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    3. Supporting Parents Of Children With Special Needs – Part 1: Types Of Challenges And Understanding ‘Special Needs’

    Supporting Parents Of Children With Special Needs – Part 1: Types Of Challenges And Understanding ‘Special Needs’

    Aruna Raghuram Aruna Raghuram 11 Mins Read

    Aruna Raghuram Aruna Raghuram

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    Every child with special needs has a unique set of educational requirements, and they may even need your support for dealing with everyday life. Understanding your child’s needs and seeking help from teachers and specialists will go a long way in helping your child reach their full potential

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    Supporting Parents Of Children With Special Needs – Part 1: Types Of Challenges And Understanding ‘Special Needs’

    This is the first article of a two-part series on supporting parents of children with special needs. Part 2 focuses on tips to help parents thrive and raise their children.

    A must-watch movie on Netflix is Ahaan—the story of an unlikely friendship between a young adult Ahaan with Down syndrome and his neighbor Ozzy, who has obsessive-compulsive disorder (OCD). The movie is refreshing in its treatment of two individuals facing challenges of very different kinds. Ahaan is particularly likable, as he has a positive outlook and big dreams. Movies like Ahaan are crucial in making people view children and adults who have special needs with more positivity. Hopefully, more such movies will inspire people to focus on the strengths of individuals with special needs and help them understand the challenges faced by these individuals.

    What do we mean by “special needs”?

    Children with special needs may be facing medical issues, physical challenges, developmental delays, learning difficulties, or emotional and behavioral problems. Because of these challenges, children need assistance in their daily life and specialized services in the educational sphere. The term “special needs” refers to the extra help and accommodations required by children to reach their potential. So, there’s a difference between the particular challenge a child faces and the special needs this challenge necessitates.

    According to the 2019 “State of the Education Report for India: Children with Disabilities” released by UNESCO, there are over 78 lakh children with disabilities in India, constituting 1.7% of the total child population. (This report was based on the 2011 census.) Moreover, 75% of the children with disabilities at the age of 5 do not attend any educational institution.

    Types of challenges

    Children may be born with a challenge (such as autism) and have special needs, or develop it over the years (like muscular dystrophy or asthma). Some children may face more than one issue. Here are some examples of common challenges:

    1. Physical – Muscular dystrophy, multiple sclerosis, epilepsy, asthma, allergies, cystic fibrosis, leukemia, juvenile diabetes, and juvenile arthritis. This category also includes visual, hearing, and speech, and movement impairments.
    2. Developmental – Autism spectrum disorder, cerebral palsy, Down syndrome. These conditions often cause developmental delays. Learning disabilities (LDs) such as dyslexia (difficulty in reading and language), dyscalculia (difficulty in learning math), and dysgraphia (poor handwriting and spelling difficulty) are also included in this category.
    3. Behavioral or emotional disorders – OCD, attention deficit hyperactivity disorder (ADHD), oppositional defiance disorder (ODD), post-traumatic stress disorder (PTSD), and other mental health issues like anxiety, depression, and bipolar disorder.
    4. Sensory processing disorder (SPD) – This disorder affects how a child’s brain processes sensory information—what they see, hear, touch, smell, or taste. While some children may get overstimulated by sensory stimuli, others may be understimulated. For instance, a child who gets fearful when he hears the sound of balloons being popped at a birthday party probably hears sounds too loud. SPD is common among autistic children. Children can be oversensitive to the texture of clothes and food as well. Often, children with SPD are misunderstood and believed to have behavioral issues till their real problem is diagnosed.

    Sometimes the categories may overlap. For example, ADHD may be categorized as a developmental disorder and cerebral palsy as a physical one.

    Different types of special needs

    The special needs of children depend on the specific challenges they are facing. For instance, a child who uses a wheelchair because of muscular dystrophy would require a ramp or lift in school to get to class. A child with a learning disability like dyslexia or dyscalculia, or a neurodevelopmental disorder like autism, would require the assistance of a special educator, while a child with allergies or juvenile diabetes would need to keep medicines handy, even in school. A child with dwarfism would need an appropriate chair and desk as per their height, whether at home or school.

    How early can you know if your child has special needs?

    Early detection depends on the type of challenge the child faces. For example, cerebral palsy and Down syndrome are easy to identify, while autism and dyslexia are harder to spot. Track your child’s developmental milestones and look for signs of developmental delays. If you notice that your child is facing some intellectual, emotional, or developmental problem, approach an expert at the earliest.

    Early intervention is the key to helping the child have as normal a life as possible. As Dr Deepika Jain, developmental pediatrician and director of Shishu Child Development and Early Intervention Centre in Ahmedabad, explains, “Early childhood—the period from birth to 3 years of age—is the time of rapid brain growth. This is the critical period during which stimulation therapies will help the child get maximum benefits. It’s possible to identify developmental challenges when a child is not attaining age-appropriate developmental milestones.”

