CHILDHOOD TANTRUMS

CHILDHOOD TANTRUMS

What are tantrums?

Tantrums represents a child’s way of communication being upset in the absence of matured language or expressive skills. They can involve sudden bursts of anger, frustration and disorganised behaviour. The child may demonstrate cats of crying, screaming, kicking, falling down, flailing about or running around. Sometimes, they may hold their breath, vomit, break things or get aggressive. It is also a learned behaviour.

Click below to watch a video on how to deal with tantrums

Why do tantrums happen?

Tantrums are very common in children aged between 1-3 years because at this age, the child’s social and emotional skills are only just starting to develop at this age. Children have not learnt enough words to express their emotions yet.

There are some factors which may make a child more likely to throw a tantrum:

  • Stress, hunger, tiredness or being overstimulated. In these situations, a child is more likely to throw a tantrum
  • Situations that children just can’t cope with. A child may not be able to do a puzzle or had a toy taken by another child
  • Each child has different ways of reacting to being upset or frustrated

How to reduce the chance of tantrums

Here are some things you can do to make tantrums less likely to happen:

  • Reduce stress or tiredness. Let your child sleep when he/she is tired.
  • Tune in to your child’s feelings. Help your child manage his/her feelings in a calm manner
  • Identify tantrum triggers so that you can prepare ahead. If your child throw tantrums when you do grocery shopping, it might help to go after your child has had a nap and a snack.
  • Talk about emotions with your child. For example, ‘Did you throw your puzzle because you were upset you could not fix it? What else could you have done?’

How to handle tantrums

Sometimes tantrums will happen, no matter what you do to avoid them. Here are some tips to handle tantrums:

  • Stay calm and do not get angry because it will make the situation worse. Keep your voice calm and avoid showing your emotions of frustration or anger
  • Acknowledge your child’s feelings to prevent the behaviour getting more out of control. It also gives your child a chance to calm down
  • Wait out the tantrum but stay close to your child so that he/she knows you are around
  • Try not to give in to what your child wants but instead reason with him/her
  • Do not give rewards to manage the tantrum as it will send a wrong message to the child
  • Be consistent and calm in your approach

Click below to watch a video on 5 tips to handle your child’s tantrums

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Ms Katyana

Ms Katyana

Psychologist

AUTISM: HOW TO RECOGNISE THE SYMPTOMS

AUTISM: HOW TO RECOGNISE THE SYMPTOMS

When you suspect that your child may have some behavioural issues, you need to know what symptoms to look out for.

Autism Spectrum Disorder (ASD) is characterised by ‘persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviours used for social interaction and skills in developing, maintaining and understanding relationships’.

More than half the children would have the diagnosis by the age of 6 years and over 90% diagnosed by the age of 12 years.  Boys are affected more often than girls.

Source: canada.ca/en/public-health

Definition (DSM-V Criteria)

  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted, repetitive patterns of behaviour, interests or activities
  • Symptoms must be present in the early developmental period but may not become fully manifest until social demands exceed limited capabilities or may be masked by learned strategies in later life
  • Symptoms can cause clinically significant impairment
  • Disturbances are not better explained by intellectual disability and Global Developmental Delay (GDD)
Source: harkla.co

What are these repetitive patterns of behaviour?

  • Stereotypes or repetitive motor movements, use of objects or speech
  • Insistence on sameness, inflexible adherence to routines or ritualised patterns of either verbal or non-verbal behaviour
  • Highly restricted, fixated interests that are abnormal in intensity or focus
  • Hyperactivity to sensory input or unusual interest in sensory aspects on environment

Click below to watch a video on 10 early signs which may suggest ASD

There are 3 levels of severity in ASD

Level 1: Requires support

  • Without support in place, deficits in social communication cause noticeable impairments
  • Difficulty initiating social interactions and clear examples of atypical or unsuccessful responses to social overtures of others
  • May appear to have decreased interest in social interactions
  • Inflexibility of behaviour causes interference with function
  • Difficulty switching between activities
  • Problems of organisation and planning hamper independence

Level 2: Requires substantial support

  • Marked deficits in verbal and nonverbal social communication skills even with support
  • Limited initiation of social interactions (reduced responses to social overtures from others)
  • Inflexibility of behaviour, difficulty coping with change or other repetitive behaviours appear frequently enough t be obvious to the casual observer
  • Difficulty changing focus or action

Level 3: Requires very substantial support

  • Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning resulting in limited initiation of social interactions
  • Minimal response to social overtures from others
  • Inflexibility of behaviour, extreme difficulty coping with change or other repetitive behaviours markedly interfere with functioning in all spheres
  • Great distress when changing focus or action

Take your child to a child psychologist or therapist for assessment if you have any concerns.

Download Teleme’s mobile app and consult Ms Katyana, Psychologist.

Ms Katyana

Ms Katyana

Psychologist

CONSTIPATION IN CHILDREN: TREATMENT OPTIONS

CONSTIPATION IN CHILDREN: TREATMENT OPTIONS

Constipation is defined as abnormally delayed or difficulty in defecation (bowel opening). If your child continues to have symptoms despite changing the diet, modifying the lifestyle and increasing fluid intake (see previous article Constipation in Children – What Is It?), then your child may need treatment.

