Dyslexia is a type of specific learning difficulty. A child with dyslexia may find reading, spelling and writing difficult, even though he may appear to be very able in other areas. These difficulties are caused by brain differences. This means that your childs difficulties have nothing to do with the way the child is taught, or parenting style, as this is biological.

The difference in the brain makes it more difficult for the child to process information for sounds in language. Therefore, it may take your child a longer time to recognize sounds, and to understand instructions said to him.

Dyslexics have poor phonological awareness, meaning they may find rhymes difficult. They also find it difficult to learn the sounds of the alphabet, and to use this knowledge to help them read or write. Many dyslexics have poor working memory, and so they find that verbal information such as spoken words are quickly forgotten.

Sometimes, dyslexia is accompanied with poor attention and speech and language development. Saying that, no two dyslexic children are the same. Some may find reading very difficult, some may find it easier, but they read slower. Some have problems with just writing.

Some languages are more difficult for dyslexics than others, and English words are considered to be more challenging for dyslexics, because the spelling is more irregular than for example, Spanish.

While dyslexia will make school more difficult for the child, there is a lot that we can do to help. At the end of the day, we must always remember that every child can learn. Research shows that most dyslexics will learn to read and write.

Some dyslexics can become highly successful. The way the dyslexic brain thinks may be different, and in some cases, this is an advantage. By providing your child with the education they need, the child is more likely to reach their potential.

With appropriate help from specialist teachers and using strategies, the effects of dyslexia can be largely overcome. Research also shows that the differences in the brain can also be overcome with teaching.

At Dynamics Therapy Centre for Kids, we provide dyslexia remediation services as well as speech therapy suitable for children with dyslexia.

Each children develops in his own pace. The following table describes the age by which most children will accomplish various speech-related skills (taken from ASHA website.

Hearing and Understanding		Talking
Birth-3 Months Startles to loud sounds. Quiets or smiles when spoken to. Seems to recognize your voice and quiets if crying. Increases or decreases sucking behavior in response to sound.		Birth-3 Months Makes pleasure sounds?(cooing, gooing). Cries differently for different needs. Smiles when sees you.
4-6 Months Moves eyes in direction of sounds. Responds to changes in tone of your voice. Notices toys that make sounds. Pays attention to music.		4-6 Months Babbling sounds more speech-like with many different sounds, including p, b and m. Vocalizes excitement and displeasure. Makes gurgling sounds when left alone and when playing with you.
7 Months-1 Year Enjoys games like peek-o-boo and pat-a-cake. Turns and looks?in direction of sounds. Listens when spoken to. Recognizes words for common items like "cup", "shoe," "juice." Begins to respond to requests ("Come here," "Want more?").		7 Months-1 Year Babbling has both long and short groups of sounds such as "tata upup bibibibi." Uses speech or non-crying sounds to get and keep attention. Imitates different speech sounds. Has 1 or 2 words (bye-bye, dada, mama) although they may not be clear.
1-2 Years Points to a few body parts when asked. Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?"). Listens to simple stories, songs, and rhymes. Points to pictures in a book when named.		1-2 Years Says more words every month. Uses some 1-2 word questions ("Where kitty?" "Go bye-bye?" "What's that?"). Puts 2 words together ("more cookie," "no juice," "mommy book"). Uses many different consonant sounds of the beginning of words.
2-3 Years Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down"). Follows two requests ("Get the book and put it on the table.").		2-3 Years Has a word for almost everything. Uses 2-3-word "sentences" to talk about and ask for things. Speech is understood by familiar listeners most of the time. Often asks for or?directs attention to objects by naming them.
3-4 Years Hears you when call from another room. Hears television or radio at the same loudness level as other family members. Understands simple, "who?," "what?," "where?," "why?" questions.		3-4 Years Talks about activities at school or at friends' homes. People outside family usually understand child's speech. Uses a lot of sentences that have 4 or more words. Usually talks easily without repeating syllables or words.
4-5 Years Pays attention to a short story and answers simple questions about it. Hears and understands most of what is said at home and in school.		4-5 years Voice sounds clear like other children's. Uses sentences that give lots of details (e.g. "I like to read my books"). Tells stories that stick to topic. Communicates easily with other children and adults. Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th. Uses?the same grammar as the rest of the family.

