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Emotions Are Cognitive, Not Innate

Emotions are not innately programmed into our brains, but, in fact, are cognitive states resulting from the gathering of information through experiences. Emotions are an innately programmed in the brain’s subcortical circuits. As a result, emotions are often treated as different from cognitive states of consciousness, such as those related to the perception of external stimuli. In other words, emotions aren’t a response to what our brain takes in from our observations, but, rather, are essential to our makeup. Emotions are “higher-order states” embedded in cortical circuits. The brain mechanisms that give rise to conscious emotional feelings are not fundamentally different from those that give rise to perceptual conscious experiences. ”Emotions are not tools of cognition”, said Ayn Rand. Innate emotions come from the brain’s limbic system, a part of the primitive hind-brain. Cognitive processing of emotion is the business of the amygdala and prefrontal cortex in the human brain.

Cognition and emotion – this phrase-connects two concepts, but it is ambiguous. For some people, it means the cognitive approach to emotion. For others, it means joining two domains, cognition and affect, that were previously thought to be disparate. A Handbook of cognition and emotion, implying as it does a productive marriage between the two research areas in its title, is something of an achievement. Cognition in emotion is like concept and action of valence, arousal, and control. A not uncommon reaction to claims about the role of cognition in emotions is to agree with the proverbial farmer, who, when asked for directions to the city, replied: “you can’t get there from here.”Emotions are both (conceptually) defined by appraisals and (empirically) constituted by them. Although recent research has shown that social cognition and emotion engage overlapping regions of the brain, few accounts of this overlap have been offered. Cognition and emotion are closely linked to music. The researcher concludes is a part of an ongoing program investigating how the dynamic aspect of musical emotion relates to the cognition of musical structure. Some research suggests that the expression of emotion in music shares properties with the expression of emotion in speech and dance.

Faculty of Behavioral Science
Department of Clinical Psychology
SGT University, Gurgaon, Haryana

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Approach to a Child with Language Delay

Communication is one of the important developmental domains that help a child to label, explore, and learn new things about him and the environment around. It exposes a child to new stimuli around and helps to build social connections so important for a developing young nervous system. It enables a child to express, understand, and share his joy and convey distress as well. Language and communication is the key towards good scholastic performance as phonological awareness, thought processing and expression are shaped when a child starts remembering and discriminating sounds or using words for describing objects.

Delay in language development can be because of various developmental or psychological disorders e.g. intellectual disability, learning disability, hearing impairment, language disorder, psychosocial deprivation, autism, selective mutism, bilingualism, receptive aphasia, cerebral palsy, etc. Early identification and intervention for these children can have a significant impact on the quality of their lives.

Speech is an act of production of sound. Challenges in speech may manifest in trouble with specific sounds, patterns of words, or intelligibility. Types of speech challenges include articulation or phonological disorders.

Language is the ability to use speech to make others understand what we express and comprehend what others say. The deciphering of the message and its correct delivery is language. A child with language challenges may not use proper sentence construction and grammar (e.g. “I go to the school) or may have trouble deciphering complex sentences or thoughts. The ability to express oneself is called expressive language ability. The ability to decipher and understand language is called receptive language ability.

Communication is the broadest category of them all. Communication not only includes spoken language but also includes many other non-verbal cues, which are essential for interacting and communicating with others. It is common that if a child or adult has proper speech and language, that they still struggle with communication. This could take the form of not understanding sarcasm, gestures, or facial expressions, which are also cues to what someone is trying to communicate to them. Children with autism spectrum disorders (ASD) often exhibit these characteristics. Speech, writing, art, body, and sign language are all methods of communication.  Because communication is central to the development of a child, the failure of a child to speak by the age of 1year 6 months should be taken seriously. Language problems interfere with a child’s ability to communicate effectively, both in the expression and understanding of ideas. The outcome of such a delay may have widespread consequences ranging from academic to social adjustments.

In children not meeting the expected milestones for speech and language, a comprehensive developmental evaluation is essential, because atypical language development can be a secondary characteristic of other physical and developmental problems that may first manifest as language problems. Types of primary speech and language delay include developmental speech and language delay, expressive language disorder, and receptive language disorder. Secondary speech and language delays are attributable to another condition such as hearing loss, intellectual disability, autism spectrum disorder, physical speech problems, or selective mutism. When speech and language delay is suspected, the primary care physician should discuss this concern with the parents and recommend referral to a child development team.

Several studies have shown that children with speech and language problems at two and a half to five years of age have increased difficulty reading in the elementary school years. Children in whom speech and language impairments persist past five and a half years of age have an increased incidence of attention and social difficulties. Children with specific speech and language impairments at seven and a half to 13 years of age have been shown to have impaired writing skills, with marked deficits in spelling and punctuation compared with children with-out speech and language impairments.

