disabilities and children FAQS

Ms Divya Singhal Prasad
Child Psychologist and Psychotherapist

Q How soon can one detect a disability in a child? What are the signs to watch out for?
A Children who are premature, and have not cried immediately after birth, have low birth weight, poor apgar score, have suffered fetal distress come under the high risk children category. They are vulnerable and their development needs to be watched. As they are growing their milestone achievement has to be reviewed. When did the child start head control, crawling, walking, speaking single words, making 2-3 word sentences etc. Any deviation of more then two months from the normal expected time of each milestone should alert the mother.

Q Can some disabilities be prevented by extra care during pregnancy? What are the elements of care and the tests to be taken during pregnancy?
A Certain viral infections are passed by the expecting mother to the growing fetus in-utero, such as HIV, Rubella, Herpes, Toxoplasma etc. In addition alcohol intake, smoking or drug dependence in the mother can lead to low birth weight, poor physical and mental development subsequently leading to academic failures. Some of these problems can be prevented by pre-pregnancy screening tests such as ultrasounds, aminocytesis etc, which help monitor the fetal abnormalities. To take care of these problems obstetricians also suggest precautions during the pregnancy.

Q What is autism? How is it different from cerebral palsy? What are the different treatments?
A Autism is a disorder which manifests during 1 ½-2 years of child's life. From birth till about 1 ½ years the child may have proceeded normally and may have developed some speech. Subsequently from 18 months of age speech doesn't develop further. . Speech is minimal and child uses gestures to communicate only his basic needs. The child seems to be totally in his own world. He doesn't play with other children, doesn't miss or show special attachment with parents, often doesn't make eye contact or respond to his name. In addition he may show some repetitive behaviour such as spinning, rocking, going in circles. He may also show self-injurious behaviour such as head- banging, biting etc
Treatment - Often it is a long term process of training the child in various activities of daily living with the special educator and psychologist. Sensory Integration theory is also used by occupational therapists. No medicines per se are available but some medicines may be given to improve hyperactivity, aggressiveness etc.

Q What are the main concerns facing the parents of special needs children apart from the main medical issues.? Are there any support groups or therapy centers for the families?
A Most parents are worried about:-

• How much would training help their children.
  
• Isn't there any quicker/ surer medical cure.
  
• What about long-term settlement issues in terms of life partner, financial, jobs etc.
  
• What would happen to our children after us?
  
• Is there an institution where I can put my child.
  

No formal support groups for various conditions are known but parent associations for mentally retarded (MR) children exist. Non-residential schools, both govt. & private, are available for MR children. Child development centers, which deal with these problems, are available in metropolitan cities.

Q How do you discipline a special needs child or teach values or interaction with others?
A Disciplining of special children should more often be direct, immediately after the undesirable act rather than postponing for a later time and with simple explanation of logic. It should be consistent, focusing on a few undesirable instances at a time.
Training of each child varies according to his/her disability, intelligence level, capabilities and interest. Commonly the emphasis is on activities of daily living, minimum and useful academics, and social skills.

Q How does one help to increase independence of a special needs child?
A The special child's deficits have to be analyzed. Once these have been identified, the task to be taught is broken into series of small steps and child is trained in each one individually. He is subsequently taught to perform them in a series. The whole procedure has to be repeated till the child is able to master it . Small rewards are given to encourage the child along.

Q. Are some types of special needs children violent? How does one manage the interaction between such children and siblings /friends/neighbourhood children?
A Some children may show aggression and hostility. This may be due to inability to temper their reactions and express it in more socially appropriate manner. Supervised play, role-play, imitation and modeling can be some ways in which these children may be trained in interactive play skills.

Q What is the difference between normal hyperactivity & Attention Deficit Hyperactive Disorder? How can a mother determine whether her child's hyperactiveness is normal or not?
A All children are naughty, curious, restless and easily bored . This could simply be channelized by the mother into constructive activities. However children who have attention deficit hyperactive disorder have 3 main characteristics :
Inattention (unable to finish a task, unable to concentrate)
Hyperactivity (unable to sit still, climbing, jumping, fidgeting so much that mother has to keep a watch constantly)
Impulsivity (does things without thinking, not scared or cautious)
An Attention Deficit Hyperactive Disorder child is like this in almost all situations including games, TV watching as well as academics. It is not that he is not interested, it is that he just cannot wait or be attentive for anything.

Q. How does one deal with physical congenital disorders?
A Children with congenital disorders such as cleft lip, cleft palate, club foot, extra digit in hands or toes etc. may or may not have other deficits. Corrective surgeries are available for many of these problems. A comprehensive evaluation would indicate if the child needs inputs in other areas of development also.

Recommended resource:

counselling - for Indian parents

indian cerebral palsy - parents and health professionals who together want to understand more about cerebral palsy