ADHD is a neuro-developmental disorder and its characteristics are:

• Inattention
• Impulsivity
• Hyperactivity (not present in ADD)
  Boys are more commonly affected by it. The estimate of prevalence in the United States is 5-10% of school aged children. The causes of ADHD are yet to be discovered but there are several theories that talk about biomedical, sensory-motor, genetic predisposition and chemical imbalance in the brain.

We can help in four different ways:

• Diagnosis and Behavior Therapy
• Remedial Teaching
• Social Skills Training
• Sensory Integrative Therapy
  
  

Diagnosis & Behavior Therapy

Our Educational Psychologists can assess your child to diagnose his condition. Furthermore, they can equip you with practical strategies to manage your child at home and at school.

Remedial Teaching

Remedial teaching is defined as Specialized instruction for students deviating from the expected norm.

At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. It may help you child if he appears to be falling behind in his school performance.

Social Skills Training

We conduct social skills training, both one-on-one and in a group setting. Our social skill classes are conducted by a special education teacher and allow children to develop age-appropriate skills of interacting with their peers.

Sensory Integration Therapy

Inattention is caused by the childrens inability to block stimulation that is not relevant to the task at hand. They attend to everything; all stimuli impinge on their senses with equal potency. This causes them to be distracted by the stimulation arriving from their environment (sounds, sights, thoughts etc), and prevent them from paying attention to the task at hand.
This is similar to what occupational therapist will call a Sensory Modulation Dysfunction (SMD), where the child has difficulties to organize the degree, intensity, and nature of response to sensory input in a graded and adaptive manner. Sensory Modulation Dysfunction can cause emotional problems as well as attentional problems such as distractibility, impulsivity, disorganization and hyperactivity.
mechanism.

Sensory Integrative Therapy provides a potential intervention for ADD/ADHD children without medication.

To modulate is to regulate or adjust to a certain level: To tone down, to adapt to the circumstances
On the behavioral level, modulation refers to responses that match the demands and expectations of the environment. Inadequate modulation may result in problems in the following:

• Modulation of sensory input
• Filtering of sensation
• Attending only to relevant stimuli
• Maintaining optimal level of arousal
• Maintaining attention to task
  Sensory modulation may be manifested in:
• Distractibility
• Impulsiveness
• Increased activity level
• Disorganization
• Anxiety
• Poor regulation
  Some children will develop inattention which is secondary to a learning disability. These children may become frustrated from academic tasks and they become inattentive as task avoidance

We have a wide range of assessment tools to assess your childs academic potential or Intelligence Testing.

For pre-schoolers:

• WIPPSI III
• K-ABC

For school aged children (6 and above):

• WISC IV
• Woodcock Johnson III (WJ III)
• K-ABC

For 17 years old and above:

• Woodcock Johnson III (WJ III)

Educational Therapy is defined as Specialized instruction for students deviating from the expected norm.
At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. Such services supplement our speech and occupational therapy services and are equally helpful for special needs children as well as any child which appears to be falling behind in his school performance.

Making an appointment is simple. Call us at 61009235 or drop us an email at inquiry@dynamics.com.sg. We are open Monday to Friday 9am to 7pm, and Saturday 9am to 6pm. We accept referrals from schools, doctors and other health professionals, psychologists, as well as self-referral by parents.

In most cases, we provide therapy sessions once a week. However, we tailor the intervention plan to the needs of the child and the preferences of parents. The frequency of therapy session is therefore quite wide. In some cases, we may see a child once a month as 'maintenance' to ensure his progress is not reversed.

We are able to help in several ways. If needed, we can provide a formal assessment (based on IQ testing, ADOS, and other diagnostic tools) to verify whether your child is indeed an ASD child. We can also design an early intervention plan to address some particular symptoms your child exhibits. Such an early intervention plan will address sensory and daily skills (by an Occupational Therapist), Speech Language and Communication (by a Speech Therapist) and academic skills and social skills (by our special education teacher). We are also providing autism-specific interventions, namely Relationship Development Intervention (RDI), and Structured Teaching. Early intervention is important, as various studies has shown that early intervention is much more effective for ASD children.

