An Innovative Training Module for Community Workers for Prevention, Early Detection of disabilities and Inclusion of Children with Disabilities

• Census 2001, collected information on the prevalence of five types of disabilities: visual, hearing, speech, movement, and intellectual. According to its findings, India’s disability population is 21.9 million, or 2.13% of the total population.
• NSSO (July-Dec 2002) estimated the population of persons with disability (PWD) at 18.49 million, a 1.8% of the total population.
• WHO estimates 10% of total population to be having a disability.
• The currently accepted figure puts 5-6% PWD in India. Converted to numbers, this is a vast humanity.

The age old saying ‘Prevention is better than cure’, holds as true today. According to WHO, 70% of disabilities can be prevented if proper care is taken during pregnancy, infancy and early childhood. If the communities and families follow good mother and child care practices like timely immunization, breast feeding, introducing weaning foods at the right time, diarrohea management, nutrition care, regular ANC check-ups, among others, many diseases and disabling conditions could be averted from happening. The first step that any community and family can take towards preventing disabilities is adopting positive caring practices.

Yet, an impairment/ disability could happen. If an impairment has happened, it becomes most important to detect it as early as possible, so that mitigating measures could be taken so that the impact of the impairment could be reduced and impairment does not become a full blown disability/handicap. Normally, a society wakes up when confronted with an adult disabled, whose disability is full blown and the early years when the effect of the loss could have been substantially minimized have been lost.

Early years are important because development is most rapid during this time, hence as caregivers, it becomes important to provide best opportunities to the child at this stage. It would be interesting to note that by the time a child is six years old, 90 per cent of motor development is complete, 85 per cent of language skills have been acquired, 90 per cent of brain is formed and 60 per cent of logical abilities have already developed. This underscores the importance of early detection and early intervention in disabilities, so that crucial childhood years when learning happens at the most rapid pace are not lost and corrective steps are taken on time.

Early years for all children have a transformational power. Brains are built over time, neural circuits are wired in a bottom-up sequence, and the capacity for change decreases with age. In the first few years of life, our brains are creating 700 new synapses every second! The interaction of a child’s experiences with his or her genetic predisposition is what determines which synapses are used and which are not. The more they are used, the stronger the architecture of the developing brain. New data from neuroscience, genetics and biological sciences indicate that early enriched environments can mitigate effects of disadvantage on later cognitive outcomes, mental health, and executive functioning

Positive experiences, such as exposure to rich learning opportunities, and negative influences, such as malnutrition or environmental toxins, leave a chemical “signature” on the genes, which can be temporary or permanent. This process is called epigenetic modification. Hence, the role early detection and early intervention can play in stimulating the brain and promoting development is now being proved by research in neurosciences.

According to CRC, Right to Development is a right for all children and children with disabilities are children first. By detecting disabilities early and initiating early intervention measures whether those are medical, educational interventions, or home training of parents or community awareness campaigns, all are steps indicating our keenness to provide opportunities for the development and participation of children with disabilities (CWD).

Legally, as per India’s Disability act, programmes should be taken up to detect children with disabilities and undertake early intervention and referrals. UNCRPD clearly reiterates the importance of Training of Community workers as of strategic importance specially in developing countries. Morally also, as a society, we are duty bound to ensure that our children are not afflicted by disease, disability, mortality and morbibilty. By addressing inequities and bringing about early intervention in childhood it is possible to change the whole of society over the longer term.

So, all arguments strongly advocate that programmes for prevention and early detection of disabilities should be taken up in the community at a large scale.