CHILD DEVELOPMENT AT HURSHBIN

Physical development:

Physical development involves growth in size along with coordination and strength of muscles involved in various parts of the body. It involves oral, fine and gross motor development through age-appropriate functional skills.

Cognitive development:

It includes intellectual growth, leading to innovation and creativity, problem solving and broader perspective of the environment.

Language development:

It involves development of receptive language followed by verbal behaviour components, to ensure expression of requests and labels, along with intraverbal communication. Mode of language expression could be nonvocal or vocal where vocal language development also encompasses pragmatics, semantics and syntax.

Social and emotional development:

This involves development of language pertaining to understanding and controlling emotions while taking care of social behaviors.

1. Attention and cooperation
2. Physical development and motor-sensory development
3. Speech, language and communication
4. Play and leisure
5. Social interactions and group behavior
6. Independent living
7. Emotional regulation
8. Academic readiness
9. Vocational independence

Child's growth and development pattern has to be looked and tracked from the moment they are born. Early childhood development is a critical period that sets the foundation for a child's physical, cognitive, social, and emotional well-being throughout their life. Monitoring a child's growth and development begins in infancy and continues through early childhood. We request to get checklist referred to ensure all important milestones and developmental stages are observed and taken care. Find the attached milestone checklist form!

Every child faces some difficulty at some or the other point in their lives. When the difficulty starts hindering the child's learning and conduct, seeking professional help becomes important. Here are some steps to consider when you have concerns about a child's behavior, emotions, or wellbeing:

Observe the behavior-

Pay close attention to the child's behavior, emotions, and any changes you' ve notice.

Talk to the child-

If the child is old enough to communicate effectively, have an open and non-judgmental conversation with them. Ask about how they are feeling, if anything is troubling them, and if they have any specific concerns.

Consult the teachers and caregivers-

If the child is in school or daycare, talk to their teachers or caregivers. They may have valuable insights into the child's behavior and any challenges they are facing in those environments.

Seek advice from friends and family-

Talk to people who are close to the child and who have observed their behavior. They might be able to provide additional perspectives.

Identify specific concern-

Pinpoint the areas of concern, such as academic Difficulties, social struggles, emotional outbursts, or changes in behavior.

Document the behavior-

Document specific instances, frequency, and Duration of concerning behaviors. This will help provide concrete examples when discussing your concerns with professionals

Lag in functional skills refer to delay in required skills or discrepancy in age and development of appropriate functional skills in an individual. These skills are essential for everyday living, playing, communication and learning. Wider the lag between age and skill development, difficult to achieve them at par with their age.

In the common man's language, stimulation refers to opportunities and encouragement to get involved in these opportunities. It can be explained as the action of arousing interest, enthusiasm, or excitement. In psychology, stimulation is the act or process of increasing the level of activity of an organism. An approach aimed at providing an enriched environment to an individual, especially to those who display inability to integrate sensory modalities required to learn naturally. It involves the use of a planned sensory stimulation program to ensure age-appropriate skill development. Stimulation programs usually help individuals learn required skills when the functional lag of expected skills is not more than one or two years. Intense programmed stimulation helps individuals learn at their best capacity when it is curated as per child's need and baseline level of functionality. Stimulation Programs are least intense of all training programs.

An intervention program is an intervention curriculum that is designed to achieve a result in lagging functional skills. Intervention programs usually help individuals learn required skills when the functional lag of expected skills is not more than two to three years. Intervention program focuses on skills to achieve along with specific strategies employed to gain results. Intervention program needs strategic stimulation thus it is more intense and effortful program then stimulation program but when employed appropriately results are inevitable.

Rehabilitation is the process of restoring and building an individual's ability to perform required skills as per his/her age through opportunities and meaningful modifications. It is an individualized skill development program taking into consideration an individual's physiological and psychological conditions, functional lag, prerequisites, ability to learn and short term/long term functional target. Rehabilitation involves intense strategic intervention with important environmental modification to ensure independence in learning & ability to perform the most important behavioral skill to promote independence. This is most intense, effortful and involving kind of program. Results and development in certain areas can targeted though few skills may need to ignored and disorders can be managed by alternative means to compensate on loss. Rehabilitation program ensure that important behavioural tasks are accomplished. Important modification in stimulus is considered if required.

Developmental difficulties, developmental disorders, and developmental delays are terms used in the context of child development to describe various challenges that children may experience during their growth and maturation. While they share similarities, there are key distinctions among them. Let's explore each term in detail.

Developmental Difficulties

Developmental difficulties refer to any obstacles or struggles a child may encounter during their development that can impact their learning and behavior in various areas of development. These difficulties may arise due to various factors, such as environmental influences, lack of appropriate stimulation, or temporary setbacks. Developmental difficulties can be considered less severe and may not always indicate an underlying disorder. It can be taken care of by putting the child on a planned stimulation program. Example: A child who has trouble with fine motor skills, such as holding a pencil properly, might have a developmental difficulty in fine motor coordination. With appropriate support and practice, the child can improve their skills and catch up with their peers.