    Medical issues and developmental delays are usually identified by pediatricians during routine checks. Sometimes developmental problems are detected when a parent expresses their concerns to a pediatrician. A developmental pediatrician may check how the child’s gross motor, fine motor, cognitive, language, and social skills are developing. Assessment tools are also used for both diagnosis and monitoring. One such tool is the Developmental Assessment Scale for Indian Infants (DASII), which gives a developmental quotient for young children. Dr Jain says there are specific scales for different challenges like autism and ADHD.

    Should your child attend a mainstream or special school?

    Some children with special needs can be accommodated in mainstream schools with special educators, while others may attend special schools. As the parent of a child with special needs, you should select a school based on the type or severity of the challenge. For instance, a child with Tourette syndrome may involuntarily clear his throat repetitively or jump up and down in the classroom. As these behaviors may bother other children, it can be challenging to accommodate the child in a mainstream classroom.

    Two common challenges: Autism and dyslexia

    Two common challenges in children include autism and dyslexia, which can be managed with therapies and interventions.

    Autism or autism spectrum disorder (ASD): Autism is usually detected between the ages of 2 and 3 years. Psychiatrists or psychologists administer a psychometric test called Childhood Autism Rating Scale (CARS). The score indicates the severity of autism. Some of the symptoms of autism are:

    • Lack of eye contact
    • The child does not smile or respond to affection, even from parents
    • Lack of speech
    • The child does not respond to their name
    • Repetitive behaviors like rocking
    • Inability to communicate or relate with peers
    • Preoccupation with certain objects or topics of conversation

    Dyslexia: Dyslexia is a learning disability that affects a child’s ability to read, spell and recognize words. Children may also find it challenging to understand what they read. A dyslexic child may have average intelligence and be hardworking. Yet they may be unable to master reading without the help of a special educator. According to a science and technology report published in 2018 by the Government of India, the incidence of dyslexia in our country is believed to be 10% and nearly 35 million Indian children have this learning disorder.

    The common signs of dyslexia are:

    • Poor reading skills – The child may feel hesitant and anxious about reading in class. Confusing “b” for “d” while reading is common among young children. If this difficulty continues, parents must seek professional help
    • A problem in pronouncing words correctly
    • Inaccurate spelling

    Lakshmi Krishnakumar, psychologist and founder-director of Chennai-based special school Sankalp, is an assessor and trainer in Specific LDs. She explains that the most common challenge children face in mainstream schools is difficulty in writing (dysgraphia).

    Written output is given a lot of importance in schools. Children with LDs are not able to copy from the blackboard, follow instructions and complete their homework. They may have serious spelling difficulties and messy handwriting. Mainstream schools do not give much importance to reading. Reading difficulty is the main challenge behind this umbrella of difficulties. Only if you read correctly and understand what you are reading will you be able to write clearly. Children at Sankalp are brought by their parents or referred by schools, with the teachers often saying the child’s handwriting is messy and that they can’t figure out what the child has written,” she says.

    According to Ms Krishnakumar, LDs are often hereditary. “Sometimes health issues like fits and seizures cause LDs. At times, anxiety, perhaps due to a family disturbance like divorce, can manifest as symptoms of an LD. Our mainstream school system lays too much emphasis on linguistic intelligence (reading and writing), and in that aspect, our children at Sankalp are mostly below average. They may have other strengths, but these are not recognized by the educational system.”

    Watch out for these signs

    Apart from being aware of the age-appropriate developmental milestones, Dr Jain says parents should watch out for the following red flags and seek timely assessments and interventions:

    • Concerns regarding vision and hearing
    • Poor eye contact
    • The poor social response to caregivers
    • Loss of skills at any age or not gaining new skills
    • Differences between left and right side of the body in strength and movement
    • A very floppy or stiff baby

    Regarding LDs, Ms Krishnakumar says these are some of the signs parents must be aware of:

    • Poor attention span
    • Poor eye-hand coordination
    • Trouble learning alphabets
    • Trouble learning self-help skills, like tying shoelaces
    • Limited vocabulary
    • Doesn’t enjoy being read to
    • Can’t make sense of what they hear or see
    • Uses words inappropriately
    • Hyperactivity and restlessness
    • Inability to follow simple directions
    • Chooses younger playmates or prefers solitary play
    • Spatial confusion between left and right

    A multidisciplinary team is involved in diagnosis and intervention when it comes to a child with special needs. The first point of contact is the family pediatrician, who guides the parent to a development pediatrician, psychiatrist, or psychologist for diagnosis and assessment, based on the child’s needs. Intervention typically involves psychologists, occupational therapists, and special educators.

    Knowing that your child has special needs can be devastating for you. But there is hope these days with medical advances and more facilities to treat challenges of all sorts. It’s important that you take prompt action, as early intervention, as mentioned earlier, brings more positive outcomes.

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