Hello, Dr.T speaking...

reginang

我地呢度"民風淳樸" ~~~~      

小孩子的天空

Hi Dr.T:

我兒子在精神科跟進中，他被label了三個’大名’－－－１．過動．２．對立性反抗．３．資優．

但醫生每次都只是叫我們嘗試給他吃藥，是否我們不打算吃就不用再去呢？

校長和班主任都認為他不需要吃藥，班主任還跟我說她不覺得他是過動兒，只不過他上課pick up得快，找些東西搗蛋．
我跟醫生說他在校的情況已有改善，但他說小朋友大了一點是會有進步的（唔係進步了不是就不用吃嗎），而且他有過動和對立性反抗日後會成邊緣少年和濫用藥物的機會很大，還是叫他吃藥．真的那麼快就可以知道他的未來？我有很多疑問？？？？？？可否給點意見？謝謝！

稚言治語

這個我可以代答，因為我曾在大口環根德CAC工作，希望Dr. T唔好介意﹗

那個招募是因為DK(大口環根德CAC)會定期舉辦培訓，其中包括在DK評估用的Griffiths Developmental Scale。那是一個評估整體發展的工具，培訓對象是醫生和心理學家。在課程中(約四五日)需要一些小朋友作實習及考核之用。所做的評估和在平時到DK做的差不多。如果發現小朋友有問題也會跟進及轉介，但就不用像平時般排期。除了評估者可能學藝未精外，其實相當不錯，尤其是減省了排期的時間，小朋友可以及早接受服務。

lam's-mother 寫道:
除此之外, 我想問吓你知唔知....最近大口環根德公爵夫人兒童醫院有個招募兒童參與兒童體智發展評估的活動?  其實主要係評估咩嫁(遲緩?)?? 同健康院的test, 是否一樣??? 唔好意思, 咁多嘢問    tks!

Dr.T

多謝幫忙...老實講我孤陋寡聞,從未聽過這個評估活動. 我想除了測試員可能技藝比較幼嫩之外,家長要考慮的是通常經正式測試後,即是孩子表現不如意,也要隔一段時間才可重做. 但當然可以排訓練快一點那也不錯呢!

稚言治語 寫道:
這個我可以代答，因為我曾在大口環根德CAC工作，希望Dr. T唔好介意﹗

Dr.T

曾幾何時期期有樣睇 但現在因各種原因只係偶然客串一下...唉...編輯部熟果d老友都走哂囉...而且而家都唔係太想幫佢地...

Hey...據我記得"稚言稚語"也有出現過係"學前教育"...

lam's-mother 寫道:
Hi! 我想八吓.....你最近有無係學前教育出現過呀?

Dr.T

對不起,打了一大段,又錯手刪去...容許我打英文...
1. Really eye-opening...
2. As you have already paid the tax for the psychiatrist's salary, why not having him/her follow up your son's case?
3. I think it'll be better to locate a social worker or counsellor who can communicate with the kid well, than merely giving drug. See whether you can identify one in his school?

小孩子的天空 寫道:
Hi Dr.T:

1. 我兒子在精神科跟進中，他被label了三個’大名’－－－１．過動．２．對立性反抗．３．資優．
2. ...是否我們不打算吃就不用再去呢？
3. ...我跟醫生說他在校的情況已有改善，但他說小朋友大了一點是會有進步的（唔係進步了不是就不用吃嗎)...

Jolly

小孩子的天空,
to your Q2, i suggest you tell the doctor that you don't want your kid drugged instead of stopping the drug yourself. at least the doctor will understand you parents more and find other ways to help your child.   i understand the reason you don't want to give medication to your child and of course, nobody want their children become drawsy and slow motion after taking drugs. and most psychiatric medication hv long-lasting side-effects. so let the doctor know your concern.

Dr.T

也許我看漏了???"小孩子的天空"好像沒有接受醫生的建議用藥.

Jolly 寫道:
...i suggest you tell the doctor that you don't want your kid drugged instead of stopping the drug yourself.  

小孩子的天空

是的還沒有接受醫生的建議用藥.

他老師說如果用了藥她會舒服很多，但現時她不認為有需要．

Dr.T

多謝你的信賴,你的個案會是一些始終覺得外國月亮一定圓的家長一個參考...

根據你的描述,如果我理解沒錯的話,她現時的問題是兩歲才出現的,由原本正常到看來不太正常,這是令人擔心的地方,所以可能醫生才會為她做那麼多測試...

測驗1及2相信是用來撇開小朋友是因為腦部發展不正常而引致她現時的情況的可能性.EEG,據我有限的醫學知識,是用來觀察病人的腦電波是否有異,例如癲癇;而MRI是用來監察腦部結構是否有不正常,例如腫瘤.至於血的測試是分析小朋友是否有其他毛病,因為個中不同部分的組成會代表不同的情況--這一點你無須太在意,因為所謂WBT(Whole Blood Test)通常都是指定動作而已.

