DHANVANTRI CHILD REHABILITATION CENTRE

(An Associated Institute of Dhanvantri Ayurvedic Sanasthan)

NATURE AND SCIENCE HEALING TOGETHER

HASSUPURA NOORPUR MORADABAD ROAD BIJNOR UTTAR PRADESH INDIA

ASSESSMENTS & DIAGNOSIS

Assessment and Diagnosis involves a more in-depth investigation of children and differentiates them from various developmental disorders. Lack of acquisition of the normal standardized milestones within known accepted and established ranges are considered abnormal and associated with a high probability of a developmental disability. In-depth diagnosis and evaluation are important in determining optimal interventional strategies based on the child’s profile of strengths and weaknesses. Assessment is done in a holistic approach on Behavioral, Emotional and Social Development parameters which consist of clinical, psychological and standard therapy assessments. The key to appropriate teaching lies in careful and ongoing assessment linked with teaching.

Clinical Assessment: PSYCHOLOGICAL ASSESSMENT

Baseline Assessment: The therapist observes children to see if they can do tasks they are expected to do at their ages. Based upon their assessment of individual body functions, an individual therapy program is designed which is reviewed after every 2 months. Base Line assessment include the following assessments

Base Line assessment include the following assessments:

Speech and Communication assessment:

Contrary to popular misconceptions “SPEECH THERAPY” is not simplistic speech therapy. It includes physical therapies designed to teach or restore functions of the body from neck to nose. These include sucking, chewing, swallowing, saliva drooling control, soft and hard palleted control, breathing, phonation, non verbal communication and where possible, verbal communication. Assessments for speech therapy measure each of the above parameters to decide on the therapeutic approach to be taken to restore them toward normalcy.

The assessment made by a speech and language pathologist is usually the definitive measure of the presence or absence of a communication disorder. A combination of interview techniques, behavioral observations, and standardized instruments is used by the speech and language pathologist to identify communication disorders as well as patterns of communication that are not pathological.

ADL (activities of daily living) assessment :This includes assessment of activities of self and social management such as toileting, eating, self grooming, performing all daily activities, going to the shops, being on public transport etc.

Physiotherapy / Occupational Therapy: It involves a detailed assessment and motion analysis in generating a specific goal for spasticity management that should be started as early as possible to prevent irreversible changes in musculoskeletal system which will further distort the biomechanics of movement. Motor assessment includes muscle tone, the capacity of co-contraction of muscles, involuntary extremity and trunk movements, the stability of extremities correction and equilibrium reactions, sitting balance, upper extremity and hand functions, sensorial perceptional problems, speech and language function, and feeding. In addition, orthosis, mobilization devices and other adaptive equipment, the general health status of the child is evaluated.[13,19] Realistic goals are defined, and plans are communicated with other members of the treatment team and family

Special Education Assessment: They will basically assess the cognitive level and overall understanding level of the child.

After complete assessment, the treatment goals and instruction are set and target a broad range of skill areas such as communication, sociability, self-care, play and leisure, motor development and academic skills. Goals emphasize skills that will enable learners to become independent and successful in both the short and long terms. The instruction plan breaks down desired skills into manageable steps to be taught from the simplest (e.g. imitating single sounds) to the more complex (e.g. carrying on a conversation). The analyst meets regularly with family members and program staff to plan ahead, review progress and make adjustments as needed.

ASSISTIVE DEVICES

Assistive Technology:

Assistive devices are types of equipment that are used to improve function in persons with disabilities. Assistive Technology describes devices that help children move more easily and communicate successfully at home, at school and in community with family and friends. These are devices that assist a child to overcome physical and communication limitations. There are a number of devices that help children stand straight and walk, such as postural supports or seating systems, open front-walkers, quadrupedal canes. It can also include more high tech equipment like customized wheelchairs and electric wheelchairs that let children move more freely.

As individuals mature, they may require support services such as personal assistance services, continuing therapy, educational and vocational training, independent living services, counselling, transportation, recreation/leisure programs, and employment opportunities, all essential to the developing adult. Simple technology can be used to assist with skills (modified eating utensils). Complex technology can substitute or replace abilities that do not exist (power chairs for walking, electronic speech aids for talking). Learning to use the equipment may include education from a therapist or teacher, depending on the technology.

A variety of orthotics, braces or splints, are recommended by doctors and physiotherapist for your child to correct muscle abnormalities. These may be used on your child’s legs, arms, hands or trunk. Some of these supports are used to help function, such as improved walking, sitting or standing. The purpose of other types of orthotics is for additional stretching or positioning of a joint.

