Mamta Kavach Prevention and Identification of Disabilities in Early Stages of Childhood
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Early childhood is the most rapid period of development in a human life. The years from conception through birth to six years of age are critical to the complete and healthy cognitive, emotional and physical growth of children. The disability among children of this age group is thus, a matter of serious concern as it has wider implications. The Census 2011 showed that, in India, one in every 100 children in the age group 0-6 years suffered from some type of disability. Therefore it is vital that disabilities are identified as early as possible. There can be many reasons for disabilities like • Genetic Causes • Environmental Causes/ Life Events • Complications during pregnancy or after birth. Now complications can either be prevented or managed to a certain extent. Prevention can begin once a lady gets pregnant with the help of screening. Screening to create a complete developmental profile, is a brief assessment procedure designed to identify children who should receive more intensive diagnosis or assessment. The emphasis in screening has shifted to a younger age, with the current focus being on infants and children from birth till 3 years of age. This is an age at which the clinician is very closely involved with children and families and is in a position to have significant impact on the course of the child's development. Because developmental screening is a process that selects those children who will receive the benefits of more intensive evaluation, or of treatment, all infants and children should be screened for developmental disabilities, otherwise some may be denied access to needed care. Unfortunately, many are not identified until after these critical years. We can consider the example of Hearing Impairment. Screening a New Born • Is there anyone in the family with deafness since childhood? • Did the mother take an abortificient drug or any other medicine in large doses during the first three months of pregnancy? • Is the birth weight below 1500 Gms? • Did the child have a delayed cry after birth? • Did the child have significant jaundice (yellowness of eyes) during the first10 days after birth? • Does the child have a cleft in the lip or palate, or a malformed pinna? Screening Children in the age group of 6 months to 2 years: • Does a child turn towards the source of sound which is located either at the back or towards one side of the body? • Does he/she have discharge from the ear? Screening Children above 2 years age • Does he/she turn when called from behind? • Uses gestures excessively • The child does not speak or has a defective speech. • The child does not understand the spoken language. • The child has an ear discharge Such screening can serve as guideposts for parents, teachers and others involved. They should not be used in isolation, but may lead the parents to seek further assessment.