Dear Readers,

A.L. is a 29-year-old mother who writes to LIFELINE from Spanish Town. She is very concerned about her second child, a girl, who is nearly four years old, A.L. says she is 'slow'. The child is not talking more than a few words and is not nearly as accomplished as her older brother was at the same age. She is not dressing herself. Her basic school teacher is also concerned that the child is not "keeping up" with her other children at school.

A.L. tells LIFELINE that her labour with her daughter was long and the baby did not breathe very well at first and was kept 24 hours in an incubator in the nursery. A private doctor, that A.L. took her daughter to see, told her that the complications the baby experienced at birth could have affected the baby adversely. A.L. asks if LIFELINE agrees with her doctor and, if so, what can be done to help her child.

'Slowness' to achieve milestones of development can be due to conditions resulting in brain damage as well as to conditions which limit communication and lessen information reaching the brain such as blindness or deafness. There are several causes which contribute to slowness. Some children are born with a small head with a small brain which does not grow adequately, other children are born with chromosomal abnormalities such as those which occur in Down's syndrome and manifest some degree of mental slowness or mental retardation. Brain damage also occurs in infants who experience trauma before, during and after birth, often resulting in cerebral palsy. Common causes leading to this type of brain injury would include:

❒ Meningitis

❒ German measles

❒ Hydrocephalus

❒ Severe Jaundice

❒ Head injuries

❒ Baby born with cord around the neck.

In most places in the world, the most common causes of mental retardation are brain damage and Down's syndrome. There is no specific treatment for mental retardation. What we need to do is to help the child develop to the best of his or her potential. Each child is an individual and their problems differ. The committed personal support of caregivers, medications and adequate diet, hygiene, physiotherapy and mental stimulation will make a great difference in what and who these children eventually become.

When slowness is due to a specific physical disability, such as deafness or blindness, which makes learning more difficult for the child then more can be done specifically to improve and expand the child's ability to learn - visual and hearing aids, special schools, braille books, etc. As the child's 'slowness' is due to the handicap which prevents communication and the gathering and processing of information, removing the handicap and improving communication allows the child to catch up with other 'normal' children.

Parents tend to know instinctively when a problem exists with their child for where the mind is slow to develop there is also slowness in learning to use the body. Milestones are delayed and these children lift their heads, sit, use their hands, stand, walk and talk at a later time than is normally expected.

They are physically delayed because of their delayed mental development. Early stimulation and early correction of visual and hearing loss is important to put the child back on track (age appropriate behaviour and achievements). It becomes harder to 'catch up' as the child grows older. Stimulation is very important as exercising the powers of the brain helps the brain to develop and grow and helps the child to interact as much as is possible with his or her environment and the people in it.

A.L. should take her child for full assessment at a hospital paediatric clinic (or do so privately). A paediatric neurologist may need to determine exactly what the problem is. Certainly it could well be related to her problems at birth. Hearing assessment and psychological testing for educational placement and determination of any contributing emotional problems would also be helpful.

The 3D clinics located at Monk's Street in Spanish Town, St. Catherine, is near to A.L. and is another organisation where A.L's child can be examined, tested and properly assessed. Advice and help will be given.

Write Lifeline

P.O. Box 1731

Kgn 8

A.J.M.