HANDICAPPED CHILD
A handicapped child may be defined as “a child with some disability, which interferes with normal growth, development or capacity to learn and consequently, to achieve maximum potential as a human beingquot;.
In this context, the term disability refers to “any restriction or lack of ability to perform an activity in a manner or within the range, considered normal for a human beingquot;, which may be due to: (a) intrinsic impairment, i.e. anatomical, physiological or psychological dysfunction, or (b) external environment, e.g. neglected or destitute children.In simple terms, genesis of a handicap may be denoted as a sequence of events, i.e. disease gt; functional impairment gt; disability gt; handicap. One handicap may give rise to another, denoted as primary and secondary handicap, e.g. blindness (primary) leading to illiteracy (secondary).
Incidence: Although difficult to quantify, ~ 5-10% of children in India are estimated to have some kind of handicap/s.
Etiology: According to primary disability, handicapped children may be classified into 3 major categories-physical, mental and social handicaps. Malnutrition, perinatal brain injury, infections and accidents account for ~3#8725;4th of handicapped state in children (Table 28.12).
TABLE 28.12: Common handicaps in childhood
• Physical handicaps
- Anatomical: birth defects, accidents
- Neurological: cerebral palsy, poliomyelitis
- Sensory: deafness, blindness, dumbness
- Chronic diseases: PEM, epilepsy, asthma, etc.
• Mental handicaps
- Mental retardation
- Learning disabilities
- Behavioral problems
• Social handicaps
- Emotional deprivation, e.g. orphans
- Child abuse and neglect
- Juvenile delinquency
Management of a handicapped child aims to maximize functional ability, provide the capacity to earn livelihood and restore social relationship, personal dignity and confidence.
It may be broadly divided into three stages:a. Primary prevention (disability prevention), i.e. control of causative disease by measures, e.g. genetic counseling, good perinatal care, immunization, growth/developmental monitoring and nutritional support.
b. Secondary prevention (disability limitation), i.e. to prevent progression of disease into a disability by measures, e.g. early diagnosis/treatment of causative disease and identification/modification of adverse environmental factors.
c. Rehabilitation by physiotherapy, occupational therapy, vocational training and assistance.
However, community participation and family support are key-factors in management of handicapped children.
Rights of Persons with Disabilities Act, 2016 covers 21 disabilities including Physical (locomotor, vision, hearing), Intellectual (Learning disorders and Autism), Mental illness and disabilities due to chronic diseases, e.g. parkinsonism, thalassemia and haemophilia, apart from multiple disabilities. Persons with “benchmark disabilitiesquot; are defined as those certified to have at least 40 per cent of the disabilities specified above.
The act entitles them for benefits under various government schemes including reservations in education and jobs, as well as special legal protection against harassment and crime.
28.4.6