When your child just won't talk

AT HOME, Corrine behaves like a normal seven-year-old. She is chatty with her parents and her sister and loves telling stories to her grandfather.

At school, though, she is known as 'the girl who doesn't talk'. She freezes when a stranger speaks to her and stares blankly when asked for her name or age.

She kept silent through two years in kindergarten and now, four months into Primary 1, she has still not uttered a word to her teacher or classmates.

At first, her parents thought she was just shy. Her mother said: 'I didn't think it was a big problem. I just thought she was a little reserved when out in public.'

But once she entered kindergarten, they realised it was much more than that.

Her teachers said she was not speaking up in class. When she needed to go to the bathroom, she would rather hold it in or wet herself than ask for permission.

Also, she did not seem to know her ABCs - and yet she read avidly.

Corrine's parents took her to a child psychologist, who diagnosed her problem as selective mutism, a little-known anxiety disorder.

A child with this can understand what is being said and speak normally at home but becomes unable to talk in specific situations, such as in school or in public.

The Child Guidance Clinic (CGC) at the Institute of Mental Health (IMH) and psychologists in private practice have seen more such cases in recent years.

The CGC alone has diagnosed 115 cases in the last five years. Three years ago, it diagnosed 18 children; last year, the number nearly doubled to 34.

The Education Ministry said 65 students in mainstream schools were diagnosed with the disorder in 2007; last year, the figure was 80.

Dr Daniel Fung, who heads IMH's Department of Child &Adolescent Psychiatry and the Child Guidance Clinic, said the condition often goes undetected because awareness of it is still low and because parents and teachers think the child is just shy or anxious about school.

But there is a difference between ordinary shyness and selective mutism.

Dr Fung said: 'A shy child, given a familiar environment and some encouragement, will eventually open up. But a child with selective mutism will remain mute.'

A 2002 study in the Journal of the American Academy of Child and Adolescent Psychiatry said the condition affects about seven in every 1,000 children, and strikes girls more than boys; it becomes obvious when the child starts pre- school.

The severity varies. Some children are completely non-communicative, others may use gestures and nods.

At one time, psychiatrists thought the condition was a child's way of showing defiance, but they now believe it has its roots in social anxiety.

Treatment involves lowering the patient's anxiety through medication such as Prozac and helping the child become more communicative in stages.

Dr Fung said it is important that parents of such children do not keep harping on speaking up because that would only reinforce the anxiety.

Occupational therapist Yael Sasson of Dynamics Therapy Centre, a private clinic for children, said the biggest challenge is to move the child from non-verbal to verbal communication.

She suggests getting the child to read at home, recording the session and playing it back in school so the child gets used to hearing his voice and overcomes the anxiety.

'It is a big step when the child starts whispering the answer to a friend in school or even to the teacher,' she said.

Most children get better in a year, said Dr Fung, but some do not overcome it.

One of his patients came to him at age 11, and despite medication and behavioural modification, the boy got no further than whispering to him, and was selectively mute even in university, where he studied computer science.

Corrine, meanwhile, has made slow progress with treatment.

Two weeks ago, she began using a book with symbols in it which she showed her teacher to indicate what she needed.

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Green envoys plant the seed

THE Vegetarian Society of Singapore (VSS) wants to spread its creed among youth and has roped in a dozen Raffles Institution (RI) students for the job.

The boys, all in Secondary 3 in RI's Integrated Programme (IP), will spread awareness about health and environmental problems caused by eating and producing meat. They will do so by giving talks and mounting exhibitions in schools.

Their mission: To get fellow students to eat more vegetables and cut down on their meat intake by year's end. With help from VSS, they will also try to get canteen stall owners on board by suggesting ways of including more greens in their menus.

The IP students are doing this project under Research Education, a subject in their curriculum.

Just a month in, the 12 ambassadors of vegetarianism have yet to decide on the schools where they will promote their cause, but they scored a victory two weeks ago when they persuaded RI's Indian food stall owner to sell vegetarian burgers.

To fan publicity for these new-style burgers, they ran a quiz on environment-related issues over two days. Students who answered at least two questions could buy the $1.50 burger for 50 cents.

The team's head of publicity Amos Mah, 14, said 300 burgers were sold on each of the two days of the campaign, but this has fallen to under 100.

Undaunted, he said: 'We learnt that it is not easy to change eating habits and mindsets. But we believe that, over time, by presenting our schoolmates with the facts on the effects of eating meat, they will be encouraged to make changes to their lifestyles.'

The team has been busy: It has produced posters, now plastered all over RI, on the environmental and health benefits of a more plant- based diet.

VSS education officer Loh Yeow Nguan said the society decided it was best that students be the ones to persuade their peers to eat more greens, since VSS has not had much success after years of giving talks and holding exhibitions in schools.

He added: 'Getting the students directly involved helps them to understand better the damage that eating meat can do to their health and the environment.'

This has certainly been true for team member Cheong Kah Wah, 16, who said: 'I did not know eating meat could cause so many health and environmental problems. I've decided to eat less meat and am cutting down on fast food.