Developmental Delays:

Developmental delays refer to when a child does not achieve specific developmental milestones within the expected timeframe. It indicates that a child is not performing age-appropriate tasks and that lag is hindering the child's learning, growth and development. Delays can be temporary or long-term and may be caused by a variety of factors, such as physiological, psychological or environmental influences. Example: The same child who has problems holding a pencil, if not stimulated or intervened until age 9 or 10, can face severe challenges due to delay in skill development.

Developmental Disorders:

Developmental disorders, on the other hand, are more serious and long-term conditions that significantly affect a child's ability to function in various aspects of life. These disorders often have a neurological, psychiatric, psychological and physiological base and typically become evident during early childhood. They can have a profound impact on the child's cognitive, emotional, and social development, if not given the required learning environment through either stimulation, intervention or rehabilitation program (as per child's age and functional lag). We strongly believe that most disorders being natural or developmental have long term effects on a child's wellbeing and they can be well managed by helping them learn required skills. Example: a child when diagnosed with physical challenges, experiences delay in learning to write as a skill until age 12, would require environmental modification to perform tasks related to language expression.

Childhood disorders, often known as developmental disorders, refer to a range of problems characterized by impairments in physical, language, or social behavior areas. These conditions usually begin during childhood, have an impact on day-to-day functioning, and usually last for the rest of a person's life. Although, we can minimize the impact by appropriate skill development programs. Most children with developmental disabilities are often affected in multiple domains of function because of the nature and extent of brain dysfunction. As a parent, if you feel that your child is not meeting his/her age-appropriate milestones, or if you think there could be a problem with the way your child plays, learns, speaks, acts, or moves, talk to your child's pediatrician and explain your concerns. Acting early can help in early intervention and can make a great difference. Some common developmental concerns are:

• Physiological
• Neurological
• Psychological
• Emotional
• Behavioral
• Learning

Other than physiological and biological conditions which could be easily diagnosed at infancy and can be worked upon through medical and surgical treatments, there are various other developmental disorders which can be screened and diagnosed by assessing child's functional and behavioral patterns.

Global developmental delay (GDD):

Refers to a condition where, due to physiological or neurological dysfunction, a child takes longer to reach certain developmental milestones than other children of their age. It usually affects a child's overall development from their physical to language to intellectual abilities. It can be screened as early as a week or two. Early stimulation or intervention can help children learn required skills as early as possible to live independent functional life.

Autism Spectrum Disorder (ASD):

Is a neurodevelopmental disorder which can be screened by age 1-1.5yrs through observation of some particular behavioral pattern, fixations and delay in ageappropriate functionality and learning.

Attention Deficit Hyperactivity Disorder (ADHD):

Neurodevelopmental disorder which is characterized by inattention, high energy, and impulsivity, causing delay in age-appropriate functioning and learning. This condition can be screened between ages 2-3yrs.

Generalized Anxiety Disorder (GAD):

GAD in a child can be characterized by excessive worry and tension about day-to-day events, significantly noticed in a high demand situation. It can be screened at ages 3-9yrs.

Obsessive Compulsive Disorder(OCD):

Many children occasionally have thoughts in which they get fixated leading to repetitive behavioral patterns. OCD in children can be screened and justified through unwanted thoughts, unwanted behaviors, anxiety with regards to change in environment at the age of 3-12years.

Oppositional Defiant Disorder (ODD):

A disorder in a child marked by defiant and disobedient behavior to authority figures. The cause of oppositional defiant disorder is unknown but likely involves a combination of genetic and environmental factors. ODD can be screened as early as 3 years of age up to 12 years.

Tourette syndrome (TICS):

Is a neurodevelopmental disorder which is characterized by multiple repetitive movements due to anxiety. It usually comorbid with other neurodevelopmental conditions like ASD, ADHD and OCD and displays its symptoms between age 4-7 years of age which surfaces more noticeably in high demand situations.

Selective mutism:

Selective mutism is an anxiety disorder where a person is unable to speak in certain social situations regardless of developed speech. the onset of selective mutism can typically be screened between ages 3-8 years. The roots of these difficulties could be genetic or environmental or both.

Learning Disability (LD):

Learning Difficulty or Learning Disability is a condition that displays any of the above difficulties or disorders impacts a child's learning and clearly shows its link to low academic performance. Taking care of child's learning at earliest age can lower down the impact of disorders on child's learning and development. Children between 3-14 years of age display difficulties in learning which when not helped impacts ability to learn overall, followed by lag in age-appropriate functionality and can be justified as learning disability.

1. Developmental pediatricians
2. Pediatric neurologists
3. Occupational therapists
4. Speech therapists
5. Physiotherapists
6. Special educators
7. Psychologists
8. Behaviour therapists.

