Shashank Kanaujiya

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.