Understanding of disabilities

1) Developmental Delay
Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing major or minor delay in the process of development. If your child is temporarily lagging behind, that is not called developmental delay.


What are the possible causes of developmental delays?
Developmental delay can have many different causes, such as genetic causes (like Down Syndrome) or complications of pregnancy and birth (like prematurity or infections). Often, however, the specific cause is unknown.

Can a child with developmental delays catch up?
Conditions that can cause developmental disabilities include Down Syndrome, Angelman Syndrome, autism and brain injuries. These are not caused by lifelong physical and mental conditions. There maybe signs of learning and attention issues. Early intervention can often help kids catch up.

How is Developmental Delay treated?
There is no one treatment that works for every child with a developmental delay. Children are unique; they learn and grow an develop in their own way, at their own pace, based on their strengths and weaknesses. Any treatment plan will take this uniqueness into account and be designed to focus on individual needs. Early intervention programs are the main theme of treatment, but any underlying conditions that have led to the developmental delay will need to be treated as well.
Early intervention programs may include:

  • Speech and language therapy
  • Occupational therapy
  • Physical therapy
  • Behaviour therapy


2) Autism

Autism or autism spectrum disorder refers to a developmental disability as a result of a neurological disorder that changes the way the brain functions - causing delays or problems in many different skills from infancy to adulthood. From example, both children and adults with autism usually exhibit difficulties in social interaction as well as in verbal and non-verbal communication. They also tend to be interested in repetitive or restricted activities. While the majority of autistic children look completely normal, they differ from other children by engaging in perplexing and distressing behaviours.

Autism's most obvious signs tend to appear between 2 and 3 years of age. In some cases, it can be diagnosed as early as 18 months. Some developmental delays associated with autism can be identified and addressed even earlier.


Why is Autism called a Spectrum Disorder?

Autism belongs to a collection of dvelopmental disorders known as the autism spectrum disorders (ASDs). A spectrum disorder is a group of disorders with similar features.

The three different types of autism spectrum disorders are:

Autistic disorder - this is the most common condition among the ASDs. It is marked by major delays in language, difficulties with social interactions and unsual behaviour. Some people with autistic disorder also have impaired intellectual abilities.

Asperger syndrome - people with this syndrome display some of the milder symptoms of autistic disorder, such as social challenges and unusal behaviours. They generally do not have any delays in language or impaired intellectual abilities.

Pervasive Development Disorder - individuals may be diagnosed with this disorder if they meet some of the criteria for either autistic disorder or Asperger syndrome but not all. They typically have milder and fewer symptoms than those with autistic disorder. Symptoms may be limited to problems with language and social interaction.


Common Treatment Options for Autism

There is no single best treatment package for all children with autism. However, most professionals agree that early treatment is important and that most people with autism respond well to highly structured, specialized programs.

Many types of treatments have been developed, including Applied Behavioural Analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) and sensory integration. Specialied therapies include speech, occupational and physical therapy.


3) Cerebral Palsy

Cerebral Palsy (CP) is a broad diagnostic term used to describe a problem with movement and posture that makes certain activities difficult. Although someone who have cerebral palsy have problems moving his or her muscles, this is not because there is something wrong with the muscles or nerves. These difficulties are caused by problems in the brain.

Simply stated, 'cerebral' refers to the brain and 'palsy' refers to muscle weakness and poor control. There is currently no cure for CP, however there are different treatment options for people with CP. These options include therapy, medications, surgery, education and support. By taking advantage of these treatment, people with CP can improve their function, minimize the development of complicating issues and optimize the quality of their lives.


What causes Cerebral Palsy?

CP can be the result of an injury to the brain during gestation or in the first year of life (acquired cerebral palsy) or it occur when the brain does not develop properly during gestation. The injured or abnormal brain is unable to optimally control movement and posture. Acquired cerebral palsy can be caused by brain infections, like bacterial meningitis or viral encephalitis. It can also be caused by a head injury - such as that from a motor vehicle accident, a fall or child abuse.

How is Cerebral Palsy treated?

There is no one therapy that works for every child who has cerebral palsy. Although CP cannot be cured, treatment will often improve a child's capabilities. Many children with CP go on to enjoy near normal adult lives if their disabilities are properly managed. In general, the earlier the treatment begins, the better chance the child has of overcoming developmental disabilities or learning new ways to accomplish the tasks that challenge them.

