20
electric children
The HEALTH | JUNE, 2018
Epidermolysis Bullosa
I
Dr Nazirin Ariffin.
N “A very rare disease”, the article
quoted Hospital Kuala Lumpur
Institute of Paediatrics, Paediatric
Dermatologist consultant Dr Sabeera
Begum as saying that there are 100
families in the whole of Malaysia who are
affected by Epidermolysis Bullosa (EB).
Globally, the United States National
Organisation for Rare Disorders (NORD)
estimated that EB occurs in one out of
every 50,000 live births. The disorder
occurs in every racial and ethnic group
throughout the world and affects both
sexes equally.
Pantai Hospital Kuala Lumpur
Dermatologist consultant Dr Nazirin
Ariffin emphasised that EB is actually a
rare inherited disease. Children with EB
are known as butterfly children because
their skin is as fragile as the wings of a
butterfly.
What Causes Epidermolysis
Bullosa?
The skin is made up of an outer layer
(epidermis) and an underlying layer
(dermis). The area where the layers meet
is called the junctional zone. They are
glued together by at least 15 types of skin
protein (Collagen 7, Collagen 17, Keratin
5, Keratin 14, Plectin, etc).
EB happens when one of the skin
protein is decreased. The loss of this skin
‘glue’ makes the skin weak.
There are four types of EB:
• Epidermolysis Bullosa Simplex
• Epidermolysis Bullosa Junctional
• Epidermolysis Bullosa Dystrophic
• Kindler syndrome
RF123
Methods for
parents and
teachers to
help a child
with ADHD
Attention deficit
hyperactivity disorder
Recognise the signs and
symptoms in children
you will have attention problems as a
secondary problem.”
According to Raja Juanita, part of the
assessment is to look for other develop-
mental difficulties.
“Often, you would find that when you
improve certain areas such as speech
and language delay which in itself causes
attention problems, you will find that
the attention will also improve. That’s
for the younger age group that’s under
five,” she said.
A
PPROXIMATELY five per-
cent of children will have
attention deficit hyperac-
tivity disorder (ADHD).
This however, should not be
confused with attention problems due to
other developmental disorder especially
under the age of five.
Pantai Hospital Kuala Lumpur
Paediatrician consultant and Develop-
mental Paediatrician Dr Raja Juanita
Raja Lope pointed out that children
under the age of five, may have some
other underlined developmental
problems such as speech and language
disorders, speech and language delays
or global developmental delay —when
all the skills are below that is expected
of a child’s age.
“And if you have a problem with other
areas of development such as dyslexia,
Early signs to look out for
Raja Juanita Raja Lope.
Parents may notice early signs of hyper-
activity where a child is unable to sit
and play with one toy. They might just
play with it for a minute or less than a
minute and move and play with another
and other. They may not even be able to
sit still to watch a programme. However,
you have to look at it in the context of
the age as well.
“As ADHD is diagnosed in children
who are older above the age of five, the
main problem would be attention deficit
OCCUPATION therapy can help
with attention as therapist
utilise methods such as sensory
interpretation to help with some
expects of inattention. However,
it doesn’t cure.
There are certain techniques
such as attention training, which
helps the child sit and regulate
their attention and behavior
better which can be used by
parents and teachers.
Another technique is making
sure information is given in
bits and varying the types of
information. More visual than
verbal helps as children pay
attention better to visual than
verbal information.
Varying the way information
is provided with a combination
of talking, followed by visuals to
gain the child’s attention.
In addition to this, teachers
can get the child to sit in front
of the class. Tapping on the
table when you notice the child’s
attention wondering may help
too.
Finally, break down any work
than giving the child a big list. This
will increase the success of task
completion.
and hyperactivity,” she added.
“In such situations, the child’s speech
and language and other developmental
areas are fine, but the child would
be easily distracted. Noise, different
lighting, anything sensory can be a
distraction.”
“Perhaps he or she would be looking
around in class, getting up and walking
around, may be very impatient and
impulsive in the sense that they aren’t
aware of danger which are the key fea-
tures of ADHD as well.”
“They will not listen and tend to
interrupt often, and they also find it
difficult to complete task. Everything
that requires more thinking —it is not
that they can’t do it— as the primary
diagnosis of ADHD is that the child’s
skills are pretty much age appropriate,
but the attention may interfere with the
ability to learn and function in different
settings.”
Children with ADHD may also have
problems with social skills as they are
overly enthusiastic or rough.