The brain's ability to integrate information is called "sensory integration." The rich sensory information in the environment includes vestibular, proprioceptive, tactile, visual, auditory, olfactory, and gustatory information. A child's brain, functioning normally, can receive and integrate sensory information from the environment and respond appropriately. During this integration process, the brain must receive diverse and rich sensory experiences, react and make corrections. Through repeated integration, its function is further enhanced and perfected. During the period of rapid learning development from birth to preschool age, children learn to recognize and control their own body movements and interact with their surroundings through various sensory inputs. For example, when learning a new movement, they appropriately counteract gravity and maintain their balance; they make appropriate limb controls and ranges of motion in a corresponding space; and they also learn the different meanings and characteristics of various sensory inputs of different sizes, weights, speeds, and textures. By integrating these sensory inputs with motor learning, the brain learns how to appropriately and effectively control or adapt to the environment, respond to the needs and requirements of the environment, and play an appropriate role in environmental activities and interactions with others.

Sensory integration is like a small tool for humans, helping us to better perform the actions we want to do and adapt to the environment. It is also the best tool for therapists to use in therapeutic activities. Through the joint efforts of parents, sensory stimulation is integrated into daily life to provide the maximum and richest stimulation to help children's development. This is the best tool we can provide for them.

If you find that your child's development (e.g., motor skills, language) is slower than expected, you can first contact our Child Development Center for professional consultation. The center will help you understand your child's developmental status and provide relevant skills training and activity suggestions. After the consultation, you can decide whether you need to bring your child to our hospital for evaluation. If the medical evaluation confirms this, please remember to seize the golden stage of your child's development and provide early intervention services in a timely manner to assist their development. You can also report to the city's Child Development Reporting Center to obtain early intervention welfare subsidies and resource provision.

Parents often have similar questions, but do they really understand ADHD? ADHD is a common childhood neurodevelopmental disorder, affecting about 5-8% of school-aged children. This disorder stems from local and connectivity abnormalities in multiple areas of the brain, causing children to have inattention, poor organizational and planning skills, impulsivity, restlessness, and emotional and motor control disorders. Its impact includes learning, interpersonal interaction, social functioning, and even self-esteem. The main symptoms are classified into three types: Attention Deficit Hyperactivity Disorder (ADHD), Hyperactivity with Impulsivity (ADHD), and Combined ADHD.

The five diagnostic criteria for ADHD in DSM-5:

• Distractor-related or developing persistent attention deficit and hyperactivity.

• Several types of inattention or hyperactivity were present before the age of 2.

• Several symptoms of inattention or hyperactivity-impulsivity manifest in two or more situations.

• There is clear evidence that symptoms interfere with or reduce the quality of social, academic, or occupational functioning.

• These symptoms do not appear alone in schizophrenia or other mental illnesses and cannot be better explained by another mental disorder.

  
  

According to the latest psychiatric diagnostic criteria, a diagnosis of ADHD requires symptoms of inattention, hyperactivity, or impulsivity that are more frequent and severe than those of children of the same age and persist for more than six months. Some children develop symptoms before the age of seven, and these symptoms occur in more than two settings (e.g., at school and at home). These symptoms cause personal distress for the child and affect their social skills and academic achievement. A professional diagnosis still requires evaluation by a physician.

The current treatment methods are as follows:

1. Drug therapy: Studies have confirmed that drug therapy is the most effective treatment for resolving the core symptoms of ADHD; however, when symptoms are mild, parenting education, behavioral therapy, psychological counseling, and educational guidance are important basic intervention methods.

2. Behavioral therapy: Utilizing the principle of stimulus-response reinforcement or inhibition, it enhances appropriate behavior in children and corrects inappropriate behavioral responses.

ADHD is a treatable condition. It is also important to identify and affirm the strengths of each individual during their development. With the cooperation of children, parents, teachers, and therapists, children can have excellent developmental potential. Parents are welcome to consult doctors and therapists with any questions regarding early intervention.

During the infant and toddler developmental stage, a child's abilities can be altered through medical rehabilitation and special education interventions. However, therapy does not necessarily "disappear" all of a child's delays or disabilities. This is because each child's situation is different; some children may have delays in a single area, multiple areas, or even generalized delays. What is certain, however, is that early intervention is beneficial to a child's development. Some children, after receiving therapy, may achieve abilities comparable to their peers; others may experience a reduction in the severity of future disabilities. Therefore, it is recommended that parents maintain a positive attitude: accept their child's true situation, do everything possible to provide a safe and appropriate environment for growth, encourage their children to overcome their disabilities, and learn independent living skills.

