Dealing with Dyssemia

Do the expressions on these faces convey something to you?

70

March - April 2013

Searching for meaning beyond words – Dealing with

DYSSEMIA If they do, it may be hard for you to imagine what 10% of all adults and children who have dyssemia go through. Dyssemics can neither decipher facial expressions nor use them appropriately. They also have no understanding of the tone and pitch of voice. According to Albert Mehrabian, who has conducted extensive research on non-verbal communication, we decode another’s feeling or emotion by relying 55% on their facial expressions, 38% on tone of voice and only 7% on words. Imagine the dyssemic’s plight – communication and social interactions go awry as he receives and sends skewed non-verbal signals!

Children who ‘just do not get it’

Clinical psychologists and academicians Stephen Norwicki and Marshall P. Duke coined the term ‘dyssemia’ to define trouble with non-verbal cues in communication. They also developed a test, called the Diagnostic Analysis of Nonverbal Accuracy (DANVA) to assess dyssemia, by breaking down non-verbal communication abilities (see next page).

Peers and adults find children with dyssemia ‘irritating and weird’. Social interactions are tedious for children with dyssemia. They are often alienated and frustrated, as most of their efforts to be friendly backfire. Left with a feeling that they have no control over how others treat them, dyssemic children end up feeling powerless and apathetic.

March - April 2013

71

Non-Verbal Communication: all the things left unsaid Objectics: Style of dress - knowledge of the aptness of different outfits for various social scenarios.

Children with dyssemia do not dress appropriately for a situation and often look out of place or awkward.

Kinesics: aspects of body movement

Vocalics: use of the voice and vocal sounds (not words)

Emblems – Holding up palm to indicate ‘wait’ Illustrators – Using hands to show how big something is Affect displays – Frowning to show anger Regulators – Nodding one’s head during a conversation Adaptors – Tapping a pen on the table to vent restlessness Posture – Slumping shoulders when tired or bored

Volume – A loud voice to show anger Pace of speech – Fast speech when excited Intonation – Tonal differences (for example, the rise in tone at the end of a statement turns it into a question.)

Pitch – High pitch used when nervous Segregate – Use of ‘uh-huh’, ‘hmm’ (to indicate interest) and ‘shh’ and silence/ pauses (to indicate boredom)

A child with dyssemia is incapable of reading what these little signs mean and may also misinterpret them – he may also read friendly gestures as malicious ones.

Children with dyssemia speak fast, in high pitched, loud voices. They are unable to associate pauses or lack of ‘hmm’s’ to disinterest or boredom.

Proxemics: understanding of how we use and manage personal space (in the context of a given culture).

A child with dyssemia may often stand too close to others since he does not realise when he encroaches on another’s personal space.

Haptics: understanding of comfort zones for touch (dependent on culture) and associated intentions (holding someone by the waist denotes intimacy) Children with dyssemia are known to touch others in an ‘irritating’ manner.

They are also unable to decipher different touches – a shove by a peer who does not want their company.

72

March - April 2013

Dr. Jaishree Ramakrishnan, consultant psychologist and member of ParentEdge’s Panel of Experts, who has worked closely with dyssemic children, says, “Many a time, these children are labelled blunt or sarcastic because their words, their expressions and physical demonstrations do not go hand in hand. They may wish someone ‘Happy Birthday’ but their intonation may make it appear insincere or sarcastic. Individuals with dyssemia also have challenges in managing their impulsiveness. If a teacher arrives five minutes late for the class, the child with dyssemia will immediately blurt out, “Do you know you are late?’”

Often, the child’s symptoms are termed as bad behaviour. Punishment is doled out to ‘teach the child a lesson’ or ‘keep him in line’. A vicious cycle is triggered.

Dyssemia, if left unmanaged, will continue into adulthood as well, and interfere in the individual’s workplace life as well as social life.

Causes of Dyssemia Neurological disorders – 5% Emotional difficulties or trauma that derail social development – 10% A lack of appropriate situations and experiences to learn non-verbal language – 85%

Struggling to make sense of the world Parvathi* is a 33-year-old HR professional who received a diagnosis of dyssemia only in her adulthood; in her case, frustration, despair and loneliness led to clinical depression. Parvathi faced many problems while growing up, which, she now realises, were signs of her dyssemia. “I did not understand the world at all. I was reported to ‘say one thing and do something else’ or ‘blow hot and blow cold’. In spite of all this, if I made friends, I could not keep them.”

She could not turn for acceptance or help to her mother who was “a perfectionist - a critical and autocratic parent”.

Rekha’s* daughter Neha* was diagnosed with dyssemia when she was in Grade Ten. “Her teacher expressed concern that she had social difficulties. She was aloof, and is said to have ‘overreacted to normal teasing’.”

Much earlier, when the child went to preschool in the US, she did have problems getting along with a few children; however, these were not mapped to dyssemia. The emotional tantrums she threw from when she was a seven-year-old were put down to ‘adjustment problems because of relocating to India.’ As a teenager, Neha was different.

“She did not do the things parents of other *

Names have been changed to protect identity.

girls were reporting - spending long hours on the telephone or showing interest in boys.”

