Special Children

10% : children with special needs 20% : borderline intellectual functioning, various learning, speech, visual, hearing impairments 6 per 1000 live births suffer hearing loss at birth or neonatal period

Earlier the Better

Improved maternal and Child care Education of Women

Primary

Screening & Early Identification of Disabilities Secondary Infant Stimulation &Remediation

Tertiary

Prevent/ reduce complications of Disability Rehabilitation

Nature and Nurture

Complex
Genetic program(Nature) Environment (Nurture)

Simple

Growth and Development

Handle with Care

Central Nervous System

100000000000 nerve cells

Networking

Growth and Development

Use it or Lose it !
Twice the no: of synapses in the adult

2yrs
Brain is 95% of adult size

5yrs
Weakly formed synapses start regressing

10yrs

Child Development
Critical Periods
Windows of opportunity Time of selective vulnerability

Plasticity
Part of the functions of Damaged Brain can be compensated within limits by forming alternate pathways

Language
Most sensitive, receptive, language skills and ability to recognize speech till 5-6 years

Motor Skills
Myelination of Cerebellum peaks by 4 years of age Gross motor Skills grow through stimulation initiated by childrens advances

Hearing Auditory perception has reached adult levels by age 2 years

Vision
Visual acuity increases from Birth: 20/800 to 20/200 to 20/70 at 8 months 6 months: Infants Visual Cortex develops Cataract has to be removed before 4-6 months of age Squint correction before 7 yrs of age

Areas of Development
Moral
Cognitive Social Physical

Emotional
Psychosexual Temperamental

Screening Methods
Sensitive
Specific Inexpensive Simple Repeatable Acceptable to Public & Professionals

Screening Methods
Pregnancy: Amniocentesis, Chorionic villi Sampling, Ultrasonography New Born: Phenylketonuria, Galactosemia, Hypothyroidism <4 years DQ, Gessell Developmental Schedule Vineland Social Maturity Scale Denver developmental Screening Test

Screening Methods: Hearing

Infants: Transient Evoked Oto Acoustic Emissions (TEOAE) Automated Auditory Brainstem Response (AABR)

Screening Methods : Vision

Screening

Intervention

Family

Environment

Child

Early Intervention
Before school age 0-3 yrs/ 5 yrs Systematic and Planned effort Series of Manipulation of Environmental / experimental factors

Multidisciplinary team

Early Intervention for Family

Provide Info and skills Individualised Family Service Plans Understand Limitations, strengths and needs of the Infant Genetic Counseling Emphasise need for Spacing and Small size of Family Family Involvement is strong predictor of language development

SCHEME TO PROMOTE VOLUNTARY ACTION FOR PERSONS WITH DISABILITIES (Min of Social Justice and Empowerment, New Delhi)

Projects for Children < 5 yrs Pre-School & Early Intervention Home Management Projects AIM: Prepare the Disabled Children for their Schooling in Special Schools and /or integration at the appropriate stage in regular schools

 Early detection and identification: A concerted drive to detect children with special needs at an early age should be undertaken through PHCs, ICDS, ECCE centers and other school readiness programmes. Identification of children with special needs should become an integral part of the micro-planning and household surveys. Functional and formal assessment of each identified child A team should be constituted at every block to carry out this assessment and recommend most appropriate placement for every child with special needs.

Early Years of Development

Most Rapid development in all areas Critical and Irreversible changes Disabled are vulnerable & sensitive to early experiences

Facilitates family adaptation

Limits the Effect of Disability/ prevent the development of the secondary disability

 International Society on Early Intervention (ISEI) (www.isei.washington.edu)

Journal of Early Intervention (http://jei.sagepub.com)