Communication Disorder

This problem is much missed and misunderstood. It is the central tenet of Autism and Asperger's syndrome. Much over diagnosing of these conditions misdiagnoses Communication Disorder without autistic features but many of these diagnoses are false because there is no communication disorder. Sadly many children/adults do not have proper speech therapy and social skills training because people do not understand the Communication problems.
There are four basic components to Communication disorder-
1. Receptive. This means that the person can hear but does not understand spoken and non-verbal language. They are often described as selectively deaf.
2. Expressive. Difficulties saying or the non-verbal component of language causes frustration. This disorder is often seen as aggressive behaviour when the frustration becomes overwhelming
3 Pragmatic. The nuances of communication with grammar, full stops, emphases, rules of turn taking and flow of language are affected. At the severe end of the scale speech is robotic with little eye regard and lack of associated movements.
4 Narrative. This is the lack of understanding context and the whole aspect of communication. It means not understanding that people cannot read your mind and you have to introduce a topic, build a story and have an ending.
Most sufferers have problems in all four areas.
One can see why these problems cause learning difficulties. They also cause social skills problems.
The diagnosis and treatment is for the speech pathologist but many children see the child psychiatrist due to associated learning and behaviour problems or concern about the autistic spectrum of illness.
There is an overwhelming number of boys rather than girls who have this disorder so probably genetic rather than birth trauma (or lack of oxygen) that these 'soft brain' signs used to be the problem. There is an increased risk however in those babies who suffer lack of oxygen, breathing difficulties which means the premature baby. These babies have difficulty sucking, the same nerves that are needed for speech.
There is an acquired form related to chronic middle ear infections and glue ear. It is thought that the loss of effective hearing in the early developmental stages of communication can mean that that part of the brain lacks stimulation to develop normally.
Help is important. These children are picked on by other kids who recognise their problems as 'nerdy'and self esteem becomes a major problem. They are often in trouble for fighting back and do not cope with school work as well as they could.

Attachment in infants

The mother and baby form an attachment during pregnancy. The mother feels the baby's movements and has dreams about the birth and holding the baby once it is born. The mother usually prepares clothes and baby gear for the baby due to this attachment. The baby hears the mother's heartbeat and voice and cues into the mother's emotional state.
This does not always happen and sometimes the attachment occurs some time after the baby is born.
The visual and tactile clues, holding and seeing the baby, make it much easier to fall in love with the baby. It is akin to a distance romance- wonderful but not as good as actually seeing someone and cuddling in reality.
In this attachment the language is emotion. The baby is keenly sensitive to emotion. It is of course a highly emotional state, the birth of a baby. There is anxiety about the job and responsibility and sadness at the loss of pregnancy, a relief for some people. There is loss of independence, loss of sleep, loss of body shape and loss of friends who do not have babies. There is often loss of work and social respect for your professional life is much more than for the role of a mother. After all the fuss and family and friends go home, it is boring and lonely to have no adult company to talk to. All these emotions, the child perceives.
The child is dependent upon the mother for everything, including emotional support. It needs the mother for safety and protection and the message that she is in charge and looking after the needs of both of them. A depressed mother finds that hard to do. The child needs to know that life is fun and people can play games with him. He needs to know that he does not need to be the centre of all attention but needs his fair share as well.
The baby needs attachment with the father but security that the parent's relationship is sturdy enough that the baby cannot take over and disrupt it. This is often the most fragile thing in a family who has to adjust to a new baby.
Through this attachment the baby learns trust, love, self esteem and the will to explore the world. Education starts here. social skills and future relationships are created in this early stage. Positive and real emotions, problem solving and creative thinking are all automatically shaped in this relationship with parents that we call attachment. The process is created in the parent's own attachment and the sense of 'rootedness' or belonging that supports the baby.
I invite comments to all my blogs. I am interested to hear your thoughts and experiences.

