CDEIRC

Introduction

Finding that:

  • Disability among the children was more widely prevalent than normally realized.
  • Rehabilitation is possible to such an extent as to enable a disabled child to lead a life of dignity and independence in adulthood in a vast majority of cases.
  • Each disability has to be specially identified and appropriate therapy and training have to be imparted for proper rehabilitation.

An institute for habilitation of children with challenges i.e. those with brain damage having symptoms of Cerebral Palsy and other sensory motor childhood developmental disorders was started at Tripunithura in 1998, under the name of ADARSH, by a Charitable Trust registered under the same name. In 2003, a separate wing for habilitation of children with Autism also was added. Today the school has on its rolls over 200 children belonging to all religions and communities and of different financial background.

Evaluation or Assessment of Developmental milestones of babies with potential risk of any disabilities or babies born with any disabilities is considered to be the primary step before starting rehabilitation. Based on the Evaluation or Assessment report suitable goals are set and different therapy programs are implemented accordingly. Early identification and early evaluation help in designing early intervention programs. Physical, emotional and intellectual defects are not unusual in children. They are usually not detected early enough. Early detection and therapy can decrease and even reverse these effects to a large extent.

Proper Evaluation or Assessment is, therefore, necessary for imparting comprehensive rehabilitation. For that, a team of experts is required to analyze each datum of evaluation and come to a conclusion as the �diagnosis". Hardly a few institutions or organizations are there for doing proper evaluation of such disabilities and often even when such evaluation is attempted; and consequently, the outcome of rehabilitation measures is not satisfactory. Proper and scientific assessment of children by trained personnel can guide parents and teachers to take appropriate steps to remedy the neurological and behavioral deficits. Ideally, intervention should begin in the first few days after birth, particularly in high-risk babies i.e. those, born with low birth weight, pre-term, or through difficult or protracted labour and those who suffer deficiency of oxygen during and after birth. Intervention is usually multi-modal, delivered by a specially trained team of professionals. It should be provided in a structure, in a closed environment. Appropriate medical and surgical inputs may be added depending on the needs of the child; finally, the place should be safe and the caregivers compassionate and skilful

For each disability, a thorough evaluation is required to design the appropriate programs. Evaluation is unique for each disability using different scales and tools. To do a comprehensive evaluation of all the three aspects, namely Physical, Psychological and Social , of a child. .It may take 2-3 days. Therefore, the specialist who does the evaluation should have, apart from a good knowledge about the check lists/scales, which she/he uses for the test , very importantly extreme patience.

Basic evaluation is done at the hospitals from there the child is referred to the concerned specialist for further evaluation. It may be very difficult to accept that there is such acute paucity of evaluation centres in such a health conscious state like Kerala but unfortunately that is the position.. Due to the non-availability of such a well-equipped centres in our state, most of the children with complicated features or symptoms are referred to centres outside Kerala(Eg. Most of the children with Autism go to Bengalooru or Velloor for evaluation). To remedy this situation at least partially, Adarsh Charitable Trust had started an Evaluation and Research Centre in Ernakulam.

The decision was taken after a lot of discussions with various experts and professionals. The plan is to begin a complete evaluation centre using advanced scales and assessment tools for all the disabilities at one basic intervention centre concentrating mainly on early intervention. As the name, "Child Developmental Evaluation,Intervention & Research Centre" indicates, we intend to make it also a research centre for disabilities , particularly Autism Spectrum Disorders (ASD). ASD is found to be the most complicated situation in children. Its habilitation is also considered to be quite difficult as it is generally diagnosed late. Through this centre we expect to produce a change in the scenario brought about by late diagnosis not only of ASD but also other childhood developmental problems.

The centre provides the following services:
Developmental Evaluation & Psychological Assessment
Children with various developmental disorders are assessed and evaluated comprehensively by a Developmental Pediatrician with the help of a Clinical Child Developmental Therapist and a Child Psychologist. Newborn babies from 2 months upwards are examined at the centre. The centre focuses on early detection of developmental disorders and early intervention. So far, the centre has been able to identify very early) disabilities like Cerebral Palsy, Autism, Down syndrome and Learning disorders. In addition, the Psychologist helps school going children by identifying the precise problem leading to their learning difficulties. There are facilities to check the Intellectual Quotient of children using advanced tools. Apart from this, there are provisions for child guidance clinic and family counselling. On an average around 10-15 new children are being assessed at the centre every month.