'I hope that, by doing this, I can encourage my friends to change their eating habits too.'

In recent years, efforts have been made in several countries to change the eating habits of youth. Britain, for example, has banned junk food from its school canteens.

Here, schools under the 'Model Tuckshop' Programme do not sell drinks with more than 8g of sugar per 100ml as well as deep-fried food and preserved meat more than once a week.

VSS president George Jacobs said these efforts are heartening, but more needs to be done. 'We can restrict the number of times fried food is sold in schools, but it won't make much of a difference if students do not believe in the importance of healthy eating. They will still buy fried food from other places.'

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China learns lesson from fake degrees

BEIJING: One hour and about US$40 (S$60) are all it takes to get a fake degree in China, but the chances of fooling an employer or foreign university have diminished following a crackdown in recent years.

While the trade in counterfeit Hermes handbags or Windows software is well known, marriage certificates, driving licences and diplomas are also seen as fair game by the forgers.

Measures put in place by the Chinese authorities have made it possible to limit cheating and many counterfeit diplomas are detected by authentication procedures.

But allegations of a trade in diplomas by students intending to enrol at several French universities, if confirmed, would echo a widespread practice in China, where access to higher education is selective and a degree opens doors to a career.

The crackdown on counterfeiting may have driven the trade away from the city centres but in certain districts it is still easy to track down forgers.

In Beijing, they can be found in the suburbs. Half an hour after taking a photograph and details, the forger returns with the requested diploma.

It costs between 200 and 300 yuan (between S$44 and S$66) for a bachelor's or master's degree, depending on the fame of the university, the seal of which is reproduced on the forgery.

The package deal includes report cards.

'I got a false diploma from the Beijing Commerce Institute in 2001 for 100 yuan,' a young executive said.

'I had it after waiting for about 30 minutes in front of an alley where many migrant workers live.'

But since the installation of computerised anti-fraud systems by the Education Ministry, the provincial authorities and tertiary institutes, getting a government job with a forged diploma has become increasingly difficult.

A growing number of foreign companies and universities that welcome Chinese students also systematically check the authenticity of diplomas.

'All the papers are checked. You find about 3 per cent to 4 per cent of diplomas are forgeries' among prospective students wishing to study in France, according to a person involved in the university exchanges, who asked not to be identified.

'Before 2003, you could buy a fake diploma on the street corner,' the source said. In 2002, the Education Ministry estimated that at least 500,000 people had forged degrees.

Developed countries then began establishing procedures to check the authenticity of diplomas, the source added.

Ms Li Ping, director of one of three departments in charge of certifying diplomas at the ministry, said they were receiving increasing numbers of authentication requests, 'especially from people who want to go abroad to continue their studies'.

'Last year we had 30,000 requests, that's an increase of 54 per cent,' she said.

But most private companies still do not check the qualifications of would-be employees.

And in 2004, the Chinese media carried reports of a fake Internet site that checks counterfeit diplomas, with a domain name very close to that of the official sites.

There are also cases in China of real degrees being bestowed on false students.

And it is not unheard of for civil servants whose career progress depends on a prestigious diploma to use connections to register for a degree, and graduate without ever attending the course.

AGENCE FRANCE-PRESSE

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FAST AND EASY

'I got a false diploma from the Beijing Commerce Institute in 2001 for 100 yuan. I had it after waiting for about 30 minutes in front of an alley where many migrant workers live.'

A young Chinese executive

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Let's talk to teens about sex

WITH sex in the news, I asked my 13-year-old niece: 'Do you have sexuality education in school?'

'Yes, my teacher says it's okay to watch porn!' she announced cheerfully.

I blinked. 'What was the context? Did she say, only for adults or something?'

'Um, she said it's okay to watch but don't watch every day otherwise you can get hooked,' she said, nose wrinkling in recall.

'And what did you learn about sex before marriage?'

'She said you can't prevent teen sex so you must have safe sex,' she said.

Her summary may of course be suspect. But whatever the teacher's intention was in her neighbourhood secondary school, these were the messages my niece and her friends received from the lessons.

I said: 'You know your teacher is wrong, ya? We are Catholics and the church teaches no sex before marriage. Watching porn gives you a perverted idea of sex. Sex is a loving act between a committed couple married to each other.'

She nodded. In the nature of things, today's average 13-year-old gets inundated with mixed messages on issues from what to wear and how to behave to whether it's okay to eat pork during a swine flu pandemic and whether one sneeze counts as a flu symptom.

Getting conflicting signals from the adults and the authorities around her on sexuality is part and parcel of being a teen in modern Singapore.

Still, I wonder if there can be better partnership between schools and family, so that the messages sent to teens on sexuality are congruent.

One good thing that has come about from the ongoing battle for control over women's group Aware is that the spotlight is on sexuality education in schools.

Aware has a new executive committee consisting of mainly new members who joined in the last year. The group's members, at least four of whom attend the same church, said they were concerned about a comprehensive sexuality education (CSE) programme Aware brought to 11 schools. They said the programme promoted homosexuality, although Aware members familiar with it said it discussed homosexuality tangentially and without value judgments.

