Included are case examples and list of resources. In this handbook for parents of children with special needs, a child Psychiatrist shares her clinical wisdom and step by step understanding of working through the system of care. This book will bring hope and joy for the dedicated parents and caretakers in all areas of discipline working with these children.

• Language: English
• Publisher: Archway Publishing
• Release date: Oct 7, 2022
• ISBN: 9781665728683

Khadija Khan MD

Dr. Khan is a Child and Adolescent Psychiatrist practicing in the Illinois area for over 20 years. She has a special interest in helping parents with various abilities of children. She enjoys putting the pieces of each and every child in their biological, psychological and social context together. Her psychoeducation to parents has been a valuable part of her empowerment to each family that she has helped for decades.

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Copyright © 2022 Khadija Khan, MD.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the author except in the case of brief quotations embodied in critical articles and reviews.

Archway Publishing

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Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.

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ISBN: 978-1-6657-2867-6 (sc)

ISBN: 978-1-6657-2868-3 (e)

Library of Congress Control Number: 2022915170

Archway Publishing rev. date: 10/05/2022

CONTENTS

Dedication

Preface

Introduction

Chapter 1 Aspects of Development

Chapter 2 Most Common Problems in Kids Diagnosed with Developmental Delays Seeking Help

Chapter 3 Behavioral Disorders Related to Neurological Damage

Chapter 4 Common Chromosomal Conditions with Developmental Delays

Chapter 5 Medical Problems Contributing to DD

Chapter 6 Early Assessments

Chapter 7 Psychological and Neuropsychological Testing

Chapter 8 Neurological Exam at Baseline and Follow-Up

Chapter 9 Speech Evaluation

Chapter 10 Occupational Evaluation

Chapter 11 Medical Examination

Chapter 12 Other Screenings and Assessments

Chapter 13 What to Look Out For at Different Ages

Chapter 14 Early Interventions

Chapter 15 Food, Nutrition, Digestion, and Absorption

Chapter 16 ABA And Other Therapies

Chapter 17 Music or Listening Therapy

Chapter 18 Neurobiofeedback

Chapter 19 Special Olympics and Other Recreational Activities for Kids

Chapter 20 Helping Parents Teach Emotional Regulation to Kids with Special Needs

Chapter 21 Psychiatric Evaluation

Chapter 22 Psychotropic Medication

Chapter 23 Therapeutic Interventions

Chapter 24 Case Study

Chapter 25 Take Care of Yourself to Take Care of Your Child

Chapter 26 Post-Pandemic Thoughts

Chapter 27 Final Words

Additional Resources

About the Author

DEDICATION

This book is dedicated to all the parents and children with special needs, whom I have the privilege to treat. Improving their quality of lives is the pride and joy of my work.

PREFACE

In my years of working with children with special needs and their families, I have seen parents show the utmost dedication toward their children and endless faith in various interventions. It is so important for parents to know that they did everything they could to bring about the best outcome for their kids. It is heartbreaking to see them with regrets at times for not starting a certain kind of therapy early enough in a child’s life. They all have some instinctual sense of their children’s special needs and at times atypical course of development.

This book is a small attempt to help parents at the beginning of this journey to understand the impact and importance of the diagnostic and therapeutic work that will be so monumental in their lives as a family. As knowledge is power, my hope is that once parents understand the basic areas of available resources and disability services in their school system, they will be able to make better decisions. Whether any of these interventions delivers miraculous results or not, at least parents will feel fulfilled in their hearts for trying.

For the purposes of this book, I have focused on giving parents an improved understanding of the developmental and clinical aspects of children’s special needs. Behavioral-science research is generally lacking on children, especially when it comes to treatment and medication. Therefore, it’s important to use caution and find a balance between early interventions and safe practices.

The statistical data for the prevalence of various conditions in this book is based on clinical practice and the American Academy of Child and Adolescent Psychiatry. Some of these numbers are always changing, and I have tried to focus more on action plans, available resources, and opening minds to a diagnostic understanding of each child so that the right interventions can be done.

The list of different conditions and specific syndromes is offered only for a broader understanding of the complexities of growth, from typical to atypical. These are not all-inclusive lists. I am hoping that in this age of Google and WebMD, parents will find skilled professionals to guide them through their journey and not get overwhelmed by a flood of online information. Parents should find that knowledge helps them feel empowered and not overwhelmed, if gathered correctly.

At the end of the day, it is important for all of us to improve the quality of life for each and every person in our household. For some, this will come with the right kind of therapy; for others, with a school-based intervention. But for most, there is at least some added medication that can help a few symptoms become more manageable. The key is to find the best combination of all of these to get the best results.

Parents, remember that it’s a privilege for any discipline of professionals to play a small part in and hold your hand on this amazing journey. Good luck, and more power to you.

INTRODUCTION

I have been working with children with special needs and their families for the last twenty years. I see these families as an amazing group of caretakers who will do whatever it takes to get the help their children need. I see them spending an enormous amount of physical, emotional, intellectual, and financial resources to get to the bottom of their children’s diagnosis. I have also seen that many times, they work harder and not smarter.