It is important for parents to have an understanding of milestones of speech and language so that the delay or deviation of any kind can be determined in early childhood. Normal speech progresses through stages of cooing, babbling, words, and word combinations, whereas normal language progresses through stages of understanding and expressing more complex concepts.

When to refer: When speech and language delay is suspected, the child should be referred to the early childhood developmental center for screening. Based on the screening results the multimodal intervention if needed should be developed by the team of early developmental interventionists. The primary goal of an evaluation should be to rule out cognitive deficits with language delay. Doing away with the myths as boys speak late, with age speech will come, let’s wait for some more time is the need of the hour. As professionals, we need to make discrimination between expression and understanding by going through the age-appropriate milestones. Taking parental concerns seriously and ruling out red flag signs should be a priority.

Management of language disorder is dependent on the type of processing error or expression. If the understanding, which manifests with poor expression, is affected, the focus of the therapies should be comprehension and cognitions. The primary goals of therapy are to teach children strategies for comprehending spoken language and producing appropriate communicative behavior to help parents learn ways of encouraging their children’s communication skills. There is good data available to support the effectiveness of a multidisciplinary intervention, which includes special education and speech-language therapy, particularly for children with a primary expressive language disorder. The effect of speech-language therapy for children with receptive language disorder appears to be much smaller than it is for other groups as the concern is understanding, which results in other associated behavioral problems as well. Hence the multidisciplinary developmental team approach is a must. Parents can effectively administer speech-language therapy, but must first receive training. The response to treatment is more varied when using parent administrators, which suggests that some parents may be more suited for providing therapy than others.

Parent Counseling:

Parents can be counseled that, once a diagnosis is made, there are professionals who can work with the child and parents, and that many times children show a positive response to this intervention. Looking at the increased incidence of developmental disorders like autism, communication disorder, social communication disorder it is advised that a child with presenting complaints of language delay with associated behavioral problems must be referred to a multidisciplinary team of child development consisting of a developmental pediatrician, psychologist, special educator, speech therapist and other allied rehabilitation professionals so that a comprehensive evaluation can be done as early as possible. Research shows that early diagnosis has a better prognosis than late identification and referral.

Imran Mushtaq
Research Scholar
Department of Clinical Psychology
Faculty of Behavioral Sciences
SGT University, Gurugram.

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Goodbye Exam Stress – Causes of Exam Stress

“I swear on the God, next time I will start my preparation, a month prior to exam dates”

Some students are just exam persons – they have no distress getting their heads down to brush up and seem to fly without blinking their eye. But for many others examination can be extremely stressful. Even the word examination may leave them in apprehensions. The exam is stressful but certainly not the worst thing that could happen to you. Parents make it difficult, but friends don’t make it any easier either. To avoid this anxiety, it is crucial that we deal with exams with a clearer mindset.

Signs of exam stress:

Causes of exam stress are:

  • Inadequate or last minute preparation
  • High expectations
  • Pressure from Teachers and Parents
  • A feeling of competition with others
  • Fear of failing
  • Feeling less prepared
  • Self-induced pressure: There is a belief that grows in the minds of the children that they are required to perform well consistently in order to be judged as a good student.
  • Sole bread earner: Not everybody is on the same page when it comes to financial holdings. Students who work part-time and are also studying simultaneously fall prey to this stress.

WAYS TO COMBAT: Do’s &Don’ts

Designate an area for studying: A table is meant for studying. The bed for sleeping. An uncluttered table without your phone, laptop, and other distractions is the right approach. Lying on your bed or on the sofa in front of the TV will not only damage your posture but will hamper concentration too, so find a comfortable table and chair you can work on.

Take Breaks: Breaks are important. There is only that much that you can retain at a stretch. Take a short break every 45 mins. It’s a good idea to leave the room at this time and take a break of 15 mins. During the break avoid watching a TV serial, movie, stay away from gadgets, etc rather than drink water, grab a snack, wash your face, freshen up yourself, take a hot refreshing bath, etc.

Concentration exercises: It’s very important to be focused while you are learning or revising, and to be focused you need much concentration. To keep your concentration upright, you can do small activities like Deep breathing, Striking of all ‘e’ from a paragraph, focus on a single instrument while listening to a song, highlight important points while skimming, use flow charts and mnemonics and other graphic aids to remember better. If you have ever felt that you have forgotten what you learned yesterday, revise on 1-2-7-15-30 these days to make sure this doesn’t happen again.