• Assistive Technology Options
• Braces (orthotics) and Splints
• Mobility Devices
• Canes
• Walkers
• Wheelchairs: manual or powered
• Powered scooters
• Positioning Devices
• Seats
• Standers
• Sidelyers
• Wedges
• Adapted eating equipment
• Speech aids
• Computer software or hardware
• Vision aids (magnifiers, large text print books)
• Hearing aids (telephone amplifiers)

COUNSELLING

On learning that their child has a disability, most parents react in ways that have been shared by all parents before them who have also been faced with this disappointment and this enormous challenge. One of the first reactions is denial—”This cannot be happening to me, to my child, to our family.” Having a complete diagnosis and some knowledge of the child’s future prospects can be easier than uncertainty. In either case, however, fear of the future is a common emotion:

• What is going to happen to this child when he is five years old when he is twelve when he is twenty-one?
• What is going to happen to this child when I am gone?
• Will he ever learn?
• Will he ever go to college?
• Will he or she have the capability of loving and living and laughing and doing all the things that we had planned?

Other unknowns also inspire fear. Parents fear that the child’s condition will be the very worst it possibly could be. Over the years, I have spoken with so many parents who said that their first thoughts were totally bleak. When parents learn that their child has a disability or a chronic illness, they begin a journey that takes them into a life that is often filled with strong emotion, difficult

choices, interactions with many different professionals and specialists, and an ongoing need for information and services. Initially, parents may feel isolated and alone, and not know where to begin their search for information, assistance, understanding, and support. Parents of the child with multiple disabilities struggle with feelings of isolation and alienation from mainstream programs for children.

Counselling, proper guidance and consultation play a very important role in answering the questions in parents mind. We assist parents in understanding the special needs of their child; providing parents with information about child development; and helping parents to acquire the necessary skills that will allow them to support the implementation of their child’s Individual Development Plan

It involves :

• Increasing the acceptance level among the parents and other family members
• An appropriate diagnosis for their child
• Making decisions about medical intervention
• Guidance regarding therapies and educational planning
• Managing daily behavioral challenges
• Managing unusual responses to sensory stimuli

As parents, you know your child best. You know your child’s strengths, abilities, needs, and challenges, and, as a result, you have a vital role in the treatment of your child. We believe interventions can broadly promote family well-being by focusing on parental emotional, cognitive, and behavioral adaptation to their child’s condition. Parents’ adaptation to their child’s diagnosis has been found to predict both family well-being and their child’s attachment security. The parents should be made aware that the child could achieve normal movements faster if they offer them appropriate occasions for functional activities in daily living. Even if the motor movements are retarded, the activities should be parallel with the cognitive level of the child and this condition should be explained to the families.

PHYSIOTHERAPY

Cerebral palsy (CP), Traumatic brain injury (TBI) and Hypoxic Brain Injury due to any cause and affecting motor controlling parts of the brain and the nerve fibres connecting those parts to the body are a group of permanent disorders of the development of movement and posture, causing activity limitation, that is attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain or before the age of 2 years in case of CP. The motor disorders may be accompanied by disturbances of sensation, perception, cognition, communication, and behavior, by epilepsy, and by secondary musculoskeletal problems.

Such children require intensive one-to-one physiotherapy on a daily basis till bone growth stops ( 18 years for girls and 21 for boys) and further also if required.

Physiotherapy (PT) plays a central role in managing the condition; it focuses on function, movement, and optimal use of the child’s potential. PT uses physical approaches to promote, maintain and restore physical, psychological and social well-being. A physiotherapist will focus on helping children with strength, balance, flexibility and coordination required for motor skills and functional mobility including rolling, sitting, crawling, and walking. They also select, fabricate, modify, and train children and families in the use of adaptive equipment.

Physiotherapy approaches in rehabilitation applications aim to normalize sensorial and motor functions, provide normal posture and independent functional activity, regulate muscle tone, improve visual and auditory reactions, support normal motor development and motor control, improve ambulation and endurance, increase the quality of the existing movements, prevent soft tissue, joint and postural disorders, support orthopedic and surgical procedures, and finally to prepare the child for the adolescent and adult periods.

The physiotherapist focuses on gross motor skills and functional mobility in the management of motor deficits. Positioning, sitting, walking with or without assistive devices and orthoses, wheelchair use and transfers are areas that the physiotherapist works on. The physiotherapist performs and plans physiotherapy and home program and provides the interphase with the school and recommends equipment and orthosis. This approach also focuses on gross and fine motor activities, visual, and sensory processing skills needed for basic activities of daily living, training in school-related skills and also strategies to help children compensate for specific deficits in their daily lives.

