Thursday, September 8, 2016

The procedure when you suspect your child has ADHD Hyperactive, Autism, Speech Delay and Poor Sensory Issues



Hi, reporting in the month of Aug 2016:

I noticed that my baby boy GM, has very poor eye contact and have not spoken out any words for the past 6 months. GM is 2 years old now. While most of us, especially first time parent, do not think this is serious, especially the elderly people will just brush us off as we are talking crap and just telling us that the kid is still young.

Well, the story will be more shocking as it is. Turned out this is really SERIOUS.

My friend saw that GM doesn't look at her when she see GM face to face. Susann advised me to try to start to seek for therapy/ psychologist. Initially, I thought, well, probably GM is just shy, but how could it be, if GM even avoiding his eyes contact from his own mother?

If you would like to know the symphtoms of ADHD, autism, speech delay, and poor sensory, you may refer to the link at here: http://jesonestop.blogspot.my/2017/04/symptoms-of-adhd-hyperactive-autism.html


Well, the tricky part when to detect which syndrome is - 3 of the syndrome displays quite similar signs and symptoms. Well, GM hits few 'jackpot' showing such sign. Sighed, so you may ask, what should you do?

These are the proper steps to seek treatment for special kid needs:

1st - Paediatrician 

2nd - child psychologist or *psychiatrist 

3rd - seek the right therapist



1) Seek for your paediatrician's advice. Normally the doctor will ask you some normal lifestyle questions, and try to observe and communicate with your child. A short observation of 15- 20 minutes just to see whether your child has display the symptoms as above mentioned. Bear in mind, your paedritician is judging based on symptoms and only a short observation, the doctor is not the psychologist.

My paed asks how GM spent his time in his daily lifestyle, and we told him that we let him watch TV, play toys, and stay in his playpen the whole day. He just shook his head. "This is not right, this is why he has speech delay. A child needs big space, interaction, and communication. Watching TV is not helping at all. A baby as early as 9 months old shouldn't be encouraged to watch tv or to be left alone all by himself. How could he be able to learn social and interaction by then, talk to the TV?"

***

Once your paedritician confirm your child displays some symtoms of ADHD/ autism/ speech delay. Seek psychologist/ psychiatrist for a proper assessment report on your child, but my paedritician (child doctor) do not really recommend psychiatrist (精神科) because they might give medicine to control the syndrome as your child grow.

If you are in Malaysia, this is what I recommend and also hell-ya! been through so much painful tiring journey!


2) Child Psychologist Assessment


a) PRIVATE CENTRE




i) DING Psychologist



Selina Ding is the senior principal psychologist.

My experience with SD: SD is nice, helpful and resourceful in suggesting the right therapy (private, clinic, or government) for your kid. Her rate: 1 hour RM 310, and normally assessment session takes 1-1.5 hour.

This is what I remember the most when SD asked me and my mom some simple family lifestyle questions:

SD: So what did you do when you take care of GM?

I: Normally I will just let him play his toys and watch TV the whole day.

My mom: Normally I will let him watch TV and place him in a playpen the whole day.

SD: This is definitely a big NO-NO. Allowing a child at the age of 9 months old, watch TV whole day, and putting him in a small playpen, no space (sounds like a dog locked up in a cage), limited exposure, no interaction, no communication with adults, poor sensory sense. Hence, now speech delay and GM is in his own world.

I: Why does GM have such syndromes? It seems that I and my husband are fine.

SD: the closest answer people tend to believe is tend to be DNA. But to be honest, there are kids who have been diagnosed with such syndrome, yet there's no record from both sides of family tree. But because people tend to stress for answers, too many different answers given via online as well as research. But, of course, the growing process and the child's daily lifestyle is crucial too.

I: Ccan it be cured? how long does it take to cure GM?

SD: Whether your child can be cured, improved, no improvement or worsen as he grows up, it's very much depending on his own brain development. What we can do, as an adult, change your current lifestyle and talk more to GM.

Bear in mind, a child can changes a lot in this 6 months period of time, so as he/she grows.


Presenting problems:
  • lack of focus, hyperactive.
  • speech delay
  • sensory problems
  • lack of interaction and socialization opportunities

Treatment for GM:

  • speech and occupational therapy.
  • Start sending GM to school, to improve his social and communication skills with other kids (not adults)
  • change our own family lifestyle (cut down tv session, play, interact and talk to GM, more sensory activities)
  • fish oil supplements to improve brain development.

     

    My pharmacist recommends this fish oil - NeuroGain®+ 


###

ii) Kins and Kids are also professional, but alas, too expensive for me to probe further. It can go up to RM 1000 for the first assessment.