Right Sleep: Sleepless nights for many can leave you feeling tired and low in energy. Set yourself a definite time to go to bed and stick to it no matter what. Sleep for 7-9 hours.

No caffeine. No smoking. It’s a myth that they help.

Don’t talk about the subject or the paper with your friends while meeting them on the day of the exam. Don’t try to read at the last moment. Once you have the paper, read only the first question. If you know it- perfect, if not move further. Divide your time based on each question.

Give yourself some time to relax before you start to study for the next exam.

Remember: It’s not a race. Don’t look at the supplementary sheets others take. Don’t keep looking at the clock. You don’t need to be the first one to finish. And once the paper is done, it’s finished. So no discussion about the paper and no analysis.

Don’t rely on cheating to get you the marks you want. It will leave you feeling bad and in later life, the information you should have learned could be important. So be honest with yourself.

Aastha Dhingra
Assistant Professor
Department of Clinical Psychology
Faculty of Behavioural Sciences
SGT University, Gurugram

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What do you understand by the term Autism? What do you think when you see a child with some unusual behaviour or what you call such kids whom you see repeating words, staying isolated, facing difficulty in doing their routine tasks, problems in recognizing other people’s emotions and responding accordingly, having poor interaction with peers, has a problem in expressing etc. People call such kids mad, retarded, insane and provide them with many such synonyms, but they fail to understand the causes behind them. Thousands of parents have noticed such traits in their child but are unable to understand the causes behind it or name it.

This is a pervasive development disorder or we can call it in simple words as autism. Some time back down the lane no one had an idea about the causes behind it but now researchers are trying to deliver related answers. So, first of all, we should know that there is no single cause for autism. In most cases, it is a combination of genetic risk and environmental factors both during and after childbirth, they include advanced parental age at the time of conception, maternal illness during pregnancy, extreme prematurity, very low birth weight and certain difficulties during birth, particularly those involving periods of oxygen deprivation in baby’s brain, vitamin deficiency etc.

Parents with such children face difficulty in upbringing them, for which they should know and learn some techniques to bring change in the areas of social interaction, speech, language and behavioural anomalies.

Tips for parents of autistic children

  • Use objects and actions along with words to teach skills, e.g. show the child a shoe and demonstrate pulling the lace through.
  • Keep your message very clear, brief and direct.
  • Teach both through actions and words e.g. teaching big, use your hands to show big size along with the word big.
  • Reinforce/ reward behaviour when it is done by the child. Use tangible reinforcers like toys, stickers, stars, etc and pair them up with social reward like patting, saying very good etc. Keep changing the reinforcers to avoid satiation meaning that reinforcers will lose their value if are continuously used.
  • Teach the concepts of self and name by pointing to the child e.g. you are Sam. Always teach concepts like you, your, me first then he, him, their etc.
  • Provide the child as many opportunities as possible to interact with well-functioning/ non-disabled kids who are at a more normal level in terms of social and language development.
  • Use pictures/ photos as much as possible to teach concepts.
  • Teach the child to look at the object along with you, e.g. “let us look at the fan”.
  • Establish a predictable environment and daily schedule.

There is one more category very less known which is a cognitive phenomenon known as “Autistic Savant”. “Autistic Savant” refers to individuals with autism who have extraordinary skills not exhibited by most persons. Earlier people with these skills were called as ‘idiot savants’ a French term which meant unlearned skills. The estimated prevalence of savant abilities in autism is 10%, whereas the prevalence in the non-autistic population, including those with mental retardation is less than 1%.

For learning more techniques specific to your child, seek help from professionals. Always remember that these general techniques need modification from child to child. Every child is unique in him/herself. Always remember- “Your child’s mental health is more important than his grades”.

Devika Raje
Assistant Professor
Department of Clinical Psychology
Faculty of Behavioural Sciences
SGT University, Gurugram

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‘Health’ Without Mental Health is an Illusion

Human Beings are hard-wired to avoid pain and maximize pleasure and yet they struggle to pursue Eudaimonia (Happiness for happiness sake). When it comes to pursuing happiness and well-being, they find it increasingly challenging to think of long term gains and suffer due to short-sightedness of pursuing goal-linked happiness (hedonism).

Our happiness and well-being are inherently linked to our health – it is common knowledge that unless we feel ‘fit and fine’, we cannot function optimally in any of the spheres of our lives. Yet it is only recently that physical fitness has become a ‘fashion’ and everyone from the young to the old are after physical fitness – maybe it’s the fear of disease and the desire to have socially acceptable bodies that is the driving force behind this mass movement towards physical fitness. We are now extremely health conscious and are ready to adopt a variety of diets and fitness routines to keep ourselves healthy.