Occupational Therapy

Cerebral palsy (CP), Traumatic brain injury (TBI) and Hypoxic Brain Injury due to any cause and affecting motor controlling parts of the brain and the nerve fibers connecting those parts to the body are a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain or before the age of 2 years in case of CP. The motor disorders may be accompanied by disturbances of sensation, perception, cognition, communication, and behavior, by epilepsy, and by secondary musculoskeletal problems.

Such children require intensive one-to-one physiotherapy on a daily basis till bone growth stops ( 18 years for girls and 21 for boys) and further also if required.

Physiotherapy (PT) plays a central role in managing the condition; it focuses on function, movement, and optimal use of the child’s potential. PT uses physical approaches to promote, maintain and restore physical, psychological and social well-being. A physiotherapist will focus on helping children with strength, balance, flexibility and coordination required for motor skills and functional mobility including rolling, sitting, crawling, and walking. They also select, fabricate, modify, and train children and families in the use of adaptive equipment.

Physiotherapy approaches in rehabilitation applications aim to normalize sensorial and motor functions, provide normal posture and independent functional activity, regulate muscle tone, improve visual and auditory reactions, support normal motor development and motor control, improve ambulation and endurance, increase the quality of the existing movements, prevent soft tissue, joint and postural disorders, support orthopedic and surgical procedures, and finally to prepare the child for the adolescent and adult periods.

The physiotherapist focuses on gross motor skills and functional mobility in the management of motor deficits. Positioning, sitting, walking with or without assistive devices and orthoses, wheelchair use and transfers are areas that the physiotherapist works on. The physiotherapist performs and plans physiotherapy and home program and provides the interphase with the school and recommends equipment and orthosis. This approach also focuses on gross and fine motor activities, visual, and sensory processing skills needed for basic activities of daily living, training in school-related skills and also strategies to help children compensate for specific deficits in their daily lives.

Speech Therapy

Speech and language therapists (also known as speech therapists or speech-language pathologists) observe, diagnose, and treat disorders of speech, language, voice, communication and auditory processing when the disorder results from cerebral palsy, hypoxic brain injury or autism spectrum disorders.

The services are part of a treatment plan with documented goals for functional improvement of the patient’s condition, e.g. speech, articulation, swallowing or communication with or without alternative methods.

They use a program of exercises to :

Strengthen oral muscles,

Improve feeding and swallowing disorders techniques including problems with gathering food and sucking, chewing, or swallowing food. For example, a child who cannot pick up food and get it to his/her mouth or cannot completely close his/her lips to keep food from falling out of his/her mouth may have a feeding disorder.

Auditory (Aural) rehabilitation which includes speech – language therapy

Typically includes the development and improvement of communication skills with concurrent correction of deficits; the development of alternative or augmentative communication strategies, when required; and efforts to enhance social adaptation of the individual in regard to communication.

A speech therapist works with your child on the receptive (understanding) part of speech and language as well as the expressive part (talking) to progress toward the documented treatment plan goals.

Speech therapist help improve your child’s ability to speak clearly or communicate using alternative means such as an augmentative communication devise or sign language. Speech interventions often use a child’s family members and friends to reinforce the lessons learned in a therapeutic setting. This kind of indirect therapy encourages people who are in close daily contact with a child to create opportunities for him or her to use their new skills in conversation, learning and play.

Special Education

Special Education is that component of education which employs special instructional methodology (Remedial Instruction), instructional materials, learning-teaching aids and equipment to meet the educational needs of children with specific learning disabilities. Remedial instruction or Remediation aims at improving a skill or ability in a student. Techniques for remedial instruction may include providing more practice or more explanation, repeating information, and devoting more time to working on the skill. Effective teaching strategies may include the use of ‘procedural facilitators’ like planning sheets, writing frames, story mapping and teacher modelling of cognitive strategies, although for quality and independence in learning it is crucial to extend these technical aids with elaborated ‘higher order’ questioning and dialogue between teachers and pupils.

Special education teachers use various techniques to promote learning such as :

Approaches that encourage children to regulate their behavior by teaching them self-monitoring, self-instruction and self-reinforcement skills are effective in producing adaptive behavior change (i.e. increased on-task behavior, reductions in anti-social behavior).

