Shashank Kanaujiya, a ten month old male child was referred to us with global developmental delay following birth asphyxia. His CT Scan was suggestive of cortical atrophy with infarcts and demyelination. On developmental assessment his motor age was only 3.3 months and mental age 6.5 months. Head holding was not achieved and he had left hemiparesis with generalized hypotonia. The child was from Sandila, a small town in UP with no facilities for intervention. Since the parents could not bring the child to the center on a regular basis, the strategy was to provide a home-based intervention program with medications and supportive care. The mother was taught exercises mainly for improving Shashank’s head holding and truncal control. Exercises for extremities to improve the tone were also taught to the mother. The childwas followed up on a monthly basis and intervention was monitored periodically. Shashank achieved complete head control within two months and started to sit with support. On follow up, a lot of drooling was noted and oromotor stimulation and exercises were taught to the mother. On subsequent follow up in April 2013, the child has shown significant improvement in all areas of development. He can sit without support and stands with support. The positioning of the hemiparetic left body has also improved significantly. When one considers that the intervention to bring about such a dramatic improvement in the child was only due to the mother’s active participation in treatment, who is not even a graduate, the true import of this case is understood better. This case study clearly shows the impact that simple home based intervention therapies can have on outcomes in children with developmental delays.
Nisha is a 3 year old girl who was identified at the Urban Disability Camp in Lucknow and her screening revealed developmental delays. Further assessment revealed an untreated fracture of the upper limb and a bilateral congenital cataract condition. Initially medical support was provided in the form of a POP cast and follow up by an orthopaedic surgeon, shortly followed by cataract surgery. Simultaneously, physiotherapy was started for early intervention. An immense amount of improvement was visible in just a 3-month period. She is now talking and communicating and more active. Follow up is being continued for her eyes and rehabilitation.
Archana Saubhagya is a 5 year old girl studying in Sr.kg. She was referred for assessment with complaints of her poor academic performance. She lives in a nuclear family. Her father has not completed SSC and is into business. Her mother has studied till SSC and is also into business. She also has a twin sister. Assessment showed that her social functioning was in the dull normal range. She had severe difficulties in colour/shape recognition, had poor writing skills, low attention span and poor expressive language and classroom behaviour. At the start of her intervention and remediation, the special educators found her very shy and low in self-esteem. Impact assessment after 3 months showed a drastic improvement in all her areas of weakness, with achievement in alphabet/number/shape recognition and noted improvement in her attention span and expressive and social skills. She is more verbal now and is able to perform more at par with her grade level.
Anand (name changed) is the son of a vehicle driver. He does not have a mother and he had been staying at BKN since the past five years. He was performing at around 50% in 9th standard. While in 10th grade most well-off children undergo intensive coaching, he had no access to such facilities. Throughout the year, Anand regularly attended all the secondary classes held by PEHL. He would report perfectly on time for the class and take full advantage of asking questions and clearing his doubts. PEHL Teachers held additional classes for the tenth standard and paid more emphasis on improving his performance. Anand scored 74% in his SSC Board Exams and is now pursuing his diploma in software engineering at a government institute.
Gaurav (name changed) has been staying at BKN for the past five years. His father was an alcoholic and he does not have a mother. Gaurav had an extremely low performance in 9th standard, scoring below 40% and he was well on way to failure in board exams. His handwriting and written expression was very poor and he was poorly motivated and disinterested in studies. PEHL Teachers and counselors cajoled and convinced him to attend classes. Special writing sessions and intensive coaching were provided to him. He was constantly motivated to look towards a brighter future. Eventually, Gaurav cleared his SSC Board Exams and is now pursuing vocational electronics at ITI, Mankhurd.
Kiran (name changed), daughter of a destitute single parent (she has a mother and a sister), was staying in BKN for over five years. She was very emotionally unstable, had difficulties dealing with puberty, throwing severe temper tantrums, refusing to attend classes. PEHL teachers and counsellors worked on Kiran’s emotional lability and academic issues, providing individual counselling sessions. Kiran gradually learnt how to manage her emotions better and cleared her 10th standard with 54% marks. She is now reunited with her family and is pursuing Commerce in a regular college.
Aarti (name changed) 14 years old, was physically and sexually abused by her father before being admitted to BKN. She had a lot of psychological trauma, guilt, poor self-esteem and a fear of closed spaces and crowd. Aarti was counselled using Cognitive Behavioural Therapy approach in individual sessions, which helped her to identify her negative emotions. She was given simple exercises such as writing her feelings whenever she was very upset and tearing them. Gradually, a visible improvement was seen in Aarti’s behavioural issues and her academic performance also improved greatly. Aarti has also overcome her fear of crowds and closed spaces, and gave a stellar performance on stage earlier this week at PEHL BKN Annual Day.