Developmental disabilities manifest during infancy or childhood as delays in reaching developmental milestones, and include limitations in functions such as cognition, vision, behaviour, motor performance and hearing and speech. The delay or lack of function in different domains results from disorders of the developing nervous system. ABP Live spoke to Alisha Lalljee, a Mumbai-based psychologist, psychotherapist and special educator, and asked her about children's disabilities and her recent book, 'Take Time'.
Lalljee's book was recently launched at Title Waves bookstore in Bandra, Mumbai. The book talks about mental health and disabilities, the challenges faced by individuals with these difficulties, and the importance of spreading awareness about such problems and providing support to those suffering from developmental disorders.
Emphasising the importance of giving the right kind of guidance to parents whose children have developmental disabilities, Lalljee said, "Along with disability, there is always ability, stability and capability in the child that we miss out on, and this is something we should not do."
Most common developmental disabilities seen in children in India
Lalljee said that developmental disabilities which are increasing in prevalence in India are learning disabilities, autism, and attention deficit hyperactivity disorder (ADHD). "The prevalence of learning disabilities is one in five, and that of ADHD is one in four. Two years back, the prevalence of autism was one in 59. Now, it is one in 35."
She explained that there may be delayed milestones in some children, which they may cover up later in life. This depends on the type of disability, and whether the child receives immediate intervention or not. She deals with children having disabilities such as autism, cerebral palsy, Down syndrome, learning disabilities, ADHD, learning disorders and visual impairment.
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Autism spectrum disorder is characterised by difficulties in social communication and interaction, and having unusual ways of learning and paying attention.
ADHD is a neurodevelopmental disorder initially diagnosed in childhood in most cases, and often lasts into adulthood. It is characterised by symptoms such as difficulty concentrating and paying attention, forgetfulness, and impulsive behaviours.
Cerebral palsy is a group of disorders caused by damage to parts of the brain that control movement, resulting in distorted muscle movement, balance and coordination.
Down syndrome, a genetic condition in which a person has a partial or complete extra copy of chromosome 21, causes physical challenges such as a flat face, a short neck, and poor muscle tone, and mental challenges such as impulsiveness, short attention span and difficulty concentrating and communicating.
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Diagnosis and treatment of developmental disabilities
Developmental disabilities cannot be cured, and can only be managed through therapy. "Holistically, developmental disabilities in children cannot be cured. Some traits will always remain. The aim of therapy is to work on the behaviours that are of maximum danger to the child, or are of maximum need to take care of. For instance, there are children who hurt themselves, or are violent to the caregiver. So, therapy often helps to calm these symptoms down," Lalljee said.
She explained that according to the fifth edition of the American Psychiatric Association book 'Diagnostic and Statistical Manual of Mental Disorders' (DSM-5), there is a specific age after which mental disorders can be diagnosed. For instance, learning disabilities can be diagnosed after the age of five. If there are many unusual traits in a child with autism, in social, behavioural and emotional areas, the disorder can be diagnosed after age 12. She said that it is generally not suggested to label any disability before the age of five.
Lalljee also said that sometimes, there may be late detection of developmental disabilities, the reason being that the issue is not too severe. "Sometimes, adolescents may have a stroke, meningitis or brain fever. They may also develop symptoms similar to developmental disabilities due to a fall. For instance, they may not be able to speak properly, or walk without support."
Possible causes of developmental disabilities
Developmental disabilities are innate. They may sometimes have these disabilities due to prenatal reasons such as complications at the time of pregnancy, or stress and anxiety faced by the mother, Lalljee said. "Children may have developmental disabilities if their mother had German measles during pregnancy, or if she had an accident or was exposed to lead. The age of the mother can also play a role in the occurrence of disabilities in children."
She explained that if one becomes a mother at a young age, say 21 to 23 years, there is a likelihood of the child suffering from a developmental disability in future.
Improving the lives of children with developmental disabilities
Speaking about how one can improve the lives of children with developmental disabilities, Lalljee said, "It is important to give the right kind of guidance to the parents of children with developmental disabilities. They should be a part of social circles which include people who could help their children. Family counselling is important to ensure increased acceptance and decreased guilt in parents. They should be provided help in terms of better management of the disability."
What ‘Take Time’ talks about
Sharing some interesting facts about 'Take Time', Lalljee said her book talks about a common misbelief in people that a developmental disability in a child is a bad omen. The book also explores the question of who the child gets a disability from, and mentions that research has shown that one cannot be sure of whether the disability was inherited from the mother or father. So, one must not blame any parent for their child's developmental disability.
The book talks about how different disabilities manifest in children, and the kind of help they must be given. Apart from busting myths, the book also mentions various intervention methods required for children with disabilities.
Lalljee said that the book explains how inclusion can work for such children, and the different academic boards they can study under. "Individuals with special needs need to 'take time', and this is something we must give them."
As a psychologist, Lalljee also sees patients with different mental illnesses such as anxiety and depression, the rates of which have increased. "It is important for each one of us to give equal importance to our mental health and physical health. It is important that society speaks about mental illnesses so that we can eradicate the stigma attached to mental health problems," she said.