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Promoting mental well-being in primary school students. Dr. Nilima Shah Dr. G.K.Vankar Department of Psychiatry B.J.Medical College Ahmedabad. Mentally well children……. They should be able to: • develop psychologically, emotionally, intellectually and spiritually;
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Promoting mental well-being in primary school students Dr. Nilima Shah Dr. G.K.Vankar Department of Psychiatry B.J.Medical College Ahmedabad
Mentally well children…… They should be able to: • develop psychologically, emotionally, intellectually and spiritually; • initiate, develop and sustain mutually satisfying personal relationships; • use and enjoy solitude; • become aware of others and empathise with them; • play and learn; • develop a sense of right and wrong • resolve (face) problems and setbacks and learn from them.
However….. “One in ten children and young people aged 5 to 16 have a clinically diagnosed mental health disorder and around one in seven has less severe problems”
Raju studies in 3rd std. He is a well behaved, polite and obedient boy. He gets average marks in all the subjects except mathematics. He is very good at cricket and music. However it is noted that he never completes his homework. He cannot take running notes in the classroom and his handwriting is quite bad. He leaves his answer sheets incomplete. • When asked to read aloud, he fumbles, hesitates and makes a lot of mistakes. However when asked a question in viva he can answer very well. He also ranks 1st in General Knowledge quiz. What do you think is going on???
Specific Learning Disorder • Impairment in : • Mathematics • Reading • Written Expression
Dyscalculia • Sense of Numbers • Memorisation of Arithmetic facts • Accurate or fluent calculation • Accurate Math Reasoning
Dyslexia • Word reading accuracy • Reading rate or fluency • Reading comprehension
Dysgraphia • Spelling accuracy • Grammar and punctuation accuracy • Clarity or organisation of written expression
Shyam studies in 1st std. He is always on the go and acting as if driven by a motor. He talks a lot. Even during the morning prayers he cannot remain still and keeps tapping his hands and feet opening his eyes and wanting to move around as soon as possible. • His favourite class is the sports class in which he runs about and tries to climb up the trees in the playground. He is eager to learn and often blurts out an answer even before the question has been completed. He cannot wait for his turn or stand in a line. • The concern is that his academic performance is gradually declining. What do you think is going on?
Attention Deficit Hyperactivity Disorder • Hyperactive/Impulsive type • Inattentive type • Combined type
Sheena studies in 5th std. She is a polite, well behaved, sincere and honest child. She seems to be working hard with all her subjects, completes all homework and assignments, and reads regularly. However she barely manages to get passing marks in all the subjects. • She comes across as very shy and introvert in nature. She ahs low self esteem and low confidence. She cries easily when confronted with questions. • Her school records show that she was born pre mature. She learnt to walk at the age of 2.5 years and learnt to speak at the age of 3 years. ( delayed development ) What do you think is going on?
Intellectual disability • Mild : IQ is between 50-70 • Moderate : IQ is between 35-49 • Severe : IQ is between 20-34 • Profound : IQ is less than 20
Rahul studies in 1st std. He comes across as slightly odd and eccentric. He had difficulty in making friends and playing sports with others. He often played alone and spent time alone at lunch and recess. • His communication was odd and restricted with monotonic voice quality. His academic performance was average and there were no problem behaviors. • He had keen interest in playing the violin and stole the show in all music programs in school. What do you think is going on?
Autism Spectrum Disorders • Persistent deficits in social communications and interactions • Restricted, repetitive patterns of behavior, interests or activities • With or without accompanying intellectual impairment • With or without accompanying language impairment
Autism : Associated Behavioral Symptoms • Disturbance in language development and usage. • Intellectual disability • Irritability • Instability of mood and affect • Response to sensory stimuli • Hyperactivity and inattention • Precocious skills • Insomnia • Minor infections and gastro intestinal symptoms
Shashi is the trouble-maker of the class. He is the naughtiest of all, and doesn’t seem to improve his behavior even after several punishments. • He bullies, threatens and intimidates others, often getting into physical fights. He doesn’t think before breaking things. Once he even burnt his classmate’s notebooks in school. He lies all the time and is also found stealing things from the school • He is unconcerned about his own performance, about the feelings of others and never feels guilty or sorry. What do you think is going on?
Conduct disorder • Aggression to people and animals • Destruction of property • Deceitfulness or theft • Serious Violation of Rules
Conduct disorder • With limited pro-social emotions • Lack of remorse or guilt • Callous-lack of empathy • Unconcerned about performance • Shallow or deficient affect
Mahesh studies in 7th standard. He used to get very good marks till the 5th std. However, his scores are steadily declining. He seems to remain alone, and talks less with his friends. • Even in recess, he sits in a corner while the others play. He refuses to participate in the upcoming cultural programme. He often leaves his home-work incomplete. He is also inattentive in class, and when reprimanded, starts crying like a child. • His parents have recently been divorced. What do you think is going on?
Depression • 2-3 % of children and upto 8% adolescents are affected • They are at increased risk of self-harm and suicide • May have irritablity/defiant behaviour /depressed mood
Other problems • Anxiety disorders (OCD/Phobia/Social Phobia/PTSD) • Performance anxiety • Childhood Bipolar disorder • Early onset schizophrenia • Substance use problems • Eating disorders • Internet addiction
Stressors that affect children Loss or separation – resulting from death, parental separation, divorce, hospitalization, loss of friendships (especially in adolescence), family conflict or breakdown that results in the child having to live elsewhere Life changes – such as the birth of a sibling, moving house or changing schools or during transition from primary to secondary school Traumatic events such as abuse, domestic violence, bullying, violence, accidents, injuries or natural disaster.
Signs of psychological disturbance • An unexpected reduction in academic performance. • A change in mood and marked emotional instability • Withdrawal from relationships, separation from friends • Getting into trouble at school, discipline problems • Loss of interest in usual pursuits, study, relationships. • Ideas and themes of depression, death or suicide. • Hopelessness and helplessness. • Giving away prized possessions. • Stressful life events, including significant grief. • Bullying or victimisation. • History of mental illness/ Alcohol/drug misuse. • History of suicidal behaviour or deliberate self-harm
What one can do….. Avoid giving labels…..
What one can do… • Be impartial • Be non judgemental • Be non-sarcastic • Shower appropriate praises • Be encouraging • Never give up on any of them • Give time and a patient listening ear • Understand them, accept them all • Specific interventions for specific disorders
At the school level… • Positive and negative re-inforcement techniques • ? Role of punishments • Have a student feedback mechanism in place • Address complaints and praises in a group rather than singling out students • Personal mentoring • Working with parents • Peer-mentoring • Student support service/counselors • Providing stress-buster time: Rainbow room/Oasis/ Tete-e-tete
Thank you… Contact details: 9979880789, itisnilima@gmail.com
