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Useful Tips/Guides
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(I) Integrated Family Services

(II) Child Care Services


(III) Rehabilitation Services

(IV) Elderly Services

 

(I) Integrated Family Services

1.Attention-Deficit/Hyperactivity Disorder ？
  • Attention Deficit Hyperactivity Disorder, ADHD, is a neurobehavioral developmental disorder. It is one of the most common mental disorders diagnosed in children.
  • Symptoms of ADHD can appear over a period of many months. They include:
    • Inattentiveness
      • Difficulty focusing on tasks or play activities
      • Failing to pay close attention to details or repeatedly makes careless mistakes in their schoolwork, work, or other activities
      • Easily distracted by external surroundings
      • Reluctance to engage in tasks that require sustained mental effort
      • Poor basic organization skills.
      • Often misplaces objects and generally forgetful.
    • Hyperactivity
      • Fidgets with hands and/or feet
      • Cannot sit still
      • Often leaves classroom seat without permission or in other inappropriate situations
      • Runs around or climbs objects at inappropriate times
      • Talks excessively
    • Impulsive
      • Acts without thinking
      • Frequently does things out of turn
      • Wantonly interrupts or intrudes on others
  • If ADHD is suspected, a child should be examined by a medical professional with training in the field, such as child psychiatrists and clinical psychologists. Effective treatments include behavioural therapy and medication.

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2.Language Developmental Delay or Disorder of pre-school toddlers
Pre-school (aged 2-6)
The first to the sixth years of children is a very crucial period for their language development, including both receptive part and expressive part. If parents want to understand the language development of their children, they must spend time playing with them, use toys or books which are appropriate to their children. For example, spend 15 minutes to play cook-set with the children or read picture books with children aged 5 to 6.

Children's receptive language
In the process of playing, parents could ask their children to follow some commands, the commands could be from simple to difficult level which include more complicated concepts (i.e. colour, location, size…etc). For instances, "Give me the big apple/ red cup" is a relatively easier command while "Put both banana and grapes into the small bowl and then give it to the doll" is a more difficult one. Apart from commands, asking children with different kinds of questions is also very important. Parents could also assess the child's speech development with the questions. Whether the child answers appropriately or just uses some pronouns for answering could indicate if he/she is able to use vocabulary and sentences appropriately. Parent could also examine the problem-solving skills; critical thinking and inference skills of children aged 5 to 6 as well. For example, ask the child "If the food is dirty, how will you do and why?", and "What will happen if the glass drop?"

Children's expressive language
Children learn to express by using single words, combine words and then expand them into short utterances, and finally using collectives for expressing a more complicated and detail idea. Children aged 2 should have acquired and be able to use about 200 vocabularies including nouns, verbs, adjectives…etc. (Fensen, Dale, Reznick, Hartung, and Burgess, 1990). Toddlers at this age could verbally and nonverbally reject, request for actions or objects. Parents may need to pay more attention if their children, aged-2, are still quiet and lack communication. Toddlers receive much more language input from adults and peers after they have started attending kindergarten. Much more sentences will be learnt such as "Mummy bought this dress for me", "No more chairs!". Parents could try to see the children's response by asking them to describe picture books, simple story or daily events which are going around them. In case a 4 years-old child is only able to use single words or very simple utterances (e.g. There's a dog; there's a cat…) to describe the picture only, he/she may have language developmental delay.

If parents suspected that the child may have language developmental delay or disorder, it is suggested to consult a pediatrician or speech therapist for conducting screening or speech assessments.

References:
Fensen, L., Dale, P., Reznick, S., Hartung, J. and Burgess, S. (1990, April). Norms for the MacArthur Communicative Development Inventories. Poster presented at the International Conference on Infant Studies, Montreal, Quebec.

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(II) Child Care Services

3.Preparation for starting preschool

The start of preschool can often be a difficult time for toddlers. For the first time, they are separated from their family (or maid) and thrust into unfamiliar surroundings. They can be overwhelmed with the volume of new information they must assimilate, such as people, places, routines and basic learning. By preparing a few months ahead of their first day of preschool, you can make the adjustment process easier for your child and help them enjoy the experience.

  • Encourage basic self care
    • Encourage the child to learn basic self care such as dressing without help, toilet training or tidying up their own messes. This will enhance your child's self-reliance and confidence to cope with preschool life.
  • Establish simple rules and routines at home
    • Set up simple rules at home. Teach your child learn how to follow instructions and request permission to do things.
  • Promote activities that require your child to be quiet and seatedPromote activities that require your child to be quiet and seated

Let your child get used to activities such as storytelling, and arts and craft

  • Create opportunities and encourage your child to mix with other children

Take your child to the playground, the park, birthday parties, or the neighbour's place. Let your child mingle with other children - teach them how to shake hands, buy them toys that encourage the participation of others, and give them the space to approach others.