Through my work as a child and adolescent psychiatrist, it’s become clear to me that in today’s world, we still do not have sufficient resources for children diagnosed with disabilities to fully thrive. They have very specific medical needs that continue to go ignored or underserved. I have been practicing in Chicagoland for my entire career, and I have developed a love for working with these families in order to guide them toward the right resources at the right time.

It is very important to get appropriate intervention in a timely manner. In some cases, that involves environmental interventions, and at other times, it may mean medications for debilitating symptoms. One truth is that you can never expect all the answers from one intervention. For example, you cannot put a child on medication to improve attention and focus without working with the school system to provide an individualized education plan (IEP). Likewise, you cannot insist on pursuing cognitive behavior therapy and implement a behavioral support plan in a situation where the child needs a medication intervention before any behavior plan is offered.

It is important to know, as parents of a child diagnosed with an intellectual or developmental disability, that behavior plans are an important management technique for children with severe disabilities. However, if your child is not equipped with impulse control or has severe anxiety, any such behavioral interventions will yield partial results at best. Therefore, it’s important to pursue these interventions in the correct order to obtain optimal results. There is a great need for parents to have experts guiding them on where to put their resources, especially regarding when and how.

School-age children with special needs may have a variety of challenges. They may have better-understood diagnoses like attention deficit hyperactivity disorder (ADHD), anxiety, or mood disturbances. Or they may have more complex developmental and learning delays. In fact, children with developmental delays are by far the most challenging population that child psychiatrists will work with. Psychiatrists’ responsibilities range from developing a comprehensive diagnostic understanding for parents and educational teams to understanding atypical and maladaptive behaviors in different social and learning environments.

Many children I see in my practice have some degree of developmental delay, including diagnoses of autism spectrum disorder (ASD) or broad-spectrum general developmental delays. They may also have accompanying intellectual delays or other psychiatric disorders. There is a high prevalence of neurological abnormalities in these children.

To make matters more challenging, their behaviors and functioning are affected constantly by their medical, neurological, metabolic, and chemical imbalances. It should be our first and most important work as experts to help families understand the complicated relationship between body functions and behaviors. We see this phenomenon when children are feeling ill or have a fever. They are just not themselves. They are clingy, whiny, don’t have an interest in doing playful activities, and have a reduced appetite. Once the fever breaks, you can see their personality coming back. Their difficult behavior was not a behavior problem. They just had instability in their metabolic and chemical balance at all cellular levels.

Once parents and caretakers understand the basic fact that their child’s behaviors are not equal to a behavior problem—rather, they are the manifestations of the larger scheme of things—they gain a whole new perspective on helping their child.

We all hear statistics about the rapidly increasing prevalence of autism in the world, with conflicting theories about the cause of the diagnosis. But there is little information to answer the question, Where do we go from here? It is my hope to put together a brief but concise outline of challenges and timely interventions that helps families have more answers and a renewed sense of direction in these situations.

As most of my readers know, autism is not a singularly defined or simple disorder. It is a broad spectrum of various presentations and combinations of a multitude of symptoms. It gets even more complex when we find that each child presents with a different proportion of core symptoms. For example, we can identify the social/communication deficit, atypical stereotyped behavior and obsessive compulsive patterns as the common core symptoms. In fact, the combination of these core symptoms may present in hundreds of different combinations.

One can see a seven-year-old diagnosed with ASD with good verbal skills but high social anxiety and an obsessive interest. On the other hand, we can see another seven-year-old with few verbal and communication skills and excessive repetitive OCD-like patterns, along with complicated mood swings and self-injurious behaviors. The treatment plans for these children may involve different interventions at school and in the home. It is common for each case to be different as it relates to each child’s deficits and presenting issues. Therefore, the examiner and professionals should be able to think of more specific interventions and recommendations at various levels.

When I see a family with a child with a diagnosis of developmental delays for the first time, I am always amazed by their journey—from pregnancy and birth, early developmental concerns, to finally receiving a diagnosis. I see that parents often suspect that something is not right in their child’s development way before the official diagnosis.

There have been countless instances where I’ve reviewed medical and developmental histories of these children with parents. I see a common theme of parents being told by medical professionals that children learn at vastly different rates. They all get support and encouragement and are often told, Let’s keep an eye on this. This is especially true for mothers concerned about delays in social milestones, motor control, speech, communication, odd sensory or obsessive habits, and other atypical behaviors.

By the time I see these families in the early school years, parents feel some level of grief and resentment for not having done something earlier. This may or may not be true for many children, but it’s important for all professionals to acknowledge that we do not have answers for all the questions parents have. The least we can do for them is listen.

I often find myself comforting parents that the pediatrician’s job is to mostly look into the normalcy of growth and prophylactic care. On the other hand, as a child psychiatrist, I find myself looking for anything atypical or different all the time. It is easier to understand after the fact that a five-year-old kindergartener with developmental issues who was not walking at fourteen months was actually showing signs of early delays in motor areas and not just a normal variant of motor milestone development.

Parents often feel that some intervention in the first