***

ALERT! Don’t go to this IPC: http://www.psychology.com.my/contact-us/ 


I have been told that IPC is not a licensed psychologist centre, and always cheat people’s money.

ALERT! Do not go straight to therapy centres, autism centres or adhd centres, where they tell you they have psychologist too. This is because their psychologist will only do assessment based on their very own therapy, autism, and ADHD centres, instead of a general overall psychologist report.

ALERT! never ever start asking non-professional who are not psychologist. People such as parents who have special needs children. Very simple, different kid shows different case. your kid won't be treated or to be diagnosed to be exactly the same as other kids.

b) HOSPITAL - You can try child psychologist in govt/ semi-govt hospital. However, not all government sector has child psychologist.

I was thinking since Gleneagles has expensive rates for therapies, I was thinking to explore HUKM. So, I run up and down in HUKM hospital one whole day as if I am working there, crap.

In HUKM, their government sector does not have child psychologist, only to see their government paediatrician (waiting period 4 months at least). I called up child department centre (CDC) under HUKM, they have psychologist (waiting list is 1 year). WTF.

HUKM private specialist centre – child psychologist. HUKM charged me RM 120-235 first assessment, and then yes, the child psychiatrist, Prof Salwina concluded that my baby might have autism, and need to start off with early intervention program - EIP. Early intervention is a system of services that helps babies and toddlers with developmental delays or disabilities.

Now tricky part of HUKM is that they are semi-government, and most of the time, private sectors share same facilities with the government sector.

Remember I told you I am exploring cheaper fees to get the therapy? because god knows how long will it take to treat GM, it can be one whole life expenses!

So, as I have to go to few department, for example: to get appointment for the hearing test, speech therapy, occupational therapy....The nurses notice that my HUKM letter is from the private specialist centre, and she says if your letter and chop is from private, you will have to pay private fees. WHAT! WTF again!


I called up the Prof Salwina assistance nurse and probed further.

I: Initially, your government sector waiting list is so long, but they don't recognise any letter from my private hospital (gleneagles) or private psychologist centre (DING). That's why I go to HUKM private specialist to get a proper HUKM letter, and now other nurses are telling me if my letter has government chop, then cheaper fees. But if it is HUKM private chop, then it is private fees. Eh, hello, if I want private services, I have already continue all the therapies and assessment in private hospital and private centres at outside. What for I come to HUKM?

Atiqah, Prof Salwina nurse assistant: YOU SHOULD KNOW, RIGHT? If you start off with private doctor, all assessment and therapies will be charged private fees all the way. Plus, the waiting list and appointent list of private and government are different. Private will be faster. (I did able to get some of the appointment on the following month till 3 months waiting period when I was using the private letter)

I: Eh, hello, how the heck I know your HUKM or any other hospital procedure? You all, the nurse or staff in hospital should guide patience and those who inquiry THE RIGHT PROCEDURE. I don;t know this is the procedure at all!


Anyway, I was chit chatting with another Facebook mama, and guess what? The nurse was right. HUKM government told the fb mama that the waiting list if 1 year to see the paedritician. This is real crap!


***

I was so pissed off by then. Sighed, waste my time to spend my time in HUKM.

c) NGOs

Anyway, I was recommended to go to Sau Seng Lum by a very experienced mother whose her child is autism. Sau Seng Lum is a leading non-profit health system in Malaysia serving health needs of the underprivileged improving lives in Klang Valley and beyond.



Found SSL psychologist: http://www.sausenglum.com.my/ssl/Psychology.html

Same procedure: assessment first RM 185, then recommend what therapy suitable for your child. Of course, SSL has proper facilities and therapies for your child. Fees are cheaper than those in private sectors, and to be on par with HUKM private fees though.

My experience with SSL - Made appointment with Ms Yong, SSL current child psychologist. She is fantastic, even explaining the reason of the following symptoms:

"Why kid choose to avoid eye contact? It is because he receives too much stimulation and too much confusion as your child look into your face. Most probably he/ she will end up focus on one part of your face, for eg: only your lips."

Ms Yong explains GM has sensory issues and joint attention problem as well, for eg: obsessed only on certain toy objects, or only one particular part of the toys. Doesn't attend to my cues or as I call his name, etc.

3) Therapy

So, what you do after the psychology assessment? identify the syndrome and find the right therapy to heal your child. It is all about cost, time or both. If you can wait, then go for SSL, government/ semi-govt sectors, because they are cheaper, but most of the time, as you know...waiting or appointment list again, and you might not get your therapy in regular basis, probably only 1 time in a month.

If you can't wait and have no time in waiting for miracle, go to private hospitals or private centres directly. But, bear in mind too, the therapists have long inquiry list, and they might also can help to arrange 1-2 times a month therapy for your kid.