  • Overcoming separation anxiety

Your child may feel anxious upon separating from you or other close family members. To help overcome this anxiety when starting preschool, practise separation in advance. Initially, leave his/her for only a few minutes then find a babysitter your child likes, and gradually increase your away time to a few hours.

  • Expose your child to interesting school life

Give your child an early taste of preschool to help them build up an interest. Visits to the local nursery or kindergarten in the neighbourhood with them, and reading to them about school life can spark their interest.

Before school actually starts, familiarize your child with the route to school. Attending the orientation programme is also a good opportunity for them to get to know the school environment.
Try to take a short period off from work and accompany your child to school for the initial period. Some preschools encourage parents to stay with their children in class for the orientation period (lasting from one to a few weeks). The time will be progressively shortened to introduce the child to the new school life and allow her/him to adjust to separation from parents. Be prepared for minor problems to arise no matter how much preparation you have done. It is common for children to cry, leave their seats, snatch toys, be restless or temporarily regress in behaviour. Keep frequent contact with the teacher to understand your child's adjustment and establish a partnership with the school to help them along to a happy school life.

(Reference: DH Family Health Service)

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4. Understanding Your Child’s Development - for parents of pre-school children
Starting kindergarten is one of the first major milestone in a child's life. Their development is influenced heavily by both the family and school environment. When parents and teachers work closely together, it can have a symbiotic effect on the child's growth and learning.

Children should ideally have a balanced education in cognitive, language and physical curricula. If parents are concerned with their child's development, they should try to avoid unnecessary anxiety. Instead, they need to first consider the following factors:
  • A child's development is a continuous process, and the pace of progress commonly varies.
  • It is very common for children to develop quickly in certain areas, but slower in others.
  • Different environments can produce different results; when parents and teachers communicate frequently, they can do more to provide the ideal settings for the child.
  • In early learning classes, the age range for the same cohort can be over one year. At this stage, the older children in the cohort will often develop more quickly than their younger peers. Parents and teachers should therefore consider the relative age of the child and have realistic expectations.
  • If parents are concerned with a child's development, they should first observe how well the child adapts to school life. If the problem is short-lived, there is no need to worry too much as their learning abilities are still developing. However, if over time the child's progress appears to be falling significantly behind, parents and teachers may need to explore the possibility of providing extra support.

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5.Preparing children for primary school

The transition from a relatively free mode of learning in preschool to a structured curriculum in primary school represents a major period of change for children. In additional to their personal development, children will also learn about the routines and processes that they must adhere to in the classroom. Adapting to these changes will take time, so parents must be open-minded and supportive by not placing too much pressure on their child, otherwise their efforts might actually become counterproductive.

Supportive things parents can do for their children:
  • Buy stationery and school bags with them.
  • Through dialogue, introduce children to the enjoyable aspects of primary school, such as playtime and making new friends.
  • Talk to your children every day and listen attentively to what they have to say. Have a genuine interest in their new experiences and be proud of their achievements.
  • Gradually handover some basic responsibilities to your child, such as packing their own school bags, dressing themselves for school in the morning and putting on and taking off shoes and socks.
  • Read to the children, and let them read back to you. Pick stories they like and which are appropriate for their age.
  • Participate in the school parents' orientation programme and understand the school's educational vision and mission. Take the initiative to build a relationship with the teachers and develop a positive attitude in handling children's problems at school.

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6.What is concentration?
Concentration refers to the mental focus on a specific task, such as learning, reading, conversing and playing games.

In general, concentration improves with age.

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(III) Rehabilitation Services

7.Buying the right school shoes
  • Trying on for size is crucial and we recommend trying and buying shoes in the afternoon as feet are slightly bigger then than in the morning.
  • The upper is the portion of a shoe that surrounds the toes. Uppers are made with many different kinds of materials, which provide varying degrees of support for the front of the foot. The choice of support will depend on the shape of the child's foot.
  • When choosing shoes, look closely at the sole of the shoe. A sturdy sole is important for control of the back foot when walking. Since the right sole will help them balance more easily, children can walk faster and in a more stable manner.
  • The right pair of shoes should provide ample support for the arch.
  • There should be space for one finger between the front of the toes and the front of the shoes (8mm-10mm). Don't buy shoes that fit perfectly, as the children will grow out of them quickly. On the other hand, shoes that are too big will impair the child's comfort and walking ability.
  • School shoes should be replaced as required.
  • Please note: mentally handicapped people have difficulties communicating and may not be able to express clearly whether a pair of shoes are the right fit. Extra effort and patience is necessary to help them pick the right shoes.