聽覺測試(稚言稚語可幫下口 )當然不可能知道孩子聽到的跟她明白的有沒有分別,但這個測驗的作用是要確定小朋友的基本聽覺功能是正常的,否則任何言語治療也是徒勞無功(5)

6. Occupational Therapy 通常譯作"職業治療".你看似玩遊戲的過程其實是訓練小朋友的手眼協調及小肌肉發展.也許他們是擔心小朋友不能夠從一般渠道學習這些技巧故加以訓練.

7. 1.5年才有結果???真的很誇張呀!

也許目前你小朋友所欠缺的是一個懂中文的Case Manager將所有測試/訓練整合起來及向你解釋.

roy&shiny 寫道:
1. EEG / 2.MRI / 3, Blood test---creatinine,albumine,calcium total,phosphate inorganique,AST,ALT,kinase(CK),NH3,Lead,FMR-
1..... Can u tell me what are they...

4, Auditory( I know which is for listening)
But i am wondering Can they identify, if the child they have no hearing problem, but If they received message is not the same messgae they release. Can they test them also?
5, Speech theraphy(take 1 year to wait, but i already paying the private to help her

6, Occupation theraphy( I dont know what is this, are they playing game to encourage or are they training her to hold pen , walking, jumping,(but my daughter she is no problem on those)

7. After that, they will give me the result in after 1 1/2 year....

carolsin

Dear Dr. T,
Sleeping problem
My son (23months old) is having sleeping problem.
(It is not a standard problem that can be found in books/internet: he can sleep on his own, so not related to sleeping association, normally he will not cry during the nite.  We saw a few family doctors but they just replied me briefly saying that it will improve when he gets older).
He normally sleeps from 10:xxpm - 7:xx/8:xxam, in the afternoon 2:xxpm-4:xx/5:xxpm.  During sleeping, he turns over his body, rolls over, moves his arms and legs constantly and frequently, he will have 打柯欠 too.  He moves very frequently, say, he stay quiet for a few seconds and then will move.  When he stays quiet / steady, he seems like sleeping with normal breathing, sometimes seems like dreaming with laughing sounds, but it only lasts for less than a minute and then moves.  This happens continuously.  This situation can happen (1) right from start 10:xxam til the next day morning OR (2) sleeps quietly without moving til 1:xxam/3:xxam and then starts to move for a few hours until morning.  OR (3) starts to move around 6:xxam.
Sometimes he can sleep normally (for a few days), ie. that is sleeping description found in book/internet that he sleeps in cycle pattern.
Questions:
- I really wonder, while he is moving, whether he is still sleeping, I guess not, as in the morning, I find that he has black eye circle. But he is still very active daytime.
- Did you encounter similar situations before?   
- Do you think clinical psychologist / 精神科doctor can help on this matter?

When I tried to ask this question to doctors / friends that my baby turns while sleeping, usually people will just comment that I am too nervous and that it is normal for baby.  But, the situation is that he will turn / move / roll after a few secods for a few hours, which I think is not normal situation.

I guess, Due to this long term sleep deprivation, during daytime, he is a slow learner, still cannot speak, very active with ADHD behaviour.

I am much much appreciated for reading this and offer me some comments as I feel so depressed and helpless that I don't know where I can go for help.  Many thanks again.

Carol







  

Dr.T

Dear Carol.

1. To be honest, no. I seldom see kids this young.

2. I don't think so and the best they can do is to support you, rather than solving the baby's problem. Your son requires (relatively) long term observation and a brief clinic visit is not useful. Probably an experienced paediatrician might be more helpful.

I found this site which you might find useful. It mentions a condition called sleep apnea & its (possible) relation with ADD
Website on babies' sleeping problem

3. I agree and his sleeping problem might be part of the cause

carolsin 寫道:
1. Did you encounter similar situations before?   
2. Do you think clinical psychologist / 精神科doctor can help on this matter?
3. ...Due to this long term sleep deprivation, during daytime, he is a slow learner, still cannot speak, very active with ADHD behaviour.

kmwun

Dear roy&shiny

正如Dr T所言你需要有個懂中英文的人幫你，最理想當然係一個Case Manager可以將所有測試/訓練整合起來及向你解釋．退而求其次醫院找一位較能幫你做翻譯嘅人員幫忙，相信他們會較多認識．再不然找個英文較好的朋友幫你做翻譯，加強溝通．或者要求治療師幫你寫下有關事項的重點，你之後可以找人幫忙．

你亦可以考慮做一個中英對照表，慢慢將治療師用的名詞記低，一來方便自己對照，唔使次次查字典，亦可以在聽唔清楚治療師嘅時候，嘗試直接指對照表上的英文．少少建議希望幫到你！努力！加油！

mrsphcheung

Dear roy&shiny,
I know two boys (7 yrs old & 12 yrs old) in Canada and a boy (12 yrs old) in USA who are late speakers.  All of them can speak very well now.  Having different medical systems and ideologies, the doctors there are very conservative to make a diagnosis as the labelling effect may affect the life of a child.  They emphasize training rather than the name of the diagnosis.  Don't mind what happen to your child.  Just give her as much training as you can.