Developmental Disability

8/8/2019 Developmental Disability

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Children withChildren with

Disabilities:Disabilities:

Experiences, ChallengesExperiences, Challenges

Anita RajahAnita Rajah

Dept of Clinical PsychologyDept of Clinical PsychologyAmrita Institute of Medical Sciences,Amrita Institute of Medical Sciences,

KochiKochi


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Magnitude of the problemMagnitude of the problem


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IdentificationIdentification

Greater possibility ofGreater possibility of

identification whenidentification when

staying in urban areasstaying in urban areas

HelpHelp--seeking behaviourseeking behaviour

influenced by severalinfluenced by several

factorsfactors

Accessibility, availabilityAccessibility, availabilityof helpof help


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What these children may not attainWhat these children may not attain


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And therefore, may miss out on this..And therefore, may miss out on this..


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AnnaAnna 6 yr old nursery student6 yr old nursery student

Reported by teachers as suddenly unresponsiveReported by teachers as suddenly unresponsive--

would stop whatever she was doing, starewould stop whatever she was doing, stare

vacantly into space for a while, would notvacantly into space for a while, would not

respond to teachers, friends, calling herrespond to teachers, friends, calling her

Parents felt that she was okay, came for helpParents felt that she was okay, came for help

only because a cousin had recommendedonly because a cousin had recommended

psychological evaluationpsychological evaluation


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JijoJijo

4 yr old boy, older of 2 children4 yr old boy, older of 2 children Developed wounds, bruises in his jointsDeveloped wounds, bruises in his joints

whenever he hit somethingwhenever he hit something

Parents prevented him from playing, toldParents prevented him from playing, toldteachers at school to restrict his activitiesteachers at school to restrict his activities

Pediatrician has told parents that they shouldPediatrician has told parents that they should

take him for further tests with specialisttake him for further tests with specialist Parents confused, upsetParents confused, upset


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AhmedAhmed

11 yrs old11 yrs old

Road traffic accident 6 months agoRoad traffic accident 6 months ago

Fractured his right hand and legFractured his right hand and leg Lost his father,( was working in the gulf, comesLost his father,( was working in the gulf, comes

home once in two years)home once in two years)

Difficulties in concentration, unable to completeDifficulties in concentration, unable to completehis home work, poor marks at school, does nothis home work, poor marks at school, does not

feel interested in studiesfeel interested in studies


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What does having a child withWhat does having a child with

disability really mean?disability really mean?Endless seriesEndless series

Constant careConstant care

TimeTime

EffortEffort

MoneyMoney

Neglect of othersNeglect of others

No light at the end of theNo light at the end of thetunneltunnel


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Other related needsOther related needs


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Types of disabilitiesTypes of disabilities

Different types of classificationDifferent types of classification

GeneticGenetic-- CongenitalCongenital AcquiredAcquired

EarlyEarly Late onsetLate onset MildMild-- ModerateModerate-- SevereSevere

PhysicalPhysical MentalMental

PrimaryPrimary-- SecondarySecondary


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Sensory deficitsSensory deficits

HearingHearing

VisionVision

MotorMotor

Caused by inadequacy inCaused by inadequacy in

sense organssense organs

Or faulty brainOr faulty brain

developmentdevelopment


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Cerebral palsyCerebral palsy

Affects both physical asAffects both physical as

well as mentalwell as mental

developmentdevelopment

Rigidity of limbsRigidity of limbs

Clumsiness ofClumsiness of

movementsmovements

Psychomotor slowingPsychomotor slowing Can have normalCan have normal

intelligenceintelligence


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Abnormal development of the brainAbnormal development of the brain


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EpilepsyEpilepsy

Abnormal firing of neuronsAbnormal firing of neurons

Can be in one area orCan be in one area or

generalised to all parts of thegeneralised to all parts of the

brainbrain Can be in response to certainCan be in response to certain

situations or stimulisituations or stimuli

Need detailed investigationsNeed detailed investigations

and longand long--term medicationterm medication


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Trauma to the BrainTrauma to the Brain

Otherwise normal childOtherwise normal child

Injury due to infection,Injury due to infection,

traumatrauma

Disrupts normalDisrupts normal

development in the childdevelopment in the child


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HemophiliaHemophilia

Bleeding DisorderBleeding Disorder

Usually affects only malesUsually affects only males

Deficiency of clotting factorDeficiency of clotting factor Genetic transmissionGenetic transmission

