My daughter’s first child has Down’s Syndrome, and is now two years old. She is being pressed by her in-laws to try for another baby but she is scared that the next child may also have the same thing. What should they do?

Acceptance of your first grandchild is key. If the family is looking at welcoming another baby because they are longing for a regular child to replace the one they have, it is likely to negatively affect both children. Being a parent is a commitment. Being a special needs parent is a lifelong commitment. Presently, accepting and loving the child that is in your life is essential, as it will forever influence family relationships, irrespective of the arrival of a second child.

It is hard on families, especially the mother, to realise and accept that her child will not have the same life as most regular kids. There is grief of losing the child she had imagined having and mourning for the memories she had planned on making. She may be feeling scared about her first child’s future too and worried about how he/she will be treated by her in-laws.

If she is worried that her second child may also have Down’s, she can go in for screening or diagnostic tests specifically designed to detect chromosomal abnormalities.

Please note, testing is only suggested if a couple already has a child with Down’s or if anyone in the couple’s immediate family has Down’s or has a child with Down’s. Please consult your doctor before taking a decision.

I would definitely suggest the couple’s counselling and family counselling before your daughter and her husband make a decision. And while the family is entitled to their opinion, at the end of the day, this is a decision that solely rests with the parents.

Does not like to interact with children of his age: one of the red flags for children with autism spectrum disorder (ASD) iStock

My three-year-old is not responding, not making eye contact, seems to be distressed by hugs, and keeps moving around in a room or from room to room on his own. My family doctor thinks he may be autistic and has asked us to visit a psychologist. Is that really necessary?

There is no harm in visiting a psychologist as he/she will carry out preliminary assessments to understand your son and his behaviour. And if it is indeed autism, the earlier you know the better, as then you can prepare his education and life journey accordingly.

Here are some red flags for children the autism spectrum disorder (ASD):

ß Does not like to interact with children of his age.

ß Does not respond or react to the parents’ smile, laughter, frown.

ß Does not initiate conversations.

ß Shies away from making eye contact with anyone.

ß Used to talk before but has almost stopped talking.

ß Has developed an increasing sensitivity to light or sound or touch.

ß Either keeps staring or looks from where they cannot be seen.

ß Constantly shakes their hands, feet, rocks back and forth, sways from side to side, flaps their hands, and so on.

ß Seems to be fascinated by repetitions and patterns — does the same things or says the same things over and over again.

My 24-year-old cousin has a low IQ, gets moods swings multiple times a day, and also is violent occasionally. My aunt and uncle think that marriage will be a cure. They are not willing to admit that he may have intellectual disabilities and are planning to hide his issues. I don’t think this is right. How do I intervene?

Due to the stigma attached with having and getting help for mental health issues, many families refuse to accept that a family member may need professional help. Stereotypically, in the past, marriage had long been suggested as a cure-all for multiple issues, especially for men. Sadly, this mentality exists today too. Marriage is a serious commitment that requires trust at its foundation and not telling the potential spouse and in-laws about your cousin’s issues will be a grave injustice.

I would suggest that you speak with your aunt and uncle to arrange for a few counselling sessions for your cousin. Until he is assessed by a mental health expert and given a formal diagnosis, it will be difficult to say what type of a regular life he can have and whether he is at all capable of comprehending, agreeing to, and upholding marriage.

He is easily distracted and finds it difficult to sit still for a long time: one of the red flags for children with ADHD

My five-year-old son has been getting into trouble at school very often. He is a very sweet boy but very naughty. He doesn’t pay attention in class and doesn’t want to do his homework. Every teacher is complaining about him. I think he may have ADHD. What should I do?

There may be many reasons why a child is suddenly distracted and having trouble concentrating. Listed below are a few red flags for ADHD:

ß He is easily distracted and finds it difficult to sit still for a long time.

ß He makes careless mistakes quite often.

ß He has trouble waiting for things, especially when taking turns in class.

ß He rarely completes one activity before moving on to the next.

ß He avoids not just academics but also fun activities that require concentration/mental effort.

ß Despite reminders, he frequently forgets to do things.

ß He frequently loses his belongings or forgets where he puts them.

If you find yourself saying yes to most of the above, I would suggest you connect with a child psychologist to discuss his behavioural issues and the types of complaints from school in detail. A specialist will be able to guide you about whether your son needs an assessment, how to go about it, and how to proceed if the diagnosis is confirmed to be ADHD.

Minu Budhia is a psychotherapist, counsellor, founder of Caring Minds, ICanFlyy, Cafe ICanFlyy, and a TEDx speaker. Write to askminubudhia@caringminds.co.in