A gem indeed: Developmental Paediatrics changing children’s lives

Eastern Mirror Desk

Dimapur, Sep. 2:  “Why are you looking sad, Aayon (name changed)?” the teacher asked.

“My mother did not give me pocket money for today because I wrote ‘dear’ for ‘bear’,” Aayon replied. “She always complains that I am careless.”

“Yes, you are, Aaron,” the teacher too approved it. Aayon was in tears.

Aayon is eight years old and studying in class-III. He always had confusion between the letters ‘b’ and ‘d,’ besides the ‘p’ and the ‘q’.  He reads ‘eat’ as ‘tea’ and ‘pat’ as ‘tap.’  He started complaining about pain in the eyes when reading. An eye examination did not show any problem.  He developed a dislike for school work. The school’s counsellor advised his parents to take him to a psychologist.  It was the psychologist who assessed him and found him to have the problem of ‘specific learning disability’ (SLD).

Expectation from children in education in the recent years is becoming too demanding. Children are expected to score high marks in all subjects.  When students perform poorly at school, teachers, and schools are blamed for the pupils’ performance.

Poor performance in the academics may be due to several factors.  When a child struggles in academics in school, the first question one can raise is about the intellectual functioning of the child for which an intelligent quotient (IQ) test is warranted. If the IQ is below 70, the child is said to have intellectual disability (ID).

About 2-3% of children in India are considered having this disability, a medical practitioner at the Developmental Paediatrics department of Christian Institute of Health Sciences and Research (CIHSR) said.  Regular school curriculum will not benefit children with intellectual disability; the curriculum is meant for children with average IQ i.e., 90-110.  They need special schooling with trained ‘special teachers.’

Others may score an average IQ in intelligence testing, yet may have problems in the academics due to SLD, which Aayon had.  If the problem is present in reading it is called Dyslexia; in writing it is called Dysgraphia; Dyscalculia for mathematics. There are special assessments available to diagnose SLD in children.  It is difficult to identify the disability in children before the age of seven. About 5-6% of children are found to have the disability in the country.  There are trained special teachers who help such children through remedial teaching programmes.

There are other children who suffer from inattention and restlessness, which is otherwise called attention deficit hyperactivity disorder.  This may be present in about 4-5% of children because of which they struggle with having to sit quietly or in having to focus their attention on anything.  There are specific assessments to find out the severity of the condition based on which intervention strategies are worked out.  Such children may need either behavioural intervention or both behavioural and pharmacological intervention to control the disorder.

Other group of children within the similar grouping of learning disorders may have difficulty in socialising; some may also have lost their communicative skills after the age of two.  They may prefer being alone most of the time getting engaged in repetitive and odd behaviours such as finger play, poor eye contact, spinning of wheels, sudden emotional outburst without obvious reason; fear of objects; walking on toes, and such behaviour.  These are the features of Autism Spectrum Disorder.  This condition will be diagnosed using specific assessment tools. The intervention may be charted using behaviour modification techniques.

Often, such as the mentioned disabilities are misunderstood by the public as some form of “mental illness.”  It is important for one to know that these are all different forms of disabilities which are invisible in character.  Proper diagnosis and timely intervention by well-qualified and experienced specialists can minimise the severity of mentioned disabilities.

Also, many parents and schools tend to ignore children with such disabilities considering them to be minor issues and also because they are not aware about how to approach it. They might realise it only when the case turns severe. Associated ailments such as seizures and other similar conditions can occur in some of the children with the disorders.

Apparently, these children with look normal but they are often ignored among peers or the society due to their lack of intelligibility. They need special attention and therapy to break loose from such disabilities. The consequence: The child becomes more dependent on others throughout their life. If intervention is essential, the chances of such children gaining useful skills are much higher.

A multidisciplinary group of specialised professionals consisting of psychologists, special teachers, speech therapists, occupational therapists, social workers, physiotherapists, paediatricians, and related specialists can jointly devise effective and appropriate intervention strategies by which the child with special needs can benefit at the maximum.

‘Precious Gems School’ of the Developmental Paediatrics department of CIHSR was started with the objective of being an intervention for children with special needs. The department was founded by Dr. Y Simpson, in March 1 2016. It is located at 4th Mile in Dimapur.