Physiological symptoms of Post Traumatic Stress disorder

Interesting research from Dr Phobe Tucker, U.S., has shown sustained changes following trauma of body responses in the flight fight mode. Increased blood pressure, heart rate, cortisol levels with subsequent autonomic, immune and neuro-endocrine changes were found years after a traumatic incident and even after the emotional aspects of PTSD had ceased. This raises the possibility of long term changes in the body and the subsequent medical effects of these.
It will be interesting to see the effects of treatment and resiliency factors on these long term changes.Israel has sadly had its fair share of trauma and leads the world in management of PTSD using psychotherapy. You can access their website   http://www.traumaweb.org/content.asp?PageId=163&lang=En
As we all experience traumas, some big some small, on a daily basis, I wonder if there is an accumulation process or a threshold for experience that triggers autonomic responses. More research into resiliency is needed, who and why has more inborn capacity and what are the protective factors. We know already that maturity plays a great role and trauma can be more difficult for children to understand and process. We know that people who do not have anxiety and depression before an incident will do better so this is a risk factor in trauma responses and critical incident stress debriefing. We know that those people who are in a relationship and have a supportive network of family, friends and colleagues will have better outcomes. It is often difficult for family and friends to know what to do or how to help. I think, just listen and accept that it is beyond understanding or help validates a person's experience and their response. There is a lot to be said for the warmth of human to human touch in the healing process.

Children who care for their parents

It must be tough to be a child in such a bewildering world. Thankfully most children rely on their parents for support. Parents are human too and they get sick and sometimes suffer mental illness. If one in five adults suffer depression and one in three suffer anxiety then there are probably many children whose parents are battling mental illness. Most are fabulous parents while coping with their problems. Many choose to share some of the information for their children, so their children understand, can have strategies in place to cope and monitor themselves in the case of genetic illness. Many discuss limits to their lives, like not going out, or meeting people or going in lifts so their children can understand.
Many parents keep the information to themselves and this is probably good to a level as too much information overloads children. Depending upon developmental level and maturity, some children  cope well and others worry, try to take control or feel guilty that they may have caused the problems. Some children develop separation anxiety as they are scared to leave their parent alone in case something bad happens.
A good thing is to get information. This website is good
http://www.copmi.net.au/parents-and-families/family-friends/advice-on-coping.html
There are a number of books and pamphlets available to help parents and children understand and cope.
Ask for help!

The meaning of life

This topic sounds something between a heavy philosophical tome and Monty Python.
Victor Frankl wrote on this topic extensively following WWII. He started a following of people who felt that this was a very important aspect of life and cause of mental illness called logotherapy. His book, Man's search for meaning, (1946 in the original title and in German) was followed by The Will to Meaning (1988). He died in 1997.
His work started from Vienna in Freud's circle but he was placed in a number of concentration camps during the war. He was bound for America to escape but on the morning of his departure he was torn between staying with his elderly parents and leaving for a new future. he saw the words, Honour thy father and thy mother  and so decided to stay with them. During his many years in the concentration camp, as a psychiatrist, he tried to help his fellow inmates. He also studied the human mind under such oppressive conditions. His books make sobering reading. He came to the existentialist position that to survive this, and normal life, you had to create a meaning for your existence. Poor self esteem, lack of self confidence, subsequent abuse of drugs and alcohol, depression, nihilism and suicide all stem from a lack of understanding your role in the world and the purpose of your life he says.
This seems to me to be very relevant today. We, in a consumerist society have everything we could want and yet we are increasingly unhappy. All this hedonism, individualism, and narcissism has failed to make us complete.  It reminds me of the saying  Ask not what your country can do for you but what you can do for your country ( JF Kennedy 1961).
Search for meaning is about what you can do to make the world a better place, using the skills and talents you have.  It sometimes means standing alone and battling to achieve against the odds but it can be in a group and achieving small goals. For some people it is climbing a mountain or sailing around the world, solving world hunger or curing childhood cancer. For most of us it is helping someone else, raising funds for medical research, saying hello to new neighbours and switching off a light to reduce carbon emissions. If you buy a magazine from a homeless person, donate a dollar to a charity, give a dinner to a homeless person, the giving bounces back on you as well, a win / win situation.
I suggest that you think about these goals on a regular basis, update them and work at upholding your personal meaning.