Based on the principles of protecting children's rights and confidentiality, case information will not be disclosed. If a child has been identified as a special education student after entering primary school, parents who are concerned that their child may be stigmatized and excluded can contact the Special Education Division of the Education Bureau to have their special education status revoked.

Before starting primary school, a baby's body continues to grow, and their nervous and intellectual development continues as well. They go through a certain developmental process in various aspects, including cognition, language, motor skills, social adaptation, and emotions. For example, they might crawl or walk, smile at their mother, say "daddy," show fear of strangers, or enjoy playing hide-and-seek or pretend play. If a baby's developmental milestones are not keeping pace with other children, we call it developmental delay.

In the past, many parents held the belief that "a baby's development will catch up eventually" and that they could simply observe and wait. However, it is now recognized that young children have more plastic nervous systems, so children with developmental delays should receive early intervention, with the golden period being before the age of three for optimal results. Failure to provide early assistance to these infants and toddlers may negatively impact their subsequent neurocognitive development. Therefore, early intervention, like disease treatment, is crucial for a child's physical and mental health!

How can we detect developmental problems or delays in children early? We recommend that parents closely observe their baby's development at home and take them for regular health checkups. Parents should regularly observe and fill out the "Parent Record Items" for each age group in the child's health handbook, noting the baby's mature developmental steps, and provide the doctor with the baby's information at each health checkup. Below are some key points of child development; parents can check their child's development against these age-specific guidelines based on their full-term age.

In terms of movement, does the baby have:

• At 3 months old, when lying on his stomach, he cannot lift his head to 45 degrees and does not open his palms on his own.

• When the baby is 6 months old, he still cannot sit up independently and cannot transfer items from one hand to the other.

• Even when they are 1 year old, they still cannot walk while holding on, and cannot pick up small objects with their thumb and forefinger.

• When he was 2 years old, he still couldn't run or scribble on paper.

• Even at 3 years old, he still cannot stand on one leg or turn the pages of a book.

• Even at 4 years old, he still cannot hop on one foot or draw circles.

• By age 5, a child will not be able to walk in a straight line heel-to-toe or draw a cross.

In early childhood intervention, many parents often ask if their child has flat feet. Because bone development is not fully complete in early childhood, some normal developmental processes are often considered abnormal. The arch of the foot is mostly formed by the age of two to three. If the inner side of the foot is still flat when standing, it means that the navicular bone has shifted downward, causing the inner arch to collapse. When stepping on the ground, the inner arch disappears, which is what is called "flat feet".

Most cases of flat feet are asymptomatic. A small number of people with flat feet may experience frequent falls due to impaired gross motor skills such as walking, running, jumping, and balance caused by flat feet or overall developmental delays and ligament laxity. However, if there is also an outward tilt of the heel, it may lead to inflammation and pain caused by excessive stress on the soft tissues. Symptoms usually appear after puberty, but some people may experience problems such as foot pain, needing to be carried after walking for a short time, frequent falls, or abnormal gait in early childhood.

Generally, flat feet in young children do not require any treatment; observation and monitoring are sufficient. They usually recover gradually between the ages of five and seven, and at the latest, they will naturally form by the age of ten. However, 5-10% of children still have flat feet that cannot recover naturally. Therefore, parents should pay attention to their children's foot development during the arch development period between the ages of two and eight, avoiding incorrect postures and strengthening foot exercises to induce arch development. However, if the flat feet are accompanied by pronation, special medical insoles should be given at the age of three to support the arch and keep the foot in the correct position for development. This will prevent other related tissues from being subjected to abnormal forces and causing developmental abnormalities. Foot braces are only necessary in cases of severe foot deformities or as advised by a doctor. If there are severe deformities or other congenital bone fusion problems, a professional pediatric orthopedic surgeon should be consulted to assess the necessity of surgery.

Advice for parents

1. If an elder in the family has flat feet, special attention should be paid to the development of the child's feet.

2. Do not put weight on the feet of infants under ten months old too early, especially when using "baby walkers" or "crab walkers" to learn to walk.

3. Avoid having children under six years old kneel at home or in kindergarten.

4. When choosing shoes for children with flat feet, special attention should be paid to the stability of the heel.

Parents should avoid purchasing commercially available corrective shoes or arch supports without an evaluation by a doctor or therapist. High arches can impair arch function and cause foot pain, while low arches lack support. It's also important to consider any forefoot issues, taking into account the child's weight and overall physical development. If a child frequently falls, it may indicate a foot problem, overall developmental delay, or sensory integration dysfunction. If you notice any abnormalities in your child's feet, it is recommended to observe them for a period of time. If there is no improvement, consult a professional pediatric orthopedic or rehabilitation specialist for diagnosis, or seek a detailed evaluation from an experienced physical therapist. Long-term monitoring of their foot development is necessary to determine if foot braces are needed. 