Not many are aware of the centre. Eastern Mirror interacted with Dr. Simpson on Wednesday. Till now, only eight schools have come forward to receive therapy that is offered by the centre. Interestingly, there are over 50 schools in Dimapur.

Dr. Simpson said that till now 81 children had been registered since the past two years of its introduction. One may assume that there will be many children whose parents are still unaware about the special classes being offered by the centre.

The centre focuses on intellectual and developmental disabilities by training children and their parents. The parents are also trained simultaneously.

Provisional diagnoses are taken after the child being initially assessed which is through collecting birth history and developmental history.

A moment with parents

Eastern Mirror interacted with a number of parents whose children were undergoing therapy at Precious Gems School. Every parent was content and positive about the changes that they are seeing within themselves and their children.

A mother named Akhono Kulnu told this reporter that she and her husband detected her son’s problem few years ago, but left it unattended for two years due to busy schedule. They had believed that the problem would be corrected in time as he was studying in an XSEED school, a specialised play-learn institution.  Her son was seven years nine months during the time of diagnosis. She said that her son’s IQ was in the range of nine years four months.

“He scored 120 in his IQ test. His performance age was ten years six months but his social age was eight years three months,” she explained.

“He has inattentiveness and becomes quite emotional at times. For example, the colour of the sun is either drawn with yellow, orange, or white. It will irritate him if one of his siblings colours it with different colour besides the three,” she described.

Longkumer said that her son used to write ‘mirror images of letters’ and had slow writing speed due to low hand-eye coordination. He had a hard time catching up with his friends at schools, especially during tests, she said.

After being introduced to the centre, the mother said that she and her husband enrolled their son for handwriting practice for a week where he was made to do various activities to improve his dexterity.

“We also learned a lot on how to raise him and his siblings better. We were informed on how to be patient and to rationalise any problem and explain, especially when he gets emotional, so that he can understand better,” she expounded.

Another mother by the name Temjenrenla Zhimomi, whose son was undergoing therapy for the past two and half weeks, said that her son was ‘hyper-active’ and had difficulty in reading and writing the alphabet. She also said to have received numerous complaints from teachers saying that he does not sit still for five minutes.

Initially, the mother did not pay much attention as she thought he was just being naughty. But when he reached grade-2, she said that her son really struggled to write even the simplest word. “He cannot even copy words that are written on the blackboard. All his notebooks were full of teacher’s handwriting. Multiple tuitions were conducted for him but it was not effective,” she sighed.

During a parent-teacher’s meeting, Zhimomi said that someone recommended her to child psychologists at the CHIRS.

After being introduced to the centre, the diagnosis showed that her son had specific learning disability. Zhimomi said she now sees a lot of improvement in her son as well as herself after being introduced to Precious Gems School.

“It is really nice to sit with him and understand. It helps me to be more patient than I was before,” she said in praise. The teachers at the centre are very helpful and will benefit her son in the future, she said in optimism. She suggested that every parent should opt for the centre if they find difficult in dealing with their children’s intellectual development, and not to shy away from it.

A moment with teachers

Eastern Mirror also interacted with teachers of the school who were willing to share their experiences, and their advice to parents.

A teacher by the name Yangerla C Sangtam said that she had completed four months in the profession at the centre. She said to have been intrigued by the profession while she was doing her masters in psychology: The idea of teaching children with intellectual development disabilities. Once she had completed her studies, she could help the people as most of them were not aware of medical concerns such as development disabilities.

“If I come here (in Nagaland) and work with our people, they will be aware of it and the stigma that is attached can be removed,” she said.

Another teacher by the name Tumchobeni Ngullie, who is there for more than two years, told this reporter that counselling parents during the therapy plays an important part in the lives of children.

Ngullie said that there were certain parents who let the teachers alone take care of their children claiming that a child listens to the teachers better.

“Sometimes they fail to understand that they (parents) are the one who has to take care of the children for the life time,” she said. The teacher explained that parents also need to pick up basic concepts to teach children at home as it would help make teaching easier for the teachers.

Children are one of life’s most valuable resource and a hope for the future. They should be treated with all possible care they need when they are still early in age because the time when they can develop is when they are young.