Treatment of childhood constipation

Around 97% of cases of constipations are functional which can be managed using the by modifying their diet or with medication if required as directed by your doctor. Rare causes of constipation due to structural gut abnormalities such as anal stenosis or imperforate anus, anal tear (fissure) or Hirschprung’s disease require surgical intervention by a paediatric surgeon. Neurological disease such as spinal bifida or cerebral palsy can also cause constipation.

Medication options

  1. Faecal softeners such as DUPHALAC, LACTUL & FORLAX work by drawing fluid into the faeces making it soft to pass out. Take the medication as directed by your doctor or pharmacist.

Duphalac

Lactul

Forlax

  1. Suppository such as DULCOLAX works by softening impacted stool at the rectum. Take the medication as directed by your doctor or pharmacist.

Dulcolax

Maintenance

Once the cycle of constipation is treated successfully, you still need to encourage your child to change the habit and lifestyle to prevent recurrence by following these principles:

  • Increase fluid intake
  • Increase dietary fibre and avoid fatty, sugary or starchy foods
  • Avoid sweet drinks before meals
  • Encourage your child to exercise (avoid being sedentary)
  • Develop a regular meal schedule
  • Get the child to have regular bathroom breaks
  • Encourage your child not to be frighten of going to the toilet

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CONSTIPATION IN CHILDREN: WHAT IS IT?

CONSTIPATION IN CHILDREN: WHAT IS IT?

Constipation occurs when a child does not go to toilet to defecate regularly resulting in difficult or painful bowel opening (pooping). The peak incidence of constipation is between 2-4 years of age when parents start to toilet train their children.  Around half the kids experience constipation at least once during childhood!

The frequency of defecation depends on the child’s age; beginning with around 4 times a day during neonatal and infant period but gradually decreasing to twice daily during early years of age and once daily by the age of 4 years when children are able to achieve anal sphincter control.

Symptoms of constipation

  • difficulty or pain in defecation
  • hard dry stools (see stool chart below)
  • irregular bowel movements
  • abdominal pain or distention (bloated)
  • bleeding when it causes an anal tear or fissure
  • pain during defecation causes the child to withhold the stool even more thereby setting up a vicious cycle of stool retention

Stool Consistency is best described using the Bristol Stool Chart

Source: Wikipedia

Contributory factors to constipation

  • Low fibre diet (not enough fruits and vegetables)
  • Insufficient fluid intake (see below)
  • Poor quality diet (too much junk food)
  • Being overweight
  • Sedentary lifestyle (not enough exercise)
  • Psychological factors (such as stress or anxiety)
  • Family history
  • Organic bowel disorder

Prevention

Image Source: YMCA Harrisburg

Prevention is the best option and you can follow the following principles:

  • Increase fluid intake
  • Increase dietary fibre and avoid fatty, sugary or starchy foods
  • Increase sorbitol in the diet (apple, prune or pear juice)
  • Encourage your child to exercise (avoid being sedentary)
  • Develop a regular meal schedule
  • Get the child to have regular bathroom breaks

Recommended fluid intake (including fluid in food and drinks)

The table below is just a guide and more may be required if the child is active and sweats a lot.

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WHY VACCINATE YOUR CHILD?

WHY VACCINATE YOUR CHILD?

Vaccines work by introducing a weakened or dead form of either the bacteria or virus (known as the antigen). This vaccine encourages the body to create antibodies against this antigen so that when the person is exposed to the infection, the body is able to fight the infection quickly without being affected too severely by the illness. In short, vaccines prepares the body to fight the disease in case the person gets infected in the future.

Source: M Klingensmith

Although there may be some side effects during the vaccination, the benefits outweigh them. In 2018, it was reported that in Malaysia, there were:

  • 6 deaths from measles (none of them receive vaccination)
  • 5 deaths from diphtheria (4 of them did not receive vaccination)
  • 22 deaths from pertussis (19 of them did not receive vaccination)

Reference: Star News Malaysia 22 Jan 2019

Do read the link below on how a lecturer had ‘wished his parents had him vaccinated’ as a baby but instead contracted polio at the age of 18 months and lost his ability to walk properly since then.

https://www.thestar.com.my/news/nation/2019/01/23/lecturer-how-i-wish-there-was-polio-vaccine-then/

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VACCINATION FOR CHILDREN (MALAYSIA)

VACCINATION FOR CHILDREN (MALAYSIA)

This is the recommended vaccination schedule for children in Malaysia. Do share this article with your friends with young children to keep as reference and useful reminder.

Explanation Notes

  • Bacillus Calmette–Guérin (BCG), vaccine that gives protection against tuberculosis
  • DTaP is the combination of diphtheria(D), tetanus(T) and accelullar pertussis (aP)
  • DT is a booster dose which protects against diphtheria (D) and tetanus (T)
  • Hib is Haemophilus Influenza type B
  • MMR is the combination of Measles(M), Mumps(M) and Rubella(R)
  • MR vaccine provides protection against Measles (M) and Rubella (R). MR Dose 2 at 7 years old
  • JE is vaccine against Japanese Encephalitis (This vaccine is only provided in Sarawak)
  • HPV is Human Papilloma This vaccine is provided only for girls aged 13 years. Dose 2 is given 6 months after dose 1

This an additional list of vaccines which you can discuss with your doctor about the suitability for your child:

Reference: myhealth.gov.my

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