Sensory Integration Theory was formed by A. J. Ayers who was an Occupational Therapist with advanced training in Neuroscience and Educational Psychology. She defined Sensory Integration as the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment. All the information children receive from their environment arrives through the sensory systems. Most of us are familiar with the sense of Smell, Taste, Sight and Sound. There are 3 more senses that we are less aware of and these are: the sense of Touch (the Tactile Sense), the sense of Movement (the Proprioceptive Sense) and the sense of Balance (the Vestibular Sense). The SI theory puts an emphasis on these 3 important senses: Tactile system detects qualities and locations of external stimuli applied to the skin. Information from the skin, about location of touch, pain and temperature is transferred through this system to the brain.

Proprioceptive system refers to sensation of movement (i.e. speed, rate, sequencing, timing and force). It's important for the development of body scheme, praxis (motor planning), and adaptive action. The information on proprioception arrives from the muscle receptors and partially from skin receptors which provide to the brain information about muscle change during movement. This allows generation of proper amount of force needed to act on objects

Vestibular system - the vestibular input contributes to posture and the maintenance of a stable visual field. The receptors for vestibular input are located in the inner ear. There is a combined impact of vestibular and proprioception input on muscle tone, posture, equilibrium, and motor behavior

Dysfunction in Sensory Integration (DSI)

If one or more of the sensory systems are not fine tuned to work with harmony with the rest, or information from the senses is not well processed the level of functioning of the child might be compromised.

Symptoms that are commonly displayed in DSI include:

• Being overly sensitive to touch, movement sights or sounds
• Being under reactive to sensory stimuli
• High or Low Activity Level
• Coordination problems
• Delays in speech or language skills
• Poor organization of behavior
• A poor self concept

Sensory Integration (SI) Therapy

It is important to do an assessment with the child and interview the parents in order to identify the areas of strengths and weaknesses in order to tailor an individual intervention plan and to create a base line for future intervention.

The SI therapy is being done mainly in a special gym that includes plethora of suspended equipment (swings, ladders, tunnels, therapy balls and many more). The equipment allows us to give a variety of stimulation to all the sensory systems.

Autism Spectrum Disorder (ASD) ASD is a developmental disorder, characterized by difficulties in communication and language skills, imaginative play and social interaction, and odd behaviors. Children with ASD often show early signs of deficits in sensory processing and social responsiveness. At Dynamics Therapy Centre for Kids we provide autism assessment services (using ADOS), Occupational Therapy, Sensory Integration Therapy, Social Skills Training, Remedial Teaching, and RDI®. How can I find out whether my child has ASD? Early assessment of a child who is suspected to be on the spectrum is crucial so that intervention can start as early as possible.

Dynamics Therapy Centre for Kids provides an assessment service, done by a multidisciplinary team. The tools for assessment are standardized and provide a wide range of information in order to make a diagnosis. The assessment includes observations on the child, cognitive assessment, speech assessment and a comprehensive interview with the main caregivers regarding developmental milestones, sensory issues and functional behavior.

The synthesis of all this information provides sufficient data to make a diagnosis.

The information taken from the collected data should be considered in respect to the DSM IV (Diagnostic and Statistical Manual, 4th Edition, 1994, American Psychiatric Association) criteria for autism. (The criteria can be viewed here http://ani.autistics.org/dsm4-autism.html).

What help you provide for ASD children?

We provide a comprehensive array of therapy services: Speech Therapy, Social Skills Training, Remedial Teaching, Occupational Therapy with emphasis on sensory integration, and RDI.


What is Social Skills Training?

Individuals with ASD or Asperger Syndrom have severe difficulties with social skills. Social skills training helps such individuals to improve the way they interact with others. We provide social skills training in a one-to-one setting, as well as in a group setting. Social skills training makes extensive use of role playing, soft play, and games in order to allow the child to have fun while learning to improve his social skills.
Our social skill training is conducted by a special education teacher with extensive experience. The sessions are tailored to the needs of individual children, and children in a group setting are chosen to ensure that the group session is effective.


What is Remedial Teaching?

Remedial teaching is defined as Specialized instruction for students deviating from the expected norm.
At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. For children with ASD, our remedial teaching sessions focus on structured teaching and the use of PECS (Picture Exchange Communication System) to achieve acadmeic intervention.


What is Sensory Integration?