Sex education in schools is a hot- button issue, fraught with concerns over moral and religious values. There is no such thing as a value- free sex education.

Although the new Aware exco focused on homosexuality as a key threat to family values, in fact the key distinction in sex education programmes is whether they promote abstinence only, or include information on contraception and sexually transmitted diseases (STDs).

Advocates and well-organised groups on both sides will point to voluminous research to argue their case. Essentially, those who advocate an abstinence-only message say that teaching teens about contraception, STDs and abortion tempts them into having sex earlier and experimenting more.

Others point to a World Health Organisation study of 35 sex education programmes around the world. This found no evidence that comprehensive programmes encourage sexual activity, and concluded that abstinence-only programmes are less effective than comprehensive classes that promote abstinence and also teach about contraception and disease prevention.

What is a parent or concerned aunt to do? First, find out just what the MOE's stand is on sex education. Its website reminds parents that the main responsibility for sex education lies with parents, not schools. What the school teaches should be viewed only as complementary.

This is a sober reminder. The onus is on parents to engage their teenage children to talk about sex and not abdicate this role to the school.

Second, find out what schools are actually teaching teens about sex. Is sex before marriage okay? Do boys and girls behave differently? What does respect for others mean? How do you say 'no' if in a relationship? These are issues that schools should explore - and the values espoused by the school should be consistent with those of the majority of parents.

Most reasonable parents would want their teens to understand that sex is not the vehicle for lust as seen in movies, but is an expression of love within a loving, committed relationship. Most sensible parents would want schools to promote abstinence until marriage.

Beyond this, however, values will diverge. Do you want your teen to learn about contraception and STDs? Some do, believing this helps teens protect themselves. Others do not. Yet others prefer to educate their teens on such sensitive matters themselves.

One thing that is not useful is to assassinate sex education programmes by label. The label 'comprehensive sexuality education' is sometimes taken by advocates of 'abstinence-only' sex education as being a short cut for promoting promiscuous behaviour, and encouraging sexual experimentation at a young age with members of the same and opposite sex. No less an organisation than WHO has debunked this view.

It also does a grave disservice to the CSE movement, which at its heart aims to put information on sex, and the consequences of sex, into the hands of teens so that they know how to protect themselves.

A good sexuality education programme for Singapore's teens - exposed to multiple influences, but mostly residing in fairly conservative homes - would be 'abstinence-plus'. This would promote a loving family unit as ideal, advocate abstinence before marriage, and discourage early sexual activity.

But unlike head-in-the-sand abstinence-only programmes, abstinence-plus programmes also teach teens about STDs and contraception. After all, teens may not get another chance to learn such things in a guided manner before they venture into the adult world. It makes sense to give students a rounded perspective on sex while they are 'captive', so to speak, in the schools.

There is an ongoing effort to collect signatures online to petition MOE to look into Aware's sexuality education programme. But parents must realise that they also need to do their part. Before pointing fingers at Aware, or MOE, or other groups that conduct CSE, they must talk to their teens about sex themselves.

Parents who hold MOE or other groups responsible for teaching their children morals are simply turning over their parental responsibility to the state.

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MOE now looking into sexuality education programme

THE Ministry of Education (MOE) is investigating the sexuality education programme run in some schools by the Association of Women for Action and Research (Aware) after receiving complaints from parents.

The move comes two days after the ministry said in a letter to the media that it had not received any complaints about the programme and thus saw no reason to intervene.

But since then, it said, some parents had expressed concern about the content found in an instructor guide for Aware's programme, which had been posted online.

The Straits Times understands that since the ministry's letter was published on Wednesday, the new guard of Aware has encouraged parents to make their concerns known to MOE.

In addition, a petition has been circulating online. It wants the Education Minister to probe Aware's programme.

The ministry is now looking into whether the Aware instruction guide was used for sexuality education workshops run by the group in schools.

It is also reviewing the contents of the guide.

In a statement yesterday, the ministry also said it had received some feedback and queries from parents.

In general, it said, parents had asked for clarification on what students are taught during sexuality education programmes in school.

In response, the ministry said its programmes reflect 'the mainstream views and values of Singapore society, where the majority of Singaporeans hold conservative views of sexuality'.

It added that homosexuality is covered in one lesson for lower secondary classes.

'The lesson seeks to inform students of the definition of 'homosexual' and that homosexual acts are illegal under Singapore's law,' said its spokesman.

'It does not promote homosexuality, but follows social norms of mainstream society.'

The online petition, meanwhile, is gaining steam.

In just a few days, more than 1,200 people have put their names on it.

Apart from seeking a probe, it also wants the Education Minister to inform parents 'more accurately about values and contents' of sexuality programmes taught in schools.

It was started by a woman who signed off as Madam K.F. Khoo.

She declined to be interviewed by The Straits Times.

Mr Vincent Lim, a 34-year-old private tutor and father of two young children, said he signed up because he wanted MOE to carry out a 'thorough investigation' into Aware's programme.

He said: 'If it is found out that Aware's programme portrays homosexuality in a positive light, I will strongly object to it and want it to be stopped in the schools.'

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