Must-Dos for parents Keep a close eye on your child’s social skills development Just as you track a baby’s motor skills development (crawling, standing with support), and a primary schooler’s scholastic milestones (naming the planets, reading independently), you should also chart your child’s social skills progress. (see Box)

Social skills and Non-verbal skills - Milestones 1 year - responds to his own name and imitates simple actions of others 2 years - refers to himself by name and can recognise self in mirror or picture 3 years - plays near other children, and knows his gender identity, learns to label emotional expressions 4 years - actively plays with other children conceals emotions in expression, able to falsify expression of emotion 5 years - interacts with other children and dramatic ‘pretend’ play now features specific details 6 years - chooses his own friends and plays competitive games and cooperative play with them, reads facial cues of like and dislike

March - April 2013

73

Bring behavioural patterns to the attention of professionals rather than labelling them yourself Dr. Ramakrishnan explains, “When guests visit, children with dyssemia may not receive them appropriately – do not assume this as ‘stranger anxiety’. When the child starts school, if he says he does not have any friends, don’t always attribute it to shyness or the initial difficulties of settling down at school.”

Parents misreading signs is the primary reason for delays in diagnosis. The average age of diagnosis is 11 years, which is late when compared to the age of diagnosis of other learning disabilities.

Look out for other disabilities and conditions Dyssemia may also occur along with other learning disabilities; this is called comorbidity. When a child has both dyslexia and dyssemia, she faces trouble with schoolwork (reading and writing) as well as making friends and being accepted by the other children. If a child with dyssemia also has dysgraphia, she is likely to be ridiculed as ‘butterfingers’ for her clumsiness and indecipherable written work.

Parvathi had trouble with Maths (possible dyscalculia) and faced a double whammy

Asperger’s Syndrome (AS) and Dyssemia Also known as ‘highfunctioning autism,’ individuals with AS also face difficulty in social interactions. However, unlike children with only Dyssemia, AS children also have difficulty with language and verbal communication, intense interest in some areas and exceptional talent in music or maths. Dyssemia is thus one of the indicators of AS.

74

March - April 2013

of not matching expectations of a high performing school environment with her poor social skills. Not all children who have dyssemia, however, perform poorly at school.

Neha was exceptionally good at academics, which may have unfortunately prevented early diagnosis of her disability; the school did not report anything amiss until she was in the tenth grade.

How to help the child ‘read between the lines’ Like other learning disabilities, dyssemia cannot be completely ‘cured’, but the child can be trained to manage the condition.

According to Dr. Ramakrishnan, self-awareness and self-help are valuable – the child has to understand and apply the techniques the adult support group (comprising a special educator, psychologist, parent and teacher) provides.

The process of remediation typically involves teaching: • Age-appropriate etiquette and reinforcing the learning through repetition. Skills such as making polite conversation, appropriate touch, style of dress may be imbibed by average children through observation, but a child with dyssemia has to be consciously taught such things.

• Discrimination of nonverbal cues (how to differentiate between an angry expression and a happy one).

• Ways to express using nonverbal cues (nod head to indicate understanding), either in addition to words, or instead of words.

Parents can carry out these simple exercises with their child: • Make expressions of different emotions like happiness or sadness at the child and ask him to arrive at the meaning.

• Play audio tapes of a narrated story and ask the child to identify the character’s emotions from the voice.

• Play a modified game of Dumb Charades by asking the child to express his feelings through nonverbal cues.

• Try to conduct as much of a conversation as possible through gestures and expressions.

• Train the child in the traffic signal technique (helps both in listening skills and containing impulsiveness)

Resources Websites Links to blogs on non-verbal learning disorders http://webpages.charter.net/nyssacugan/cgn_00004c.htm Activity ideas for non-verbal communication http://www.creducation.org/resources/nonverbal_communication/ classroom_activity_ideas.html Books ‘Teaching your child the language of social success’ and ‘Helping the child who doesn’t fit in’ by Stephen Nowicki Ph.D. and Marshall P. Duke, Ph.D. ‘The Sourcebook of Nonverbal Measures: Going Beyond Words’ by Valerie Lynn Manusov

RED (Stop) - The child is encouraged to ‘stop’ and perceive the situation.

AMBER (Pause) - The child is asked to analyse the situation.

GREEN (Go) – The child is taught to respond, rather than react.

The importance of intervention Dr. Ramakrishnan says that there are some challenges in the treatment and diagnosis of dyssemia. Because of very low awareness, parents find it difficult to accept that their child has dyssemia. They are in denial and want another label that does not carry a social stigma. With adequate cooperation between parents, teachers and the child, social inhibitions and impairment can be done away with, at least to a degree where the child’s everyday life stops being an ordeal.

Neha is aware of her condition, has read widely about it on the internet and has learnt how to cope. “Now that she is college, she seems to be realising more about herself,” says Rekha. Though delayed, the diagnosis of dyssemia has brought Parvathi a lot of relief, as she is able to understand herself and others’ actions and reactions much better now.

With diagnosis and remediation, both Parvathi and Neha look forward to relatively more normal adult lives.

- With inputs from Jayesha Koushik, 19 years, New Delhi March - April 2013

75