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Prevention and management of Disability

Lessons for prevention and management of Disability

This paper was presented in the national conference organized by Disability Commissioner, Govt. of India at Patna in April 2006.

Go to the people.

Live with them.

Learn from them.

Love them.

Start with what they know.

Build with what they have.

But with the best leaders,

When the work is done,

The task accomplished,

The people will say

‘We have done this ourselves’.

-Lao-tse in 7th century B.C.

‘Folk’ means ‘related to common mass’. Folk practices refer to those practices which have been in use amongst common mass for a long period of time. These practices evolved through ages on the basis of experiences are repository of people’s wisdom. They have been instrumental in shaping the behaviour of the people and as such have the ability to play a key role in social development. These methods have greater social acceptability and have been tried and tested for a long period. There is a need to study them closely so that we can verify the efficacy of these practices and techniques in light of modern scientific findings and wherever they are found to be compatible with them, they should be recommended for wider use for greater benefits with or without modification.

We should also study the methods of communication of these practices, which has helped them in their acceptability on such a wide scale. Couplets of Ghagha and Bhaddari and other similar poets have been of great help in dissemination of knowledge about environment and agriculture in society. Folk methods of dissemination and transmission of knowledge are relevant even today for transmission of modern scientific knowledge. Thus there is a need to study them also and use them in learning of children with disability. If folk methods are synthesized harmoniously with the modern requirements of learning it would be easier to disseminate on large scale and they can easily gain wide acceptability.

Before we really examine how folk practices can be used for children with disability, we shall see a few major scientific developments of last few decades.

Neuro-physiological studies of brain and underprivileged

New neuro-physiological studies of brain have made a big dent in the knowledge of development of brain. Scientific studies have established that maximum development of brain in a child takes place before the age of 5 years. So, the learning of the child would largely depend on the foundation laid during these early years. It has been found that if a child is born with good eyes but his eyes are covered for 3-4 years, then he may not be able to see all through his life even though his eyes may be physically well. This happens because the connections of neurons in respect of vision are over by the age of 3-4 years. If it proper care is not taken to develop them, then these neuron connections may not develop in future. (See fig) This further shows that the neuron circuiting pertaining to language development takes place primarily upto 5 years. For emotional control also the first five years is extremely critical.

Considering that all children are born with statistically similar physical properties of brain, environmental factors in which the child is brought up in initial years would greatly influence the nature of the development of brain.

Old Thinking
Development of brain depends on the genes at birth.
New Thinking Development of brain is a complex interplay between the genes at birth and the experiential interaction.

Old Thinking The experiences you have before age three have a limited impact on later development.
New Thinking Early experiences have a decisive impact on the architecture of the brain, and on the nature and extent of adult capacities.

Old Thinking A secure relationship with a primary caregiver creates a favourable context for early development and learning.
New Thinking Early interactions don’t just create the context, they directly affect the way the brain is “wired “.

Old Thinking Brain development is linear : the brain’s capacity to learn and change grows steadily as an infant progresses towards adulthood.
New Thinking Brain development is non-linear : there are prime times for acquiring different kinds of knowledge and skills.

Old Thinking A toddler’s brain is much less active than the brain of a college student.

New Thinking By the time children reach age three, their brain’s are twice as active as those of adults. Activity levels drop during adolescence.

What is disability?

Disability of a person refers to lesser physical development of any sensory organs or loco-motor systems. It may also be due to lesser development of mental processes including neuron circuiting related to management of these systems.

In light of the above discussions it is clear that the first five years of life are very important from the view of disability management. If a child is neglected in this period, s/he may not grow properly and may develop into a disabled person. It not only requires proper care of physical growth of sensory and loco-motor organs, it also requires their proper activation so that full neuro-circuiting takes place in the brain.

Hence, the learning of the disabled basically involves enabling the most efficient use of the sensory organs/loco-motor systems. This requires proper measures for physical development of the organs and their exercises.

Now we shall try to see which type of competencies we should look for development from the view point of processing of information in the brain.

Develop Core Creative Competencies

In the management of learning information processing through the brain is extremely important. In this context APCL has identified following competencies as Core Creative Competencies (C3)

  • Concentration
  • Power of observation
  • Memory
  • Thinking
  • Imagination
  • Emotional Management
  • Power of expression/communication

Now let us see what we can learn from the folk practices in the management of disability and development of these competencies.

Disability management –a family responsibility

As we have seen earlier the first few years of life are crucial for the management of disability. In this period the child remains with the family. Hence, we ought to empower family in the management of child particularly his/her disability.

One of the important features of the disability management in the traditional system is that family is considered as the main institution for management of disabled. People considered it as a pious work service to render service to disabled persons. They considered it a responsibility of the family to manage and serve these persons. Their care and concern was given priority. Entire working of the family was planned keeping their consideration in mind. In the set up of joint family set up it was not difficult to manage such persons. Traditionally they used some techniques for the development of the sensory organs at elementary level so that they can perform basic life skills. However, with the break up of joint families this concern is gradually becoming difficult to sustain. But, this has also grown desire to develop the disabled so that they may become more and more self-dependent.