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8. What are the differences between a Clinical Psychologist and a Psychiatrist?
Psychiatrists are certified medical practitioners specialising in the field of psychiatry. They normally spend four years training as a doctor and their subsequent residency working with senior psychiatrists to enhance their understanding of the medical aspects of mental disorders. Psychiatrists are allowed to prescribe medication for their patients - and will usually focus on the use of medication in order to treat their patients. The drugs used will influence the brain's ability to produce (or reduce) chemicals that regulate mood and behavior to address mental imbalances. Psychiatrists usually would have had some training and exposure to psychotherapy.

Psychologists usually hold a Masters or a Doctorate in Psychology. In Hong Kong, they are likely to hold a Bachelor degree in this area as well. Psychologists are not medical practitioners, and do not prescribe medication in order to treat their patients. Rather, they focus on using behavioural therapy and other interactive treatments in order to address the psychological issues of their patients. Psychological treatment is more progressive in nature and often requires the long-term commitment of the patient.

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(IV) Elderly Services

9.What is Dementia? How to identify signs of dementia?
Dementia is the long-term decline in cognitive function due to brain deterioration or injury. Research shows up to 10% of people aged over 65 suffer from some form of dementia. Its onset increases with age. Persons affected by dementia gradually face the deterioration of their mental functions, and will feel disoriented in time, place, and body.

Early Stage:
Sufferers becomes forgetful in their short-term [immediate] memory. For instance, they may have trouble remembering names, phone numbers and locations.

Intermediate Stage:
Cognitive function gradually diminishes. Sufferers will find it increasingly hard to recognize familiar faces, and certain people. They may start exhibiting certain behavioural traits out of their usual character, such as increased stubbornness and erratic mood swings.

Late Stage:
Self-care ability starts deteriorating, and they begin to require constant care in their day-to-day activities. Some may even become bedridden due to their regressive state of health. They may forget the most memorable issues in their life and also lose their ability to communicate with others.

Types of dementia

Alzheimer's disease is the most common form of dementia. The precise causes of this degenerative disease are unclear but premature aging processes and genetic factors have been identified as the most likely causes. People with Alzheimer's disease experience a progressive deterioration of memory.

Vascular Dementia is caused by multiple strokes and vascular diseases. Damage to multiple small vessels in the brain accumulate to impart irreversible damage to neurological functions.

Other diseases such as depression, malnourishment, thyroid disease and brain trauma can also contribute to the onset of dementia. Dementia is also associated with Parkinson Disease and AIDS.

10 most typical symptoms of dementia
If you notice any of your family members showing some of these symptoms, please consult your family doctor:
1. Memory impairment, especially short term memory which is indicative of the onset of dementia.
2. Noted difficulty in performing familiar tasks
3. Noted difficulty in expressing ideas and communicating with others.
4. Disorientation in time, place and person.
5. Poor or decreased decision-making ability.
6. Problems with basic abstract thinking and calculation.
7. Misplacing things
8. Mood swings.
9. Changes to personality.
10. Loss of will.
References:
(1) Hong Kong Alzheimer's Disease Association http://www.hkada.org.hk/ecmanage/page15.php
(2) Jockey Club Centre for Positive Ageing http://www.jccpahk.com/

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10.The Hidden Elderly
The hidden elderly refers to elderlies who are isolated from the community. The isolation is often self-imposed - the dominant causes are feelings of disengagement from, and sometimes disillusionment with, the society. They are usually unaware of the available services and the risks associated with long-term isolation from the community. For the elderly who do not maintain communication with the outside world, their absence can go unnoticed for a long time, if at all.

In order to enhance outreach services for the hidden elderly, the then Financial Secretary of HKSARG, Mr. Henry Tang, provided an additional funding of $38 million in the 2007- 2008 Budget to 156 elderly centres. The manpower of social workers in the frontline has been substantially increased to locate the hidden elderly, provide for their basic needs which may have been neglected from the isolation, arrange for them to attend their local elderly centre, and follow up on them regularly.

Who are likely to become the hidden elderly?

In a 2006 report by the Commission on Poverty, it was suggested that many elderlies do not actively seek social services due to illiteracy, poor education, physical and social conditions, and lack of social networks.

Furthermore, the elderly generation tends to view self-reliance as important to their self-esteem, as this was the prevailing attitude during their adult years growing up in pre-boom Hong Kong.

In order to help us locate and provide services to the hidden elderly, we rely heavily on information and referrals from the general public. By mobilizing community resources, we aim to assist these elderlies to ensure their access to the available support and assistance.

If you are aware of any hidden elderly people, please contact us on.
Your intervention will help to improve their quality of life.

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