About Ms Binal Shah Binal Shah

Binal Shah is a Child Development And Behaviour Modification Consultant based In Mumbai. She has several degrees and honors to her credit in the field of child development, education, psychology and behavior modification. She is one of few BCBAs (Board Certified Behaviour Analyst) to complete lengthy certification procedures and practice world class therapy approaches in India. She has been working in the field of Training And Rehabilitation for almost 21 years. Binal Shah has vast experience training kids having delays and difficulties in various areas of development from physical, language, communication, emotional to behavior and learning. She has been dealing with kids diagnosed having developmental disabilities such as GDD, LD, ADHD and intensively worked for kids having ASD for all these years. She is the mentor and Guide for all developmental professionals working for HurshBin. Additionally, she is also working closely with parents and professionals as a coach and trainer for behavior modification approaches.

We at HurshBin work on a comprehensive skill development program, taking care of all required skills in areas of development, learning and behavior. All developmental professionals work in collaboration to curate as well as execute a single comprehensive skill development program. Every developmental professional working with HurshBin along with their expertise, are trained in behavior modification approach and are also well-versed with important learning and behavior modification assessment, protocols and curriculum. This enhances their skills required to make the sessions efficient, fast-paced, and outcome-oriented.

Behavior modification is a psychotherapeutic intervention primarily used to alter, eliminate, or reduce undesirable behavior in children or adults. Behavior modification can be prompted and later internalized with the use of therapeutic intervention at three various levels according to the child's ability to comprehend language and perform required tasks. The levels are: Applied Behavior Analysis (ABA) Cognitive Behavior Therapy (CBT) Rational Emotive Behavior Therapy (REBT).

ABA is a scientific approach to understand and modify behavior which is widely used for individuals with minimal linguistic ability. It refers to a set of principles that focus on how behaviors can be changed at desirable levels by modifying or making alterations in the environment. Ivar Lovaas devoted his life researching and practicing ABA principles to improve the lives of children with delays and difficulties. ABA is widely used in various settings, including schools, clinics, homes and community settings to address behavioral challenges and promote skill development in children and adults with developmental disorders or behavioral issues. It is a systematic employment of a set of strategies to ensure skill development and behavior modification. ABA is a ground-level therapeutic approach for intervention and behavior modification, and hence when it comes to child development, ABA is a golden-spoon approach for individuals with severely compromised learning ability. Therefore, ABA is an empirical approach for children with GDD and Autism. Besides this, there are some specific strategies of ABA that are effective for children with other developmental delays and difficulties along with CBT and other therapeutic approaches. Therapists use ABA strategies to prompt language development along with other required skill development for individuals to reach up to a level where they can be linguistically and cognitively involved in self-behavior modification.

CBT is a widely practiced and evidence-based psychotherapy approach that focuses on identifying and modifying negative thought patterns, emotions, and behaviors. It is based on the premise that our thoughts, emotions, and actions are interconnected, and by changing one aspect, we can positively influence the other. CBT is a well-known therapeutic approach for individuals with linguistic ability at the level where behavior modification can be prompted using the same. Thus, strategies of CBT are scientifically proven to be beneficial for children with ASD, ADHD, and similar developmental concerns when they show ability to comprehend language. CBT empowers individuals to identify and challenge negative thought patterns and undesirable behaviors and maladaptive behavior, facilitating positive changes and improved emotional wellbeing to eventually enhance ability to take demands, learn, and develop. Aaron Beck in the 1960s, developed Cognitive-Behavior Therapy by pioneering theories and strategies in clinically treating individuals for behavior modification.

REBT is a form of cognitive- behavior therapy where individuals are prompted to identify and modify irrational thought patterns and behaviors to release underlying emotional distress beneath nonfunctional and maladaptive behaviors. The central premise of REBT is that our behaviors are results of our intentions followed by emotions which are built on the basis of our beliefs and thought processes. Individuals with advanced levels of linguistic ability and higher order reasoning can be helped using strategies of REBT. Thus, children with ASD, ADHD, and similar emotional-behavioral concerns can be helped using REBT techniques and strategies to train them for emotional regulation skills to eventually enhance ability to learn and develop. REBT was pioneered by Albert Ellis in the 1950s.

Every individual when referred to us are suggested Skill Development Assessment session which makes us understand:

Medical History,

Developmental History,

Family Structure Learning Barriers,

Learning Pattern child's Functional Abilities and Lag,

Behavioural Cusps,

Pivotal Learning Goal

Followed by assessment Skill development program is created and that helps us created task sheets which are updated every 3_5 sessions as per child's ability to learn. Every 2 months they are assessed on same tool to record progress data. We refer below mentioned standardized Assessment Protocols and Curriculums to create one assessment sheet to follow, to track the progress and consider changes if required. Parents are trained to prompt children generalize learnt goals in their natural environment setting.

• VB Mapp
• Ablls
• Essentials for Learning
• PEAK

We strongly believe that understanding and learning of Behavior management principles along with their strategies are important as well as essential for all who interact with children and are part of any kind of child development program to ensure efficiency in their practice. We have created protocol-based curriculum and step by step modules to ensure ease in Learning behaviour science. Many professionals and parents over the years have been benefited by mentioned coursework and we hope to spread this learning to so many more in coming years.