Developmental Therapy
Newborn babies who are identified with potential disabilities are being given regular and intensive Physiotherapy based on their developmental milestones. Developmental therapy includes Physiotherapy and Speech therapy, which are being administered with the help of trained and experienced Physiotherapist and Speech therapist respectively. Need based maintenance Physiotherapy is also provided on a regular basis for older children as well as for those who are attending normal schools. Similarly assistance in Speech Therapy and behavior therapy also is being given. Each member of the team has a tangible role in deciding and setting goals for the rehabilitation of the children. There are around 15 children for Physiotherapy and 20 for speech therapy every week.

One on One need based remedial education programme
This has been seen to be one of the  most effective and successful programmes of the centre. Since the inception of the centre, it has been implementing this novel programme to help the children who are having different learning problems in reading, writing, calculations etc. Majority of these children attend normal schools and come to the centre for special remedial education for their specific issues. Here the main aim is to improve the academic skills and to make the children socially acceptable, thereby improving their self-esteem. Graduate teachers and Special teachers are working in coordination to achieve the goal. On an average around 35-40 children are attending the centre every month for this programme.

Apart from the one on one training, there are some children who are not attending any schools or centres and they come to the centre regularly to attend the academic training under the National Open School syllabus. The Centre trains such children for A (2nd Std) B (4th Std), C (7th Std) and Secondary (10th Std) levels of academic skills.

For both these groups of children, facilities are available for training on computers (there are 3 computers at the centre) with a software specially designed  for children with learning problems. As is known, children can be trained more easily through computers and allied equipments like ipads (CDEIRC does make use of these too) than through mere oral teaching. It has also  been the experience that all children with Learning Disorders problems  need attention to some of their psychological problems, often leading to unusual/abnormal  behavior . Perhaps, it is the absence of facilities for an in depth study of such problems and attempt to offer the appropriate  remedial measures in mainstream schools , even in the “Resource Rooms “ ,that impedes any meaningful correction in their tardy progress. Such an effort to identify these peculiarities in each child is an integral part of the training schedule of CDEIRC.

Other programmes like Occupational therapy, Behaviour therapy etc. are also being imparted when required. In addition the centre attempts to inculcate extracurricular skills in children. Though vocational training is not a regular programme for the children, still some children are trained in some vocation like flower making, paper bag making, phenoil making, dish washing etc. In the past parents had to take their children for comprehensive assessment to specialty centres like NIMHANS, CMC Vellore etc. Now, with the availability of such a centre like CDEIRC, with all facilities under one roof, it has become  much  easier for the parents.

Started in December 2007, the centre has so far helped around 1000-1200 children for Developmental Assessment, Pediatric evaluation, Psychological assessment etc. Every month around 70-80 children avail of various services from the centre.

I.Panel of Experts available in the Centre:

  • Dr. Abraham.K.Paul, MD (Ped.), DCH - Consultant Pediatrician
  • Dr S. Sachidananda Kamat (Ped.)
  • Dr.Chalam Das,MD ( Psychiatry) - Consultant Psychiatrist
  • Shri.Lijumon, Psychologist

As on 01/0112015:

Children for Special Education-or One to One Need Based training : 42
Children for Physiotherapy : 8
Children for Speech therapy : 32

Team members include:

A Developmental Pediatrician
A Child Psychiatrist
A Clinical Psychologist
A Developmental Therapist
A Physiotherapist
2 Speech therapists
4 Special Educators

 

CHILD DEVELOPMENTAL EVALUATION, INTERVENTION & RESEARCH CENTRE
House No.38, Opp Professional Couriers and Cargo, Vivekananda Road, Near New Bharat Tyres, Puthiya Road, Vennala P O, Pin-682028
Email: adarshcderc@yahoo.com; Web: www.adarshrehab.org,
Ph: 0484-3112636, 2808818
Coordinator: Ms Chithra Radhakrishnan (Mob:7736196496)