Approaches using positive reinforcement (where appropriate behavior is immediately rewarded), behavior reduction strategies (such as reprimands and redirection), and response cost (a form of punishment in which something important is taken away) appear to be effective in increasing on-task behavior.

Combinations of approaches (e.g. cognitive-behavioral with family therapy) are more effective in facilitating positive social, emotional and behavioral outcomes than single approaches alone

Depending on the disability, teaching methods can include individualized instruction, problem-solving assignments, and small group work. Special education teachers help to develop an Individualized Education Program (IEP) for each special child. The IEP sets personalized goals for each student and is tailored to the student’s individual needs and ability. Teachers work closely with parents to inform them of their child’s progress and suggest techniques to promote learning at home. They are involved in the students’ behavioral, social, and academic development, helping the students develop emotionally, feel comfortable in social situations, and be aware of socially acceptable behavior. Special education teachers communicate and work together with parents, social workers, school psychologists, speech therapists, occupational and physical therapists, school administrators, and other teachers

ADL

The knowledge and ability to carry out activities of daily living ( ADL) is the most fundamental request at the heart of every parent of a special need child. This entails teaching how to dress, undress, wash, toilet training, eating, hand function, etc that allow the special need child/person to be an independent member of the family as far as daily needs are concerned. A small special child may be a joy to behold and easy to carry, but when that same child grows up and does not have ADL abilities it becomes a tremendous burden on a mother because she is older and the child is heavier UDAAN is the only centre in Delhi to offer ADL training to the special children ADL Training involves self-care, self-management and home management. Activities of daily living (ADL) are the basic daily activities one does to be independent.

They include :

• Eating food independently.
• Dressing-ability to wear and remove shirt, pant shoes etc.
• Grooming-ability to brush teeth, comb hair , wash hands and face etc.
• Bathing and toileting-ability to take a bath independently
• Personal mobility
• The ability to be able to serve self or make simple snacks for oneself.
• Also being able to decide which books to take for school and to take them out when needed and to organize them.
• Organize the toys in their place etc.
• Understand the concept of money and handling money.
• Understanding the concept of going to a shop and remembering the way to go to a shop or home etc.

ADL also develops Fine motor (FM) skills. They are important to ensure proper development. It is an important component of development in infants and children to practice fine motor skills for functional use of hands. Examples of FM activities are: shoe tying, manipulating small objects such as buttons, zipping and unzipping, using scissors, pinching, opening and closing objects, handwriting, grasping items and being able to isolate finger movements to push buttons or type.

Fostering this kind of independence boosts self reliance and self-esteem, and also helps reduce demands on parents and caregivers.

Art Therapy

Art Therapy is a psychological discipline that specializes in using visual art making and enhancing the inherent creative process to help children achieve their full potential and bring about therapeutic change. Art therapy is generally described as a highly illuminating, enjoyable, and unique experience.

There is a commonly held belief that art making is beneficial to people (particularly children) with Autism Spectrum Disorder due to their intense sensory needs (especially visual and tactile self-stimulation) and disregulation, often nonverbal nature, and need for more visual, concrete, hands-on therapies. ASD therapists of all kinds acknowledge this and, despite lack of appropriate training, many attempt to include therapeutic art making into their child’s activities on a regular basis. Art therapy literature on the subject is large enough to demonstrate that it is an effective, clinically-sound treatment option (especially when supplemented with studies from the fields of art, art education, psychology, and other creative arts therapies).

There are six major ASD treatment goal areas that art therapists are best qualified to treat:

• Imagination/abstract thinking deficits
• Sensory regulation and integration
• Emotions/Self-expression
• Developmental Growth
• Recreation/Leisure skills
• Visual-spatial deficit

FUTURE VISION

For the last two decades, we had succeeded in establishing a reputation of DCRC and it is now time to setup the Early Years center for excellence for helping children with who are differently abled with any type of brain damage, both acquired or genetic, in tune with new born policy of MAKE IN INDIA.

We aim to setup this dedicated institute for the Divyang/differentially abled persons/Children

OUR MISSION

Provide affordable intensive one-to-one Rehabilitation and Training to children and adults with moderate to severe disabilities, especially those induced due to brain damage. Develop and standardize affordable evidence based medical methodologies for reversal of brain damage in disabled children with Cerebral Palsy and Autism. Spread awareness about these newly established medical strategies to enhance the quality of life and level of employability of children with Neurodevelopmental disability, beyond what may be achieved by the best standards of recognized Rehabilitation Techniques.

ABOUT DCRC

DCRS for the Differentially-abled, is a centre, specialized in Neuro Developmental Delay Disorders as well as a pioneer in the Autism movement at pan India level.