Sensory Integration refers to our ability to put together the inputs from our senses. The senses are meant to work together. Each sense provides certain input, and sensory integration is a critical function of the brain, that allows it to generate a composite picture. With this composite picture we are able to know where we are, what is going around us, and we are able to interact effectively with the surrounding.

While you are reading this page, your brain is automatically and unconsciously conducting sensory integration. You are coordinating your sight, sense of touch of the keyboard and mouse with certain movement to scroll the page. In more complex situations sensory integration synthesizes sight, sound, touch, movement, and body awareness.

For most children, sensory integration develops naturally, as they learn motor planning skills and to adapt to sensation. For some children, sensory integration does not develop as efficiently as it should, and this gives rise to problems in learning, development, or behavior.

What is Sensory Integration Dysfunction?

When the sensory integration capabilities are not fully developed, the child will be unable to modulate, discriminate, coordinate or organize sensation adaptively. In particular this will cause diminished ability to interact effectively or efficiently with the demands of ones culture, environment, relationship or tasks.

ASD children often have difficulties in registration of meaningful sensory information which at times may lead to sensory overload or shutdown. The child often may have a heightened sensitivity to the sensory quality of the experience and this sensitivity can change with place and time

Modulation of sensory experiences is a process in which we gather information about the intensity, frequency, duration, complexity and novelty of the sensory stimuli as we prepare to create an adaptive response, may present as a difficulty for the ASD child.

Sensory integration therapy is aimed at improving the childs sensory integration capabilities, and in particular helping him/her to cope with processing sensory information and modulating it.

The Sensory Systems:

The Vestibular System (our sense of balance)

• Some ASD children experience severe reaction to a change in their head position and this might cause anxiety and fear
• These children may result in either seeking or avoiding movement that might be presented as:
  • Rocking or rhythmic movements that can be referred to as calming or organizing motions
  • Twirling and swinging motions that are considered alerting or activating

The Tactile System (our sense of touch)

• The system detects qualities and locations of external stimuli applied to the skin (light touch and deep pressure, vibration, temperature, texture and pain)
• The ASD child might demonstrate problems in processing tactile information
• Some will under react to touch and will need longer and stronger stimulation
• Others will over react to touch and texture and become defensive which can lead to discomfort in:
  • Self care tasks, standing in a queue, engaging in creative activities and can impact social behavior by avoiding crowds and being touched by others
  • Affecting food preference as some textures will be avoided, hence they can be very choosy about what they eat

Visual Processing (what we see and how we interpret it)

• Gives us the information about color, contrast, shape, form and movement. Helps us determine what to pay attention to and what to ignore and helps us direct our movement in the world
• Many ASD children are considered visual learners, their visual memory is strong and visual manipulation of objects is common
• They can be sensitive to lights, bright colors and have difficulty to sustain visual attention

Auditory Processing (what we hear and how we interpret it)

• The auditory system gives us information about the volume, tone, rhythm, and sequence of sounds
• Some ASD children experience sounds as painful and they are unable to filter out irrelevant noises
  • At times the ASD child can give the impression that he has hearing problems (e.g. he might not respond to our verbal communication)
  • Can seem inattentive to conversation, instructions and social communication
  • Participation in social or community activities can be irritating to the child due to many unexpected noises
  • Some can be observed covering their ears with their hands to block out sounds

Praxis (motor planning)

Difficulties in motor planning especially with ideation (an idea of how to approach a new task) can affect the quality of creative and imaginative play, engaging in new activities (hence the tendency to favor sameness and routine) and learning new skills


Sensory Integration Therapy

• Principles of SI theory are appropriate for intervention with the ASD child:
• Giving controlled and meaningful sensory experience to elicit adaptive responses is important to the therapeutic work
• Meaningful sensory experience is the most direct way to establish rapport
• An occupational therapy intervention usually starts as individual sessions in a therapeutic environment offering a variety of equipment and activities that will provide safe, purposeful and satisfying sensory experience
• Purpose of intervention is to provide the types of sensory experiences that will have most organizing effect, and analyzing them in order to offer appropriate activities to be applied at home or in school
• As caregivers there is a need to keep in mind that though therapy is helpful and can reduce many of the non adaptive behaviors, some of the ASD children (depending on the severity) might have sensory needs that will require attention throughout their lifespan
• It is recommended to design organizing and calming activities to be carried out at home to provide the child with sensory experiences daily as a Sensory Diet
• It is important that the caregiver will be involved in the therapeutic process
  

What is RDI?

