By Abha Ranjan Khanna
For all children, early childhood provides an important window of opportunity to prepare the foundation for lifelong learning and participation, while preventing potential delays in development and disabilities. For children who experience disability, it is a vital time to ensure access to interventions which can help them reach their full potential.
Developmental disabilities include a complex group of disorders that cause physical impairments, intellectual disabilities, speech disorders and medical conditions. Developmental disabilities are usually present and diagnosed at birth. Some developmental disorders, however, may not be easily identified until the age of two to three years. Developmental disabilities span the lifetime and functional needs and abilities change with age through the lifespan. Developmental disabilities may range from mild to severe. Some of the more common developmental disabilities include:
· Intellectual disabilities
· Cerebral palsy
· Down Syndrome
· Muscular dystrophies
· Tourette Syndrome
· Fragile X syndrome
· Genetic disorders and chromosomal anomalies
· Special sensory loss that results in blindness or deafness
Intellectual disabilities are very common in India with more than 10 million cases reported every year. A child with intellectual challenges may experience significant limitations in intellectual functioning such as reasoning, learning and problem solving and in adaptive behaviours that cover a wide range of everyday social and practical skills.
Intellectual disability is also referred to as a general learning disability and is diagnosed by an intelligence quotient under 70 in addition to deficits in two or more adaptive behaviours. Adaptive behaviours include all activities of daily living or basic self-care tasks that are learnt in early childhood, such as feeding, toileting and bathing, oral hygiene, grooming, dressing/undressing, mobility and transferring.
Instrumental activities of daily living are tasks learnt in adolescents and early adulthood. They require more complex thinking and organisational skills. They include managing finances such as paying bills; shopping and preparing meals; house cleaning and home maintenance; managing transportation needs; managing communication such as the use of a telephone, laptop, etc, and managing medications.
Intellectual disabilities may be associated with other developmental disorders such as autism and cerebral palsy or may present as pure intellectual disabilities not associated with any other syndromes. However, not all children with cerebral palsy or autism have intellectual disabilities.
The good news is that all recent work with children with intellectual disabilities and their families, teachers and other caregivers indicates that like all children, children with intellectual disabilities learn and thrive when they are in environments that are nurturing and appropriate. Nurturing adult responses to early concerns of very young children are key to children’s safety and development. This is most true for children with intellectual disabilities.
Providing support and training in self-care skills, social relationships and appropriate behaviour from early childhood significantly improves functional skills and effectively limits the challenges that children with intellectual limitations may experience.
Including children with learning disabilities into high quality education programmes along with same age peers provides the appropriate ecosystem that fosters care, self-esteem, compassion and sharing in both the non-disabled and the disabled child.
Please look out for the next few articles as they will provide information on the other lifespan conditions listed earlier in this article.
(The writer is an occupational therapist.)