One of the occupational therapist JY, tells me straight to the point: "No need run around. Just focus in one therapist in one particular centre, instead of going up and down to look for few therapists."

She is right. Because most therapy methods are more or less the same, and it is not about frequency, it is about the outcome, and how we, the adults and parents learn what to do from the therapist, and try to apply the methods at home with the child.

You must be wondering, why don't I directly go for therapy since I have the assessment done in Selina Ding? Well, in any therapy centres or hospitals, they need to do their own assessment, before allowing me to continue to have their therapy services.

I decide to seek for private therapies (after my bad experience with the hospital) that are near to my place, which is Cheras or Ampang.

So far, my experiences at all these private centres/ NGOs:

a) Occupational Therapy

Kidztopia: https://www.facebook.com/Kidztopia-Therapeutic-Center-648655145266802/?pnref=about.overview

Here's Kidztopia reply: "must make an appointment, you cannot walk in for inquiry because we need to protect client's privacy. "

"We are very busy, please make an appointment for assessment directly, followed by arranging the therapy session. Make sure you will be able to commit the therapy time and date once you started off with us."

My experience: Turned out they are quite professional and caring. Did 1st assessment and have a discussion on how to help GM.


b) Speech Therapy


i) Articulice Speech Centre by Ms Leong Yean Ching 014-3286009. From the tele-conversation, Ms Leong is so professional and passionate. She advised me not to start my baby with speech therapy, but to start off with occupational therapy, since my baby has sensory issue. Leong also advised me to buy more 'language toys'. What is language toys? later I will find out when I start the therapies. And to my surprise, her centre is on the same building with Kidztopia

https://www.facebook.com/Articulice-Speech-Centre-233573440159319/

ii) Kidsogenius in Cheras offers speech therapy and occupational therapy too, but mainly focus more in speech therapy, Cheryl is the person in charge: http://www.kidsogenius.com/ 




c) Private Centres that offer both Occupational and Speech Therapy

i) Siworld (ALERT!) http://www.siworld.com.my/ Too good to be true, too systematic and the way Mr Wong (the director from Siworld) speaks to the parents on first assessment,  is not professional for me. Although they offer a standard therapy classes with lower fees, I heard Mr Wong is actually not a qualified therapist or a principal. However, I wonder why he can open so many outlets and give so many talks, based on the press clippings and all those therapists certificates displayed around the wall of his outlets....so tricky...anyway, they are not professional, please take note.

ii) SHAM Therapy Centre that offers physiotherapy, occupational therapy and speech therapy (recommended by JY Teoh, a passionate OT): http://shamtherapy.com.my/index.html

I am going to SHAM physio and occupational therapy at the moment, and yes, they are really professional and passionate in what they do. Price also reasonable too.


I can see massive improvement with my boy behaviour and his development, I would like to say than you to Firuz from Sham Therapy for all her effort and the co-operation with her therapists. 

Sham Therapy at 03-4041 0751
Location: Plaza Pekeliling, Jalan Tun Razak, Sentul Selatan, 50400 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia


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The assessment fees for child development syndrome? Rates? Expect to spend RM 185 - 415 on first assessment for each place, regardless you look for psychologist, or the therapy centres (Rate as per year 2016)

***

I manage to get some recommendation from SD on the therapists who are good. Ignore the names, just look out for their centres instead:


Therapy Fees

a)  Speech/Occupational therapy fees in hospital - government RM 35 (only 1 time per month) ; if private hospital is RM 85 (1-4 times a month) depending on appointment and your budget.

b) in NGOs - Sau Seng Lum has both occupational and speech therapy services, charges are RM 50 per visit, the frequency can be 1 time a week. http://www.sausenglum.com.my/ssl/Paediatric.html

*If you confirm your child has autism and you are seeking for NGOs, you can consider Hua Ming Autism Society - http://www.autism.org.my/Online.aspx

c) Private centres - RM 90 - RM 180 per session, 45 minutes till 1 hour each session

Expect long waiting list from 6 months to 1 year for NGOs, but the good thing is that the facilities are much better than the government hospitals, or even shorter waiting period. But once the NGOs kickstart the therapy for your child, it will be a frequent therapy session. In the meantime, don't wait. 6 months - 1 year are also golden times for your child to heal. Opt for private therapy sessions at other places as per mentioned. Switch if your child doesn't feel comfortable with the therapies session.


Sources:

http://mmha.org.my/resources/directory-of-councelling-services/

https://counselingpsychologyinmalaysia.wordpress.com/general-info/where-to-find-mental-health-services/

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