Special Child...How Do We Know from Prenatal Period?

Thaweesak Siriratrekha, MD, Child and Adolescence Psychiatrist

          Nowadays, there are many problems regarding special children such as autism, Asperger’s, LD, attention deficit, cerebral palsy, intellectual disabilities, etc. This raises concerns over parents who are having a baby born with possibilities of becoming a special child. How can we foresee? And what method helps us know? 
          How to forecast whether a child is a special child is relatively dependent upon his problem. Each form of problems is different, some type can be known before birth while some know when a baby is born. Some do not know even a child has been born. We have to wait until he grows up a bit.
          Prenatal forecast is chromosomal abnormalities, for example, Down syndrome is the abnormality of 21th  chromosome causing a unique appearance with many physical and intellectual abnormalities which can be examined at 2 nd month gestation by special methods such as diagnosis of chromosomal abnormalities and bio-chemical check. It is recommended for pregnant women aged 35 years old up that medical check-up is needed since they are of high risk.  Abnormality of skull or physical impairment and misshape can be found by ultrasound as well.
         Postnatal group like cerebral palsy with abnormal movements, hypotonia or, hypertonia ,slow gross motor development. Physical impairments are easily observed while visual and hearing problems in case of severe symptoms are apparent.
          Whether a group of children was born to be normal but falls on a group of special child or not, needs time for making a diagnosis, for example, autism, Asperger’s, LD and attention deficit. 
Autism will be recognized after 1 year since clearer indicators and symptoms will show when a child is 1 and a half years old. He still cannot use fingers to point to the desired objects, lack of attention to play or join a role play or imaginative play with other children around him. He seems unable to utter any words and have only his unique language called “alien language”. 

            Asperger’s is similar to autism but a child will be talkative and has good memory as well as learning ability. Problems cannot be observed when he is an infant but only an expert child psychiatrist can tell. A baby seems to be clumsy, avoids eye contact but always asks questions over and over and could not behave properly since social skills are abnormal.  

         LD is also the same. Explicit symptoms will show when a child is in elementary school of Prathom 1. A child cannot read, write or calculate even though he seems to be vigilant and talented while talking.
          Attention deficits will show tentative naughtiness and restlessness since he was a baby but cannot clearly be verified until subsequent impacts have been evident. For example, he cannot finish his work as his friends do and academic result is lower than his normal competence. Friends avoid playing with him since he plays improperly.