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G419(P) Developmental decoding: novel methods to tackle the menace of childhood neurodisability in northern india
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  1. R Bharat,
  2. S Choudhary,
  3. S Niranjan
  1. Paediatrics, Geniuslane Child Development Centre, Lucknow, India

Abstract

Background There is a lack of integrated services for childhood neurodisability in Northern India.

Methods A Child Development Centre was set up by UK-trained Paediatricians to understand existing problems, plan new interventions and compare outcomes. Children with a diagnosis of neurodisability (developmental delay, behaviour issues and learning problems) were eligible. Children with blindness, deafness, severe quadriplegia and progressive neurological disorders were excluded.

This study was conducted in 2 phases (table 1). In phase 1 (November 2014-November 2016) children were treated using existing interventions led by therapists. Problems were identified and an intervention programme based on developmental decoding and home-based environmental modification was developed and piloted in Phase 2 (December 2016 onwards).

Problems: phase 1

  • Lack of integrated services.

  • Delayed diagnosis and lack of individualised support after diagnosis.

  • Independent therapists working in isolation.

  • Inadequate parental counselling and support. Parents expecting ‘magic cure’. High drop out rate.

Changes for phase 2

  • Interventions based on Griffith’s 3 developmental assessment and modified based on diagnosis and individual profile. An interventional algorithm (software) was developed which provided individualised intervention plans, monitored child’s progress and parental compliance.

  • All children work towards functional goals. Final (long-term) goals broken into levels(short-term goals).

  • Use of multimedia for parental counselling.

  • Parental training for home environment modification.

Abstract G419(P) Table 1

ResultsPhase 2

  • Marked improvement in target progress and decline in dropout rate was noted.

  • Parents felt motivated and empowered.

Conclusion

  • Developmental decoding and environmental modification have shown promising results in the management of childhood neuro-disability across a diaspora of diagnosis.

  • Information technology was useful in implementation.

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