Ambreen Ali speaks to MAG to give a detailed account of the neurodevelopmental disorders

Neurodevelopmental disorders are growing worldwide in both developed and developing countries. Parents are primary caregivers to recognise the signs and symptoms of children's behaviour or mental -illness. This article is to obtain basic knowledge and awareness about ADHD, LD and ASD, the most common types of neurodevelopmental disorders in children. For this, MAG reached out to Ambreen Ali, a clinical psychologist working with mental health sector for the past four years with an extensive training and experience in counselling, behaviour therapy, play therapy, cognitive behaviour therapy, eidetic therapy and psychotherapy. She is currently working at Kazim Trust since the past two years, dealing with clients having learning difficulties, ADHD and other behaviour and emotional issues. Kazim Trust is a non-profit organisation that was established in 2008 in Karachi, with the aim of spreading awareness and creating treatment programmes for children and adults facing ADHD, LD and ASD. Read on as she discusses the particulars of the three neurodevelopmental disorders and provides our readers with the symptoms, diagnosis, treatments and much more. Excerpts follow:

What are ADHD, LD AND ASD?

ADHD: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorder affecting children. ADHD also affects many adults. Symptoms of ADHD include inattention (not being able to keep focus), hyperactivity (excess movement that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought).

Learning Disorder LD: Learning disorder (also referred to as a learning difficultly) can be described as an issue with the brain's ability to process information. Individuals who have a learning difficulty may not learn in the same way or as quickly as their peers, and they might find certain aspects of learning, such as the development of basic skills, to be challenging.

Because learning difficulties cannot be cured, their effects may impact an individual's performance throughout life: academically, in the workplace, and in relationships and daily life. Intervention and support, which may be supplemented by counselling or other mental care services, can help an individual with a learning difficulty to achieve success.

ASD: Autism spectrum disorder (ASD) is a that can cause significant social, communication and behavioural challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenge. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

What symptoms should be looked out for in the case of ADHD, LD and ASD?

The symptoms of ADHD, LD and ASD are as follows:



The main signs of inattentiveness are:

1. Having a short attention span and being easily distracted.

2. Making careless mistakes – for example, in schoolwork.

3. Appearing forgetful or losing things.

4. Being unable to stick to tasks that are tedious or time-consuming.

5. Appearing to be unable to listen to or carry out instructions.

6. Constantly changing activity or task.

7. Having difficulty organising tasks.

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

1. Being unable to sit still, especially in calm or quiet surroundings.

2. Constantly fidgeting.

3. Being unable to concentrate on tasks.

4. Excessive physical movement.

5. Excessive talking.

6. Being unable to wait their turn.

7. Acting without thinking.

8. Interrupting conversations.

9. Little or no sense of danger.

Learning difficulties:

Problems with working memory – the ability to hold and manipulate information in the moment – also can play a role.

Even when basic reading skills are mastered, children may have difficulty with the following skills:

1. Reading at a typical pace.

2. Understanding what they read.

3. Recalling accurately what they read.

4. Making inferences based on their reading

5. Spelling

Written expression

Writing requires complex visual, motor and information-processing skills. A learning disorder in written expression may cause the following:

1. Slow and labour-intensive handwriting.

2. Handwriting that's hard to read.

3. Difficulty putting thoughts into writing.

4. Written text that's poorly organised or hard to understand.

5. Trouble with spelling, grammar and punctuation.


1. Understanding how numbers work and relate to each other.

2. Calculating math problems.

3. Memorising basic calculations.

4. Using math symbols.

5. Understanding word problems.

6. Organising and recording information while solving a math problem.

Nonverbal skills

A child with a learning disorder in nonverbal skills appears to develop good basic language skills and strong rote memorisation skills early in childhood. Difficulties are present in visual-spatial skills, visual-motor skills, and other skills necessary in social or academic functioning.

1. A child with a learning disorder in nonverbal skills may have trouble with the following skills:

2. Interpreting facial expressions and nonverbal cues in social interactions.

3. Using language appropriately in social situations.

4. Physical coordination.

5. Fine motor skills, such as writing.

6. Attention, planning and organising.

7. Higher-level reading comprehension or written expression, usually appearing in later grade school.

Autism Spectrum Disorder:
Social communication challenges

Children and adults with autism have difficulty with verbal and non-verbal communication. For example, they may not understand or appropriately use:

1. Spoken language (around a third of people with autism are nonverbal).

2. Gestures.

3. Eye contact.

4. Facial expressions.

5. Tone of voice.

6. Expressions not meant to be taken literally.

7. Recognising emotions and intentions in others.

8. Recognising one’s own emotions.

9. Expressing emotions.

10. Seeking emotional comfort from others.

11. Feeling overwhelmed in social situations.

12. Taking turns in conversation.

13. Gauging personal space (appropriate distance between people).

Restricted and repetitive behaviours

1. Repetitive body movements (e.g. rocking, flapping, spinning, running back and forth).

2. Repetitive motions with objects (e.g. spinning wheels, shaking sticks, flipping levers).

3. Staring at lights or spinning objects.

4. Ritualistic behaviours (e.g. lining up objects, repeatedly touching objects in a set order).

5. Narrow or extreme interests in specific topics.

6. Need for unvarying routine/resistance to change (e.g. same daily schedule, meal menu, clothes, route to school.

What’s the process of diagnosis for the three?

The diagnostic procedure includes initial screening, formal psyco-diagnostic assessment that includes international and national tools and informal assessments.

What treatment programmes are available for the three in Pakistan?

Neurodevelopmental disorders are lifelong conditions that can be managed with treatments that are right for the individual. The treatment programmes consists of several therapies that includes psychotherapy, remedial therapy, speech therapy, behavioural therapy including ABA, cognitive behavioural therapy, trauma therapy, occupational therapy, parental counselling and social skills training. With time and proper help, the child is able to manage the challenges.

What was the idea behind the creation of Kazim Trust and how successful has it been in its mission?

The main idea behind the creation of Kazim Trust is to spread awareness about children with ADHD and learning difficulties in Pakistan and to help educators and parents improve the lives of these children. By creating this awareness through our advanced screening and assessment methods, teacher and parent workshops, or private consultations, we aim to create an environment at home and school for these children which foster a high level of acceptability and support for them. We feel this unlocks the true potential of these children to help them. It has been a successful journey as Kazim Trust has been sharing examples of overcoming adversity of the clients and showcasing its services at different platforms such as television, radio shows, newspapers and social media pages and also by conducting workshops for teachers, parents, individuals and special educators, setting up free screening camps for low socio-economic class, conducting live shows and holding annual conferences.