RDI stands for Relationship Development Intervention, and it is an exciting intervention method for Autism, developed by Dr. Steven Gutstein. This relatively new intervention program tackles the core deficits of autism. These deficits revolve mainly around the inability to develop relationships, and the inability to accept novelty.

The approach taken by RDI stands in stark contrast to other intervention approaches which focus more on the symptoms of autism than on the core deficits of individuals with autism. Another difference between RDI and other methods is that RDI is family-centric, and requires immense involvement of the family. In other words, when you engage an RDI professional you are not paying her to "solve the child's problems". Instead, you are engaging her to empower you to help your child.

While RDI is relatively new, there are numerous success stories, and it is gaining popularity in the US. For more information about RDI, see www.RDIconnect.com which is the website for Connections Center which is the organization developing and promoting this method.
Yael Sasson of Dynamics Therapy Centre for Kids is currently an RDI consultant-in-training, and we are launching our RDI service in July 2006. Contact us at RDI@dynamics.com.sg for more details.

How can I find out more?

If you are interested in exploring therapy for your child, contact us at autism@dynamics.com.sg.

 

Occupational Therapy

Occupational Therapy is concerned with a persons ability to participate in daily life activities or occupations, including self care, work, and play.

Pediatric Occupational Therapy

A childs job of growing into adulthood involves continual adaptation to the demands of the environment and assimilation of its opportunities. The dynamic nature of this interaction is determined by the childs internal clock of maturation as the child adapts to a changing environment. Occupational therapy practice is based on an understanding of the interactions among children, their activities (or occupations), and their environment.

Who are the children who can benefit from an occupational therapy intervention?

Children having difficulties in:

• Fine motor skills
• Gross motor skills
• Coordination
• Sensory integration issues (Modulation and Discrimination of sensory input)
• Motor planning (praxis)
• Visual motor integration
• Visual perception skills
• Oral Motor (Oral Defensiveness, and Motor Planning)
  
  

These difficulties might result in the following issues:

• Handwriting
  
• Balancing responses
  
• Clumsiness
  
• Manipulation of objects and tools
  
• Independence in self care tasks
  
• Performance in physical education
  
• Sitting still in class
• Hyperactivity due to sensory seeking behaviors
• Short attention span
• Feeding Issues
  
  

Occupational Therapy Services include:

• Assessment (screening and in depth):
• Standardized assessments
• Informal assessments that includes clinical observations
  • Assessment is important in order to:
  • Find out where is the core cause of the difficulty
  • Set intervention goals
  • Set a base line of where is the starting point of abilities before intervention had started
• Intervention (individual sessions)
  • The use of childs strength to compensate his weaknesses
  • Direct targeting of root causes of the observed behaviors
  • Modification of environment to match childs abilities
  • Teaching strategies
  • Direct training in targeted tasks
  • Remedial approaches for sensory integration that may include a Sensory Diet
  • Oral Motor intervention to improve feeding and oral defensiveness
• Advising parents and teachers how to manage the child at home and in school
• Occupational therapy intervention is child-directed and it incorporates play for motivation and experience. It is important to design a suitable challenge fo the child to provide an opportunity to learn and improve while not discouraging the child by failure.
• The occupational therapy session should be fun and motivating for the child in order for him to benefit and get the opportunity to learn and improve his skills.
  
  

The Role of Occupational Therapy

A childs occupational performance might be affected by developmental, physical, sensory, attentional and learning challenges. The goal of occupational therapy is to improve the students performance of tasks and activities important for successful school and life functioning.

The occupational therapist is concerned with ensuring an understanding of, and match between the students skills and abilities and the expectations placed on him.

All therapy is unique and individualized as each person and every kid learns at his or her own pace, therapy duration varies. Some kids find their needs change as they get older or as they progress through the school system. They may return to the therapist to figure out new ways of coping with problems or to master a new skill. Kids can help speed up treatment by following the instructions of their therapist, and in particular practicing on their own. In some cases, where the child may benefit from intensive therapy, we recommend attending our DynamicKids intensive program to accelerate progress.