Care at birth

The child rearing is considered an important aspect of family. The infant management is considered so important that grandmothers generally spare time to assist the mothers in managing the child at the early period of rearing. In the joint family set up the concern of child, young and old used to be common concern of all.

In our traditional practices the concern of the welfare of children is seen from the stage of conception. Pregnant mother is subjected to Garbhadhan and Punsawan Samskar. This is just to underline the important phase of life. The pregnant mother is advised to remain in a happy mood. She should eat good food. In Mithila region pregnant mothers are advised to eat coconut so that their children would have good eyes. Coconut is rich in vitamin A, which is good for development of eyesight. She should remain in a healthy environment. She should listen to good and religious songs. In her room picture of happy children are hung all around. All this was to be done so that the child may be healthy and mentally active.

Be aware of disability at an early age

The age below 5 years is critical for the development of brain as such they are extremely critical for the management of disabled persons. If it is not managed at that point of time we may lose the opportunity for ever. For example, if there is a cataract in the eyes of the infant, it has to be removed immediately lest the child may not be able to see later as the neuron connectivity related to vision may cease to develop after the age of 5 years.

Similarly, if the child has some problem in ears it needs to be attended immediately so that neuron connectivity takes place in the normal way. Thus, there is a need to know that whether the child is suffering from any physical disability related to any sensory organs at the time of birth. This concern for early detection of physical disability is seen in folk practices as people test for the proper functioning of ears right at the time of birth. They also test whether the child weeps or not and if not, they kick the child at back to coerce him/her to weep. They also touch the child to test whether touch sense is properly activated or not.

Develop loco-motor systems

During infancy one also needs to attend to the loco-motor system so that they develop in the proper way. In folk practices massaging with oils has been made an essential part of care-giving. This is considered essential for giving proper shape to human body. The massaging is useful as a daily exercise of different body parts and thus helps in regulating the flow of blood to different parts of the body. Simultaneously, small physical deformities are also attended to through regular massaging.

There are various folk techniques of massaging and acupressure which are used for curing various pains/sprains. Use of a paste of tamarind and lime is quite popular in the case of sprains. There are numerous people who attend to pains, sprains and disability by properly putting pressure on veins and bones. I remember a person Ramavatar at Poiwan village in Aurangabad district who used various oils and mud plasters to cure different pains. He used to collect various snake poisons and oils from forest seeds for his treatment. He used the snake poisons in his treatment. For this purpose he used to maintain a small snake farm. He was very popular in the management of pains, sprains and weakness of organs. Similarly, Moti, a peon in the CMs secretariat at Patna (now retired) uses traditional techniques akin to acupressure in the treatment of various pains/sprains. The success rate is so high that people have to take prior appointment for treatment. There are many such traditional practitioners, who use such conventional knowledge for treatment of various ailments. These traditional wisdoms need to be documented, tested and disseminated at a larger scale.

Develop sensory organs from the cradle

In the early age of infancy we need to develop activities, which can help the child in the development of the neuron connectivity related to different sensory organs. If these activities are not performed, our sensory organs would remain underdeveloped. In order to develop visual skills children are asked to wear different coloured dresses. White coloured dresses are considered inauspicious. Similarly, on the swings of children different coloured clothes are used. Even the ‘Sujani’ (the spread sheet made of old clothes which is used for sleeping purposes) are stitched using different coloured threads. In fact, for children all items are deliberately made colourful. This is done so that children may develop proper neuron circuiting related to visual skills.

On the swings toys containing small pebbles are hung so that continuous sound may be generated which fall on the ear drum and lead to development of neuron circuiting related to auditory skills in brain. For his purpose a lot of verbal sounds are also spoken in the ears of the children. Even meaningless words are also spoken. This experience is different for different group of children as language base of different communities are different. In underprivileged sections of society the language base is generally extremely poor. Thus, the environment of language for these children remains extremely poor. The poverty of the linguistic environment becomes main factor for less development of neurological connectivity related to language development, which keeps them educationally backward throughout their life.

Sing lore to develop rhythmic intelligence

Folklore is always sung by keeping infants in the arms. This helps in the development of rhythmic intelligence among children. It also helps in developing neuron connectivity related to listening ability. There is an old practice of taking children in arms and singing songs. The songs are continued even after the child has slept. It has been seen that if the song is repeated several times the child learns the song by heart.

