Prevention of Disabilities in Children

What Is Disability?

Disability is any mental or physical condition that makes it difficult for the person to perform daily activities or have limited participation in the world. The disability may affect the person’s ability to communicate, learn, vision, move, think, hear, have mental health, and have social relationships.

What Are the Dimensions of Disability?

There are three dimensions of disability:

• Impairment: Occurs when the person's physical or mental functioning is affected.

• Participation Restriction: The person is not able to perform activities like working and being social.

• Activity Limitations: Such as difficulty walking, seeing, and hearing.

What Are the Categories of Childhood Disability?

• Physical Disability: Includes spinal cord injury, epilepsy (presence of seizure due to stroke or trauma), traumatic brain injury, muscular dystrophy, neural tube defect (severe defect of spine and brain), and acquired or congenital musculoskeletal deformities.

• Congenital Deformity: Includes mental retardation.

• Emotional or Behavioral Disorders: Includes depression, phobia, anxiety, conduct disorder, and attention deficit hyperactivity disorder (ADHD).

• Sensory Disabilities: Involves disabilities such as hearing loss, vision loss, and speech-language impairment.

• Autism: It is characterized by impaired social interaction and nonverbal and verbal communication.

• Specific Learning Disability: Involves difficulty in math, writing, and reading.

• Chronic Health Conditions: Involve asthma, tuberculosis, juvenile diabetes mellitus, congenital heart disease, rheumatic heart disease, and various other malignancies (cancer).

What Are the Causes of Disability?

• Prenatal Causes of Disability: Chromosomal disability such as Down’s syndrome. Down’s syndrome is a congenital abnormality that involves a trisomy of chromosome 21. Genetic abnormality is another cause responsible for prenatal disability, for example, sickle cell anemia. Sickle cell anemia is a blood disorder caused by the presence of a regressive gene.

• Perinatal Cause of Disability: Occurs as a result of injury, prematurity, oxygen deprivation, or infection acquired through the birth canal. For example, acquired immunodeficiency syndrome (AIDs), gonorrhea (refers to the sexually transmitted bacterial infection), and syphilis (refers to bacterial infection spread by sexual contact) can affect the fetus.

• Childhood Causes of Disability: These are the disabilities that occur due to environmental or biomedical factors.

What Are the Levels of Preventing Disability?

Primary Prevention: It is done before the disability or disease. It involves the following preventive methods such as :

• Genetic Counseling: It is done before conception to control genetically determined disabilities.

• Pre-pregnancy Planning and Premarital Examination: Involves medical assessments such as Rh factor (refers to an inherited protein found on the surface of red blood cells).

• Immunization Program: Aims to provide a vaccine against diseases like meningitis and polio vaccination.

• Prevention and Control of Environmental Pollution: Can be initiated by reducing the risk of exposure to dangerous cancerous cells and endocrine-disrupting chemicals.

Secondary Prevention: It is done at the incipient stage to prevent complications. It involves early diagnosis and adequate treatment.

Tertiary Prevention: It is done to limit or reduce disabilities and impairment. It is also known as the rehabilitation phase. Psychosocial, physical, and vocational measures can be taken to restore the patient to normal conditions.

What Are General Preventive Measures to Avoid Child Disability?

• Avoid pregnancy after the age of 35 years and before the age of 18 years.

• Avoid marriage between close blood relations like a first cousin, niece, or uncle.

• Before planning for pregnancy, the patient should consult a doctor in case of a blood disorder or incidence of congenital disabilities in the family.

What Is Preventive Care During Pregnancy?

• Avoid radiation exposure.

• Avoid using certain medications and drugs during pregnancy.

• Avoid chewing tobacco, smoking, and consumption of alcohol.

• Avoid exposure to measles or mumps during three months of pregnancy.

• Avoid sexual contact during pregnancy.

• Intake of protein, vitamins, and green leafy vegetables.

What Are the Measures Taken at the Time of Birth?

• If the baby does not cry immediately after birth, resuscitation should be followed.

• Babies with low birth weight may need neonatal intensive care.

• Feeding must immediately start after birth to protect from infection. First milk or colostrum has protective antibodies.

What Is Early Childhood Care?

• Precautions should be taken against accidents and head injuries.

• Ensure the child is provided with clean drinking water and a well-balanced diet.

• Iodized salt should be used as a precaution against cretinism (refers to a condition characterized by learning difficulty and physical deformity caused by congenital thyroid deficiency) and goiter (refers to abnormal enlargement of the thyroid due to iodine deficiency).

• Do not slap the child over the face, as it may damage the eardrum.

• All the necessary vaccines should be administered to the newborn child for protection from various diseases.

What Are the Screening Tests to Detect Child Disability?

• Amniotic Fluid Assessment: It is done for the evaluation of fetal health during pregnancy.

• Genetic Assessment of Couples: It is a genetic compatibility test to know whether the couple is at risk of conceiving an ill child.

• Maternal Serum Assessment: It is a blood test done during pregnancy to assess any chromosomal defect.

How to Manage Disabilities Effectively?

1. Medical Rehabilitation: Involves medical management for treating seizures, infection, psychological, mental illness, and behavioral disorders.

2. Physical Rehabilitation: Involves corrective surgeries for malformation and physiotherapy. For example-

• Appropriate exercise therapy for joints.

• Educate the patient to maintain physical status and return to life.

• Restoring the function of the affected part of physio training.

• Application of external appliances and splints in case of a handicapped person.

3. Vocational Rehabilitation: It is the training provided to develop new skills in an individual.

4. Educational Rehabilitation: Involves the training to learn sign language for loss of vision and hearing purposes.

5. Social Rehabilitation: Helping individuals to live as independently as possible. For example -using assisted devices such as a wheelchair.

What Is the Objective of Rehabilitation?

• The objective of rehabilitation is to restore physical, psychological, and social potential.

• To achieve the maximum level of restoration through different interventions.

• Community rehabilitation involves the equalization of opportunities for every individual.

Why Are Vaccines Important to Prevent Disability?

Vaccination is essential to prevent disabilities as early as possible. For example, polio can be prevented through vaccination. Polio can cause paralysis, and measles, which can cause brain swelling, blindness, and tetanus. In addition, vaccines keep children free from bacteria and dangerous viruses that continue to spread.

Conclusion:

Disability occurs due to the interaction of environmental and impairment factors. Seizures and brain injury can become less frequent if child caretakers take precautions during pregnancy and childbirth. Some of the causes of disability are preventable, while others are not. Children with disabilities are at risk of getting neglected or abused. They are likely to get harmed by serious injury or maltreatment.