Also through gene mutationAlso through gene mutation

No complete cure possibleNo complete cure possible Factor infusion whenever necessaryFactor infusion whenever necessary


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DiabetesDiabetes

Inadequacy of insulin secretionInadequacy of insulin secretion

Oral supplement or injectionOral supplement or injection Diet restrictionsDiet restrictions

Fear of injuryFear of injury

Delay in healingDelay in healing


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Effects of disabilityEffects of disability

PhysicalPhysical

EmotionalEmotional

SocialSocial EducationalEducational

EconomicEconomic


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Impact of Childs Disability onImpact of Childs Disability on

CommunityCommunity ParentsParents

SiblingsSiblings

NeighbourhoodNeighbourhood Extended family membersExtended family members

SchoolSchool

PeersPeers


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WHO ICF ModelWHO ICF Model HANDBOOK.htm#Handbookpg8

WHO 2001


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International ClassificationofInternational Classificationof

Function, Disability & Health (ICF)Function, Disability & Health (ICF)

Developedby WHODevelopedby WHO -- 19921992--2001.2001.

ICF model:ICF model:

recognisesrecognises disability as a universal human experience .disability as a universal human experience .shifting the focus from cause to impact .. takes into accountshifting the focus from cause to impact .. takes into account

the social aspects of disabilitythe social aspects of disability

PrimaryfunctionistocodethecomponentsofhealthPrimaryfunctionistocodethecomponentsofhealthandtheirinteractionsandtheirinteractions

Purpose:Purpose: NegativeNegative NeutraltermsNeutralterms

ExpandthinkingbeyondprimaryimpairmentsExpandthinkingbeyondprimaryimpairments

Movesfrom medicaltobioMovesfrom medicaltobio--psychosocialapproachpsychosocialapproach

WHO 2001


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Learning OutcomesLearning Outcomes

WHO International Classification of Function, Disability &WHO International Classification of Function, Disability &Health (ICF)Health (ICF)

Detection & DiagnosisDetection & Diagnosis Toincreaseknowledgeofthescreening methodsfordevelopmentaldisabilitiesToincreaseknowledgeofthescreening methodsfordevelopmentaldisabilities

CopingCoping TorecognisefactorsinfluencingafamilyscopingabilityTorecognisefactorsinfluencingafamilyscopingability

Toidentify & applystrategiestofacilitatefamilycopingToidentify & applystrategiestofacilitatefamilycoping

Challenging BehaviourChallenging Behaviour

TorecognisetypesofchallengingbehaviourTorecognisetypesofchallengingbehaviour Toidentify & applystrategiestoaddresschallengingbehaviourToidentify & applystrategiestoaddresschallengingbehaviour

Family InvolvementFamily Involvement TorecognisebarrierstofamilyinvolvementTorecognisebarrierstofamilyinvolvement

Toidentify & applystrategiestofacilitatefamilyinvolvementToidentify & applystrategiestofacilitatefamilyinvolvement


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What is the help available?What is the help available?


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AnnaAnna

Diagnosis of seizure disorderDiagnosis of seizure disorder

Moderate disability but not permanentModerate disability but not permanent

Medication until she fits are under controlMedication until she fits are under control Restriction on certain activitiesRestriction on certain activities

Likely to have difficulties at schoolLikely to have difficulties at school-- slowness,slowness,

difficulties in concentrationdifficulties in concentration


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JijoJijo

Diagnosis of hemophiliaDiagnosis of hemophilia

Father blamed mother for being the cause of theFather blamed mother for being the cause of the

problem; motherproblem; mother-- guilty, upsetguilty, upset HospitalisationHospitalisation whenever factor infusion waswhenever factor infusion was

necessary, expensive, missed out on schoolnecessary, expensive, missed out on school

Unco

Unco--operative child, refused to followoperative child, refused to followinstructions, threw tantrumsinstructions, threw tantrums

Developed permanent limp in legsDeveloped permanent limp in legs


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AhmedAhmed

Initially in griefInitially in grief

Gradually learned to cope with situationGradually learned to cope with situation

Physical disability diminished over timePhysical disability diminished over time Emotional loss persisted for a whileEmotional loss persisted for a while

Documents

Developmental Disability