Learning during sleeping

This type of teaching to the unconscious and subconscious mind has been found to be extremely useful and has been used as a technique. The great saint Swami Satyanand Saraswati, who established International School of Yoga, Munger used this technique for teaching his disciple Swami Niranjananand Sarswati right from the age of 7 years. When Niranjananand used to go for sleep Swami Satyanand used to recite the verses of Gita, Upnishads and other religious texts. This he used to continue till he was deep asleep. This technique was found to be so useful that Swami Niranjananand never went to school and learnt all lessons of life through these informal techniques of learning. It would be interesting to note that Swami Niranjananand Sarswati heads the International School of Yoga after the retirement of Swami Satyanand.

At School of Creative learning a young son of Ms Shweta, the music teacher could recite the songs of multiplication tables at the age of two years simply by listening to songs sung by her mother while taking her to sleep.

Develop touch sense

Then there are small practices which help in developing touch sense. All of us might have played the game “Atkan Matkan”. This game was played with the objective of developing touch sense.

Of the important features of these games are that they were played in groups to develop group spirit. In these games all children are included. Thus they promote inclusion also.

Laugh and live longer

There is a game called “Atta Patta” in which parent strokes the palm of the child and says, “Atta Patta, Hamar Babu Ke Paanch Ta Beta”. Then s/he touches each finger one by one and says, “ Raman, Chaman, Beni, Madhava, Kadam-Gulguli”. It should be noted that these words refer to pleasure and enjoyment. Then, s/he gradually moves fingers on the hand towards the armpit saying, “ Ata sa chala gudur kakhawan chala, gudur kakhawan chala, …..”. S/he moves on to the armpit to tickle the child to laughter.

This simple game not only develops the touch sense but also highlights the importance of laughter and builds emotional attachment between parent and child.

Play blind games

We have several blind games, which help in developing listening skills. In one game ‘Ankh Michouni’ a child is blindfolded. S/he is expected to touch other children who keep on moving singing a song. If s/he touches the other child, the latter becomes blindfolded and starts moving around to touch any other child. This game also helps in developing anticipation. These types of blind games are also available for development of other sensory organs.

Folk games to develop concentration

Concentration is one of the most important competencies in the management of disability. There are several folk games which help us in developing concentration. There are games of marbles, pebbles etc. which are used for concentration development.

There is a story of Saint Thiruvelluvar. He asked his wife to dance with a Pitcher filled with water on her head leading a procession to the King’s place. There was a condition that not a drop of water should fall. She performed the task with brilliance. At School of Creative Learning this exercise is adapted for development of concentration by keeping a book on the head of the child and move on a line. Older children are asked to keep a football on their head and move. This can also be adapted by asking the child to bounce balls on floor and keep on increasing number of bounces.

Aadrshiti Yog

Aadrshti Yog is a visualization exercise which is an extremely important exercise in the development of mental faculties particularly emotional development and imagination. It is an exercise based on Yog Nidra an ancient yogic practice. It helps in development of mental image making among children. At School of Creative Learning this exercise has been used for management of children with mental challenges particularly hyperactivity, emotional disturbance, etc. This activity has been successfully used in dealing with children who have developed alienation for learning. A few children who had attempted suicide showed great recovery after the exercise and even passed Class X examination in Ist div. with high marks.

Teach songs to blind

Singing was considered as an important skill for blind people. Generally, they were trained in singing. People realized that as blind people had better rhythmic intelligence, hence they used singing for their vocations. Even in begging singing was used as a means to evoke charity. Now that we have banned begging and want to rehabilitate them, it would be important to consider this aspect. Generally these people are asked to be rehabilitated in some manufacturing processes. They do not find it suitable to their aptitude. If we have to consider for their vocations they should be engaged in some activity in which their rhythmic skills can find some use. In this sense, they may be involved in advertising or singing for a cause such as literacy, health etc.

As there was no formal learning system people used their own symbolic systems for communication of ideas. A totally blind person is taught through auditory senses. As blind people could speak and we had developed symbolic communication system through spoken language we had several blind scholars. Soordas, a blind, was one of the all times great poets.

Similarly, we had several scholars with physical challenges. Ashtavakra, with great physical challenges, was one of the all time great scholars. We did not have deaf scholars as we did not have any standard communication system. In traditional systems deaf persons used to devise their own set of symbols for communication related to requirements of daily needs.

Use traditional functions for dissemination

There are many functions which have been designed for dissemination of ideas for regulating behaviour in family. For example, we have a social function called Madhushrawani in Mithila region of Bihar, which is used for preparing young bride for the future family. In this the bride is told stories for fifteen days which tells her how to behave in a family set up. We can use such functions for generating awareness for detecting and managing disability in infants as these brides are going to be the mothers in near future.

Similarly, Hijaras are extremely popular and are always available at the time of birth of a child. They are extremely good singers. We can definitely use them for creating awareness regarding disability.

Conclusion

It is thus clear that the folk methods provide a rich source of activities for the management of disabled and learning of special children. There is a great need to study them seriously and use them effectively with or without modification in light of modern scientific requirements. They can have important lessons in the management of learning for disabled.