Inclusive Opportunity for Children with Disability

Introduction

Salaam Baalak Trust (SBT) has been working to protect the rights of children living in difficult circumstances for more than 37 years. Placing the child’s interest first, SBT strives to provide a package of all-inclusive services to children rescued from streets. These services comprise safe shelter, health, education, nutrition and vocational training. A critical component of SBT’s package of services is its mental health programme. The programme was launched in the year 2003 with the primary objective of helping rescued children overcome their traumatic past and enable them live freely and happily in their present.

Easier said than done, enabling children living in difficult circumstances to get over the abuse, exploitation and trauma they face is challenging. It requires patience, perseverance, sensitivity and specialized skills to engage with children and help them express their suppressed negative emotions and experience. To this end, the Trust has constituted a qualified and highly skilled mental health team under the leadership of Dr. Amit Sen (one of the leading psychiatrists in India). The mental health team comprises a team of counsellors and a mental health coordinator. A counselor is posted at every centre of SBT to provide mental health services to children viz., counseling and individual and group therapies. SBT’s mental health programme is recognised as one of its kind given its child-centric nature and focus on professional and trained care. Over a period of time, the programme has evolved to improve both its reach and quality of services.

In the year 2015, the programme started a child development unit (CDU) to cater to the needs of children with neuro-developmental difficulties at the DMRC Home for Boys in Tis Hazari. The CDU was shifted in February 2018 and is now based at Aasra Children’s Home located in Najafgarh, Delhi. It adopts an integrative approach whereby the children (boys) with neurodevelopmental difficulties and in need of additional support are provided shelter along with care and protection services.

Vision of CDU

CDU’s vision is to provide children with neuro-developmental difficulties a safe, nurturing environment. It also aims to protect these children from abuse and ensure early screening of their difficulties and provide timely intervention. CDU attempts to provide 24x7 special care and emotional support to these children. CDU operates on the ‘principle of inclusion’ wherein children with mental disabilities live with typically developing children (those meeting age-appropriate development milestones) to foster peer interaction and learning. The key objectives of CDU are as follows.

• To mainstream children with neuro-developmental difficulties and disorders by provision of inclusive services in Aasra Children’s Home.
• To enable these children, learn basic activities of daily living (ADL) and communication skills to express and deal with their individual needs.

Operation and Processes

CDU Team: CDU is run through a skilled team comprising a developmental therapist, a supervisor and three care takers. The supervisor oversees the administrative work, while the therapist conducts therapeutic sessions with the children and the care takers provide food and nutrition, health and therapeutic services to children. The caretakers are trained at regular intervals to improve their work performance and efficiency.

Admission and assessment of children: All children coming to Aasra Children’s Home are screened using a baseline assessment interview at the first point of contact and if mental health concerns are observed then a more comprehensive assessment is conducted. This assessment is carefully done by the counselor. Following this, a focused discussion is conducted with the senior consultant Dr. Amit Sen to confirm the diagnosis and to ascertain if the child matches the CDU admission criteria. Upon meeting the criteria, the child is admitted to the CDU.

Activities

The key services provided to children at the CDU are as follows:

• Therapies: Many children at CDU need different therapies specific to their individual needs, including sensory integration, occupational therapy, speech therapy, developmental therapy, etc. These essential services were provided by Children First, a trusted psychiatric organization and the in-house team who is working with these kids. Efforts were made to enhance the team's skills to provide various therapies. Additionally, our therapists conducted regular therapeutic sessions.

• Education: At the Child Development Unit (CDU), we believe in providing inclusive and specialized education for children with diverse needs. Our approach is centered on understanding each child's unique abilities, challenges, and potential for growth. Every child at the CDU receives a personalized Individual Education Plan (IEP) designed to address their specific learning requirements and goals.

• Special care and emotional support: Emotional well-being is integral to overall development and learning success. These sessions may focus on building resilience, improving social skills, addressing trauma, fostering positive self-image, and promoting healthy emotional expression. These supports were provided to children by care takers and therapist on a continued basis. Caution is taken to meet children’s emotional needs adequately so that they adjust well in the children’s home. These children are under constant care and supervision.

• Pharmacology: Many children who need medicines are provided the same as prescribed by the psychiatrist. Medicines along with the therapies show noticeable improvements in children within a short span of time.

• ADL (Activity of daily Living) skills training: This is an important area of intervention with children. The therapist and care takers help children learn ADL skills to make the more self-reliant. While training when children pick up ADL skills, they feel a sense of confidence and independence.

• Occupational Therapy: Children are provided occupational therapy at both Children First and Aasra. Occupational therapists worked closely with children to address challenges related to handwriting, motor coordination, sensory sensitivity, self-regulation, and adaptive behavior. Therapy sessions involved sensory integration activities, fine motor exercises, life skills training, and environmental modifications to support best functioning in various settings. The therapy helps them actively participate in activities at children’s home and other social situations.

• Speech Therapy: Many children at the CDU experience difficulties with speech, language, or communication skills. Speech therapy sessions were conducted by the qualified speech-therapist who assess each child's communication abilities and developed targeted intervention plans. Through a variety of activities and exercises, speech articulation, language comprehension, social communication, and other related skills were improved. This improves children’s communication skills. Various techniques were used to enhance their communication in a conventional way.