Paediatric Early Intervention

Act early to help your child.

Developmental problems can hinder your child’s ability to learn essential skills while growing up. Find out how early intervention is helping parents and children improve their quality of life.

Article by : Dr Namita G Shenai

Article posted On Thursday, January 28, 2010 on www.timeswellness.com

Early intervention is indeed the ‘in’ term in the field of habilitation medicine. The word habilitation medicine might be a new term for many as it is rarely used. It means to teach a skill that was never learnt while rehabilitation means to enable an individual to relearn a skill already learnt.

Research on early development has shown that ‘a window for learning begins at birth.’ The clear link between early brain activity and brain development provides the building blocks for life-long learning and function – including entering school ready to learn and families learning of local resources for current and future needs. When there is a diagnosis of a disability or developmental concern at birth, or soon thereafter, early intervention results in greater developmental gains for a child.

Early intervention consists of provision of services for neonates, infants, toddlers and their families for the purpose of lessening the effects of the condition. The Early intervention team consists of a gynaecologist, neonatologist, developmental paediatrician, paediatric occupational therapist, paediatric physiotherapist, speech therapist, nurse, medical social worker.

It focuses on the child and the family. Early intervention programs are centre-based, home-based, hospital-based, or a combination. Services range from identification--that is, hospital screening and referral services--to diagnostic and direct intervention programs. Paediatric occupational therapists working in Neonatal Intensive Care Units (NICU) identify neonates at risk for developmental delay such as those who have low birth weight, preterm babies, those having birth asphyxia, jaundice, meconium aspiration (swallowing of stools), congenital anomalies, and seizure disorders. They use standardized evaluation and assessment tools to predict neurodevelopmental outcomes. This is followed by intervention in the NICU followed by a detailed home program and regular follow-ups till one year of age.

There are three primary reasons for intervening early with a child:

• To enhance the child's development,
• To provide support and assistance to the family
• To maximize the child's and family's benefit to society

The cost is less when intervention is earlier, preventing developmental problems that would have required special services later in life. Timing of intervention becomes particularly important when a child runs the risk of missing an opportunity to learn during a state of maximum readiness. If the most teachable moments or stages of greatest readiness are not taken advantage of, a child may have difficulty learning a particular skill at a later time.

Early intervention helps reduce the additional stresses and frustrations families of infants and toddlers with disabilities experience, enhancing both the child and the family. Supported families need less out-of-home placement. Statistics demonstrate less abuse and neglect occurs for children receiving early intervention services.

They also have a significant impact on the parents and siblings of an exceptional infant or young child. The family of a young exceptional child often feels disappointment, social isolation, added stress, frustration, and helplessness. The compounded stress of the presence of an exceptional child may affect the family's well-being and interfere with the child's development. Parents of gifted preschoolers also need early services so that they may better provide the supportive and nourishing environment needed by the child.

The child's increased developmental and educational gains and decreased dependence upon social institutions, the family's increased ability to cope with the presence of an exceptional child, and perhaps the child's increased eligibility for employment, all provide economic as well as social benefits.

It is essential that awareness on part of the government and the medical fraternity is the need of the hour to reduce the effects of neurological deficits in later life for the future of our dear children.

The doctor is a paediatric occupational therapist at the DISHA Centre, Santacruz, Mumbai.

Pic: Doriana_s

WHAT IS OCCUPATIONAL THERAPY ?

OCCUPATIONAL THERAPY (OT) is the therapeutic use of self-care, work and play activities to increase independent function, enhance development and prevent disability. It may include adaptation of task or environment to achieve maximum independence and to enhance quality of life. Occupational therapists' use the term occupation as tasks and activities as what one does in everyday life, for instance cooking, dressing, driving, performing job duties, homemaking tasks, shopping etc.

WHAT DO OCCUPATIONAL THERAPISTS' DO?

Occupational Therapists' help people with disabilities to fulfill their roles and responsibilities as spouse, parent, worker, and/or student. OT does this through the use of therapeutic methods, applied and assistive technology, orthotics (splints) and environmental modifications. OT helps people help themselves. Occupational Therapists' treats a person as a whole. Life circumstances are taken into account during the treatment process. The person is what is important to the therapist. The person's wants, needs and desires for recovery are what the therapist will address and the goals they together, along with family and friends, as a team will reach for.

SCOPE OF OCCUPATIONAL THERAPY?

This is a list of diagnoses that may be seen by occupational therapist. This list is NOT all-inclusive. It is meant to show that OT services are available and beneficial to many individuals with:

Mental Illness
such as Drug Addiction, Depression, Schizophrenia where occupational therapy aims at improving social, emotional, behavior and occupational performance through group therapy, family counseling and community integration.

Developmental Disorders
such as Cerebral Palsy, Mental Retardation, Autism, Attention Deficit Hyperactivity Disorder where occupational therapy helps the child with treatment techniques such as NDT and Sensory integration. Therapy assists in the development of neck control, sitting, standing, and walking through the use of external aids and Preschool training to prepare the child for education.

Neurological Conditions
such as Stroke, Head injury, Parkinson's disease, etc. where therapy is aimed at retraining Cognitive-Perceptual abilities to promote independent functioning, mobility training and adaptations at home.

Geriatric Conditions
such as Alzheimer's Dementia etc where therapy aims at teaching strategies for memory problems through environmental modifications, physical exercises to maintain general body mobility.

Cardiac Disorders
such as Myocardial infarction, lung diseases-Bronchial asthma etc where therapy aims at fitness exercises, work analysis & assessment for work fitness, lifestyle modification & teaching prophylactic measures such as weight reduction.

Physical Dysfunctions
due to trauma, burns, injuries leading to amputation, nerve injuries, musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, Spinal cord injuries or tumors where therapy aims at restoring the functions of the affected limbs through the use of splints, assistive devices, prosthetic training and teaching joint protection and energy conservation techniques.

Cumulative Trauma Disorders
such as Carpal tunnel syndrome, work related disorders-Low back pain etc where therapy aims at education regarding prevention of work related injuries, modification of the work set up and home environment to suit disabled individuals, prevocational testing & training and Disability evaluation.