Older people have always been vary of the importance of keeping fit may be due to the wisdom they have gained through their time on this planet and the desire to age successfully. However, it is quite an achievement of this decade that the zest for physical fitness has permeated all boundaries of socio-demography. In fact, it is kind of humorous to see many people wearing fitness bands on their wrist to keep a count of the steps taken by them in a day, as an indicator of physical activity.

However, mental fitness is still doesn’t fit in the list of human priorities – until we get down in the dumps or face emotional challenges in our life. Despite being very well aware of the fact that there cannot be any success or physical fitness till we are mentally active and fit, human beings are scared to talk about it and still vary of visiting a mental health expert when required. We are still okay to suffer in silence, take medication or tonics and go to faith healers or astrologists to deal with mental health issues. It is still considered shameful to be undergoing any mental trauma or disturbance.

Wouldn’t it be wonderful if we could all accept that the mind is above the body and there can be no health without mental health? It would then truly make human beings ‘health-conscious’.

Maybe the time has come to wear ‘Mental health fitness bands’ on our wrists and keep a count of our negative emotions, self-defeating thoughts as well as positive deeds and go after psych-health diets for a change. Just like Clinical Psychology deals with mental disorders and getting back to ‘normal’, Positive Psychology deals with Mental growth and getting from ‘zero’ (normal) to life above zero. If only little more attention is paid to that neglected part of our health – mental health – then maybe human beings would become truly fully functioning beings and be able to utilize their full potential. Being ‘mad’ or ‘crazy’ should not be equated with being mentally unwell but rather with neglecting or stigmatizing mental health. Society is a product of human perception – it’s about time we re-perceive the world we live in.

Dr. Nimisha Kumar
Associate Professor
Department of Clinical Psychology
Faculty of Behavioural Sciences
SGT University, Gurugram

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LifeStyle Disorders and Role of Physiotherapy

Lifestyle can be defined as the way to live one’s life. The world is witnessing a growing prevalence of various health-related issues owing to changing lifestyle irrespective of age or gender. A lifestyle of a person is a combination of his or her physical and mental functioning and is the result of various factors like habits, behavior, physical activity, dietary patterns, and preferences. By saying lifestyle disorders means health issues resulting from a poor lifestyle which is a consequence of leading a sedentary life, lack of sufficient physical activity in our day to today work, less inclination towards maintaining the fitness of the body and a diet that is lacking in nutritious value and is full of calories.

Modernization, mechanization, use of gadgets have certainly made our life easy but it has come at the cost of health. Health issues that can be categorized under lifestyle disorders are both physical as well as mental. Diabetes, hypertension, coronary heart disease, stroke, various types of cancers, obesity, breathing difficulties, depression, and anxieties are some of the consequences of leading a sedentary lifestyle.

Occupational lifestyle disorder can be defined as health problems like back pain, neck pain, stress headaches, and compression neuropathies, etc that result because of static and poor posture that we maintain at our workplace as well as the poor work environment. Altered biological clock and sustained mental pressure at the workplace also result in health issues like insomnia, indigestion, depression, anxiety and various other mental health issues.

Physiotherapists are the experts that aim to restore movement, function, and activities of daily living. As health experts, they not only play a crucial role in the management of lifestyle disorders but can also prevent most of them. The position statement by the World Confederation of Physical Therapy has described Physiotherapy intervention as aimed at promotion and maintenance of health and fitness for all ages and populations. They can not only identify risk factors responsible for noncommunicable disorders through proper evaluation and assessment but can also refer to other practitioners if needed. As health care professionals they also educate and guide about the importance of physical activity, exercises, volume and type of exercises and about diet modification. This can be done through an individually tailored exercise regimen, addressing behavioral changes which include cessation of smoking, optimal nutrition, maintaining a healthy weight, the importance of regular physical activity and exercise, optimal sleep and strategies to avoid and tackle stress.

Childhood Obesity is one of the major health-related issues grappling the society which results from a poor lifestyle. It can be controlled through prevention programs through advocacy in schools and communities and by prescribing the right type and amount of physical activity and fitness program. American College of Sports Medicine recommends 20-30 minutes of moderate-intensity exercises on most of the days of the week to maintain fitness and reduce the risk of developing noncommunicable disorders like diabetes and heart disease. Physiotherapists also recommend aerobic exercises for reducing the risk of developing heart diseases.

To conclude lifestyle disorders can cause significant morbidity and mortality but they are very much preventable. Physiotherapists as health care experts can educate, advise about the prevention of lifestyle disorders. They can also prescribe different types of exercises, evaluate health goals and may help to achieve those goals.

Dr. Sheetal Kalra
Faculty of Physiotherapy
SGT University, Gurugram

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