Project #364

Early Intervention for Mentally Disabled Infants

by Samadhan

Learning from our past experiences ,our present focus is expanding the early intervention services. Our methodology for the Early Intervention is as follows and has been found effective given the characteristics of our target areas. The methodology is as follows;

--Create awareness and sensitize the community using puppets in the selected target area

--Follow up immediately with a Health Camp

--Identify children with any kind and degree of disability .Refer those we cannot help to other agencies .Refer the mentally handicapped to our own Rehab Clinic. Focus group 0 to 5 years of age .

--Identify women and mothers to work as survey and community workers. --Provide a one to one service through trained community workers in homes of client families .

A CHANGE IN SERVICE DELIVERY The target areas where we work have free schools and are run by the MCD, (Municipal Corporation of Delhi) and also free schools run by the Delhi Administration. The private schools charge nominally, commensurate with the low socio economic characteristic of the area. A policy decision was taken in 2002 by the MCD mandating the admission of all children disabled and non disabled but most of the schools we contacted showed little enthusiasm for the government policy .So ,implementation has not been done at all.

However we have realized that the infant and preschool child has no possibility of getting into a mainstream educational system even though the MCD ( Municipal Corporation of Delhi ) has a policy in place which mandates inclusive education .

The problem we identified through surveys and personal encounters is that the MCD schools are not trained or prepared to launch inclusive education . We do have the experience and the expertise to expand the range and scope of our early intervention services and take it onwards from identification and clinical support only and no follow ups thereafter . So, we envisage a service which will identify the child between the ages of 0 to 5 years , train the child in our inclusive Preschool set up and when the child is five, admit the child in a local mainstream school. To implement this we will do the following :-

--Increase the identification of children in the 0 to 5 age group --Train more community workers to enable such identification --Conduct more health camps, which motivates families to contact us and ensures preliminary medical inputs --Set up a unit in selected target areas where we have completed the initial awareness and health camp to ensure the continuation of early intervention services to identified children in that particular target area. --Put the necessary infrastructure in place, such as appoint a Supervisor from the target area trained by us and locating a venue for our services. --Once this “Satellite“ unit is firmly established we can move on to other target areas. --Expand the inclusive preschool we have already launched --Advocate for inclusion n the local MCD schools and ensure the admission of children with disability and particularly the mentally handicapped in mainstream schools . --Hold workshops and seminars for the Principals and staff of MCD schools for ensuring admission of children who pass out of our preschool.


These are the results of the most recent health camps conducted in our two centers.

Thanks to donor funding, these children will now get the benefits of regular follow ups, appropriate therapy, medication and where necessary intervention provided at home by one of our trained community workers by transferring skills of home management to the mother or care giver apart from the daily care provided by our professional team at the center itself.

These children would have grown up completely devoid of any kind of a support or health care if we had not identified them in our surveys since there is absolutely no help for them in the target areas where they live. Though government health centers do exist most of them were diagnosed as mentally handicapped and that was the extant of help received.

The total number of kids identified as mentally handicapped is eleven but benefits of guidance and counseling are given to the mothers as well, so actual beneficiaries are 22.

Details of the children in Early Intervention Dakshin Puri Centre

S.N. Name, Age, Problem 1. Dimple, 2 years, Mild CP, Rickets 2. Geetika, 3years, Post meningitis, Hydrocephalic 3. Jay, 2years, CP, premature baby 4. Sneha, 2years 6 months, Epileptic Fits, MR 5. Yash, 2years, CP 6. Vishal, 2years, Epileptic Fits

Details of the children in Early Intervention Dwarka Centre

S.N. Name Age Problem 1. Sagar, 4 years, Hypothyroidism, MR 2. Rinky, 3 years, CP with speech problem 3. Karishma, 4 years, MR. with speech problem 4. Vipin, 3 years, MR. with speech problem

Inclusive Education - Samadhan

Playgroup has children with in the age group of 2 yrs – 5 yrs. Both disabled and non-disabled children are admitted into an inclusive set up.

Current number of disabled children in the group: 7 Current number of non-disabled children in the group: 8 Each group consists of: 3-4 disabled and 4 non-disabled children.

PROCEEDURE. A child with disabilities is first thoroughly examined and diagnosed by a medical professional and then referred to other professionals like the physiotherapist, Occupational Therapist, Speech Therapist and Psychologist etc. According to the needs of the individual child a therapy programme is planned keeping in mind the child’s physical/mental/social development.

In the classroom: 1. The teachers develop a monthly and yearly programme to be followed in the classroom. 2.The basic concepts are taught first with the help of books, pictures, charts, teaching aids, stories and games. a.If a disabled child has difficulty following these steps then they are taught in a modified method specially designed to suit the child’s learning style. This makes their learning faster and more enjoyable. 3.Weekly and monthly assessment helps the teacher to plan ahead. 4.Various therapeutic activities are also incorporated in the classroom sessions like: a.Activities to improve their hand functions, gross motor and fine motor functions. b.Activities to improve memory, concentration and attention span. c.Self help activities. 5.Parental support and environment in child’s development is of equal importance. Parents, teachers and medical staff work together to form a common goal for the child. 6.In an inclusive set up all children have an advantage to learn from each other. Age appropriate learning with peers is very important for children with disabilities. 7.We encourage child-to-child relationship where all children are encouraged to help one another. 8.Our focus is a child-oriented education, which relates to the daily life situation of the child and how should they deal with life skills.

Dipika: From birth to 1.5 years, she had no head control. Sitting and turning over to sides was absent. She was unable to follow objects with eyes. Her one side of the body showed marked muscle weakness. Lifting up arms to reach for objects was also absent. Now at the age of 3 yrs – With the help of continuous early intervention treatment on one to one basis- • She has full neck control • Is able to turn her head to both sides. • Is able to sit for long periods without any support. • She moves both arms and hands to reach for objects in all directions. • She is able to hold objects using palmar grasp and is able to release them voluntarily. • She is learning to walk and climb stairs. • Is learning to place pegs in pegboard. • Is learning to identify pictures from a book. She now enjoys peer group and is ready for play school.

Dimple: Dimple was an extremely shy girl. She had weakness in all four limbs. She would refuse to take part actively in the therapy programme. We involved both mother and child in our OPD treatment programme where we introduced all therapeutic activities slowly and gradually. Dimple was unable to stand or walk. She would also not use her upper extremity for constructive tasks. With gradual therapy she is now able to stand on her own with support. o Walks with support. o Climbs and descends stairs with support o Uses both hands to hold objects voluntarily. o Moves her upper extremity in all the directions voluntarily for meaningful activities. o She now also enjoys the company of other children when she is involved in-group activities.


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Organization Information


Location: New Delhi, Delhi - India
Website: http:/​/​
Project Leader:
Padma Rama Rao
Senior Coordinator, Dwarka Center
New Delhi, India

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