In terms of cognition and language, does the baby have:

* When the baby is 3 months old, it will not look at people's faces when facing its mother or primary caregiver.

* By 6 months old, they will not turn their heads toward the source of the sound.

* By the time they are 1 year old, they still cannot say one or two meaningful single syllables, such as "hug" or "mama".

* By age 2, they still cannot point out body parts.

* By age 3, they still cannot use questions or say short phrases such as "Mommy hug me" or "Look at the dog."

* By age 4, they still do not use pronouns ("you", "I", "he") or time terms ("yesterday", "today", "tomorrow").

* Children over 5 years old cannot count from 1 to 10.

Diagnosing autism in early intervention clinics requires a period of observation and a detailed mental assessment. Some young children (e.g., under 3 years old) may exhibit certain behaviors during the initial assessment due to their immature language and interpersonal skills, raising suspicion of autism-related disorders. Regular follow-up assessments are recommended. However, regardless of whether autism traits are suspected or autism is diagnosed, the importance of intervention is repeatedly emphasized.

The symptoms of autism vary greatly from person to person, ranging from a lifelong inability to care for oneself to near-normal after treatment and training. According to the latest Diagnostic Criteria for Mental Disorders (5th Edition), autism, along with other milder types (such as Asperger's syndrome or other pervasive developmental disorders), is now collectively referred to as the "Autism Spectrum" for diagnosis and discussion. In developed countries, approximately 1.5% of children are diagnosed with the autism spectrum, and males are 4 to 5 times more likely to have autism than females.

Parents should pay attention to these 5 signs of autism.

1. Difficulty in expressing emotions, verbally and nonverbally:

The onset of spoken language is slower than in other children. There may be a longer period of imitation, during which they can only repeat the words or phrases they hear. It takes many repetitions to gradually connect the language with the actual situation and then understand the meaning.

2. Social interaction disorder:

Children with autism tend to interact less with others from a young age, including rarely making eye contact with caregivers and being unable to form an attachment relationship with them.

3. Obvious fixed interests and repetitive behaviors:

They often don't play with toys in the normal way, but have their own unique ways of using them, and there will be repetitive and mechanical ways of playing with them.

4. Sensitive to certain sensory perceptions:

For example, some people are auditoryly sensitive to certain frequencies of sound and find them unbearable; others are tactilely sensitive and cannot tolerate combing their hair.

5. Other performance:

There may be delays in gross or fine motor development, but these are usually not as significant as those in language development. In addition, about 70% of children with autism also have intellectual disabilities.

How to treat autism? Autism is a developmental disorder that doesn't just appear in childhood; it's a lifelong challenge, and symptoms can change as the child grows. Autism cannot be cured by surgery or medication, but early intervention and behavioral training can reduce inappropriate behaviors and mitigate the impact of social and communication difficulties.

Currently, there are many effective treatment methods available clinically, such as behavioral therapy, cognitive therapy, sensory integration training, language communication training, music and art therapy, etc. Early detection by parents and family members is crucial for children with autism. Taking the child to a rehabilitation or pediatric psychiatry department for evaluation and treatment, and combining early intervention with collaboration across the medical, rehabilitation, and educational systems, will maximize the child's benefit.

In terms of social behavior and emotions, does the baby exhibit the following:

* By 3 months old, the baby will not smile or make a "coo-coo" sound when teased by adults.

* When he is 6 months old, he will not react if you remove his favorite toy.

* By the time a child is 1 year old, they will not play hide-and-seek or wave goodbye.

* By age 2, they still do not imitate adults' daily actions and have no visual contact with others.

* By age 3, they will not interact or play with other children. They usually play by themselves and will not respond even after being called by adults multiple times.

* Talking to oneself with fixed phrases instead of communicating with others; or repeating one's own interests like a tape recorder, regardless of others' reactions.

* Dislikes being hugged or strongly dislikes being touched.

* They react abnormally strongly to daily affairs, which may even harm themselves or others.

There are many causes of developmental delays in children, and a professional team will provide a thorough evaluation. Babies who are premature, have low birth weight, congenital abnormalities, brain diseases or injuries, whose mothers were exposed to tobacco, alcohol, or drugs during pregnancy, or who have close family members with visual or hearing impairments, intellectual disabilities, or mental disorders are more prone to developmental delays, and parents should pay special attention. If any symptoms suggestive of developmental delays are observed, seek medical attention immediately for prompt diagnosis and referral for early intervention.

If you have any questions about early childhood development, you can: * Directly contact the Child Development Center at 2995-4245#108.

Please contact the rehabilitation center's team leader, who will first assess whether your child needs a comprehensive evaluation before making further arrangements.