Other health care professionals on the treatment team may include:

  • physical therapists
  • occupational therapists
  • speech language therapists
  • audiologists
  • recreational therapists
  • music therapists
  • psychologists


4) Down Syndrome

Down Syndrome is the most common cause of mild to moderate mental retardation and the mental and physical medical problems that often come with it. Mental retardation is a disability that limits a person's intellectual abilities as well as the behaviours that people use to function in their everyday lives. It was named after John Langdon Down, the first physician to identify the syndrome.


Down Syndrome Diagnosis

A newborn baby with Down Syndrome often shows unique physical signs. The doctor usually recognizes these features immediately after the baby is born. These may include a flattened face, an upward slant to the eye, a short neck, abnormally shaped ears, white spots on the iris of the eye and a single, deep crease on the palm of the hand. However, a child with Down Syndrome may not have all of these features.

Once a baby is born, a blood test can confirm whether the baby has Down Syndrome. This test is called a chrmosomal karyotype. To get the results from this test, cells from the baby's blood needs to 'grow' for about two weeks. The cells are then examined under a microscope to see if there is extra material from chromosome 21.

Down Syndrome Treatment

Down Syndrome cannot be cured. However, early treatment can help many people with Down Syndrome to live productive lives well into adulthood. Children with Down Syndrome can often benefit from speech therapy, occupational therapy and exercises to help improve their motor skills. They might also be helped by special education and attention at school.

Some of the medical problems common in people with Down Syndrome, like cataracts, hearing problems, thyroid problems and seizure disorders can also be treated and corrected.


5) Muscular Dystrophy

Muscular Dystrophy is a group of disorders characterized by a progressive loss of muscle mass and consequent loss of strength. The most common form of muscular dystrophy - Duchenne muscular dystrophy, typically affects young boys but other variations can strike in adulthood.


Symptoms of muscular dystrophy

Initial symptoms: -

  • a wadding gait
  • pain and stiffness in the muscles
  • difficulty with running and jumping
  • walking on toes
  • difficulty sitting up or standing
  • learning difficulties, such as developing speech later than usual
  • frequent falls

Later symptoms:-

  • inability to walk
  • a shortening of muscles and tendons, further limiting movement
  • breathing problems can become so severe that assisted breathing is necessary
  • curvature of the spine can be caused if muscles are not strong enough to support its structure
  • difficulty swallowing


Treatment for muscular dystrophy

Currently, there is no cure for muscular dystrophy. Medications and various therapies help slow the progression of the disease and keep the patient mobile for the longest possible time.

Physical therapy

  • General exercises - a range of motion and stretching exercises can help combat the inevitable inward movement of the limbs as muscles and tendons shorten. Limbs tend to become fixed in position and these types of activities can help keep them mobile for longer. Standard low-impact aerobic exercises such as walking and swimming can also help slow the disease's progression.
  • Breathing assistance - as the muscles used for breathing become weaker, it may be necessary to use devices to help improve oxygen delivery through the night. In the most severe cases, a patient may need to use a ventilator to breathe on their behalf.
  • Mobility aids - canes, wheelchairs and walkers.
  • Braces - these keep muscles and tendons stretched and help slow their shortening. They also give added support to the user when moving.


6) Spina Bifida

Spina Bifida literally means 'split spine'. It happens when a baby in the womb and the spinal column does not close all the way.


How is Spina Bifida diagnosed?

In most cases, spina bifida is diagnosed before the baby is born. However, some mild cases may go unnoticed until after birth. Very mild cases, in which there are no symptoms, may never be detected.

Prenatal (before birth) diagnosis:-

  • blood tests
  • ultrasound
  • Amniocentesis

Postnatal (after birth) diagnosis:-

  • with two forms of spina bifida - meningocele and myelomeningocele, diagnosis after birth is obvious. Milder cases of spina bifida that are not diagnosed during prenatal testing may be detected after the child is born.

How is Spina Bifida treated?

There is no cure for spina bifida. The nerve tissue that is damaged or lost cannot be repaired or replaced. However, certain treatments are effective. The aim of treatment is to enable the child to reach the highest degree of functioning and independence. The type of treatment required depends on the type and severity of the disorder. Generally, children born with the mild form of spina bifida need no immediate treatment, although some may require monitoring for signs of spinal cord dysfunction and surgery if it occurs.

The Care Team

Every child with severe spina bifida will need extensive and intricate care. This requires the involvement of a specially trained team of professionals. Included in the team are:

  • Pediatricians
  • Neurosurgeons
  • Physical therapists
  • Occupational therapists
  • Orthopedic surgeons
  • Endocrinologists