We have come up again with a new model for Early Years development for children with special needs. We are offering plans in all the areas right from Remedial input, Occupational and Physiotherapy with Psychological and special education and Speech/Oromotor guidance.

Our early years plan emphasizes on child development in all spheres including all the mile-stones and sensory needs areas. Early years will help students with different needs to bring up their potential to the maximum. It will help students to be main streamed at the right age and children will get all essential therapies and inputs under one roof from highly qualified professionals.

We are the first organization in UTTAR PRADESH, to provide, under one roof: , Medical Intervention along with standard rehabilitation of Neuro development delay in persons/child, like Skill development training, schooling, pre-vocation training, Occupational Therapy, Physiotherapy, Life skill development, Computer education, ADL, Speech, Special Education, besides providing primary health and education to poor household and BPL category children, etc.

We are dedicated to welfare, growth and development of children towards their inclusion in main stream society. DCRC aims at making a meaningful difference in the life of individuals with Specific learning disability, Autism Spectrum Disorder (ASD), Cerebral Palsy (CP), Down syndrome, Mental Retardation (MR) and Traumatic Brain Injury and their family.

activities including *Early Intervention * Special Education * Assessment * Work and Employment * Independent Living * Awareness and Research & Development which aims at ensuring social, physiological rehabilitation and enabling Individual with physically and mentally challenged to enjoy their basic human and fundamental rights and they can ensure their free and frank participation to holistic development of the society

SPONSOR A CHILD

What is Sponsorship ?

Sponsoring Child with Autism is all about transforming lives and making a meaningful difference in the life of these excluded children! It is a beautiful relationship between you and your sponsored special child. Help a child from exclusion to inclusion, from dependence to independence and Self-reliance. Your monthly Contribution provides things such as Assessment & Diagnosis, Treatment, Pre-vocational training and Special education.

Your donation to DCRC will make a lasting difference in the lives of all children with mentally and physically challenged who are in grave need. Your generosity provides crucial assistance for children – children who face discrimination in every sphere of life and live in isolation. Your support is urgently needed.

The various Sponsorship schemes through which individuals or corporate houses can take care of a child are as follows:

• 7000 per month includes alternative Counseling and Pre-vocational training.
• 6000 per month includes alternative Assessment & Diagnosis and Occupational Therapy
• 6000 per month for alternative special education of children

When you decide to sponsor a child, you will receive:

• Child’s profile with his/her picture and background story of your sponsored child.
• Your sponsored child’s Annual Progress Report
• You will be able to keep in touch with your child through regular updates, letters and cards.
• You can personally visit your sponsored child and interact with him/her.
• DCRC has voluntarily decided to adhere to best practices for the collection, use and disclosure of personal information as outlined in this policy.

You can help DCRC through following ways:

A) Child Sponsorship:

Individuals can sponsor a child through ‘DCRC Sponsorship Program’. A regular monthly donation for a particular child can take care of his/her education, Pre-vocational training and Occupational Therapy.

The organization can also sponsor a group of children.

Ours Reach One and Teach one Project:

Our Reach one and Teach one Scheme provides an opportunity to reach one child and rehabilitate them by sponsoring for their education. Each member of your club and employee can contribute Rs.1 day, Rs. 30 a month for the DCRC children. Employees can authorize the organization to deduct the said amount from his/her salary and donate it to DCRC on their behalf.

Installing:

The organization can allow keeping a donation box in the premises where employees can make a regular donation. A collection could be made on a monthly or bimonthly basis.

Sponsoring:

The organization can bear the cost of making donation boxes and put their logo along. These boxes would be placed at various places like hotels, restaurants, showrooms etc. The organization can get promotion for itself through this activity.

C) Kind donation:

Computers

Office furniture

Study material for Special children And similar items of these kinds The donations made in kind can be relevant to the organization’s industry type and the organization is free to mention these donations in their promotions for image building in front of the stakeholders.

D) Volunteers:

Your employees can visit the DCRC Centre and devote their time/ talent for the DCRC Children.

CONTACT US

DHANVANTRI CHILD REHABILITATION CENTRE

HASSUPURA NOORPUR MORADABAD ROAD BIJNOR UTTAR PRADESH 246727

DIRECTOR

DR RAMVEER SINGH

EMAIL:drramveersingh@yahoo.com,8755001274

ADMINISTRATOR

Dr UMAR NAZIR

Senior Paediatric Rehabilitation therapist

Email : umarnazirumi@gmail.com, 7889824889