Outpatients come for treatment

persons_1347343923Babies and small children come with their parents for physio-, occupational- and / or speech therapy as ambulant patients. Some of them come daily or several times per week, others irregularly as they come from further away. We expect their parents to participate and cooperate to achieve the maximum result. This individual care is very time intensive and often several of our therapists are involved in the process. Unfortunately, it often happens that parents stop after some time, often when another baby is born and it becomes too hard for them to follow up on the treatment of the older child with special needs. Sometimes the expectations of parents are too high – for example they expect their child with a severe brain disorder to be able to walk and talk after a few therapy sessions, while it is necessary to continue with the therapies to reach smaller goals. Many of the children, who have stopped coming earlier, come back later – often when their parents realize that their child will not be able to follow mainstream schooling.
Most of our children had a difficult start in life. Often there were complications during the pregnancy or the delivery. The earlier we begin the better the result! We prefer to start with babies and small children as the greatest improvement can be achieved with early intervention.

DhineskarthikDinesh
came to us in 2012 as a two year old boy. His parents are blood relatives from a nearby village. The father works as a carpenter on daily wages. When Dinesh was 1.5 years old his mother realized that her son was not responding to noises and that he hardly produced sounds himself. They found their way to us. We referred him for an audiometry test. The result confirmed profound hearing impairment. The next step was to buy good quality hearing aids which Deepam supported financially as it was not affordable for his family. Since April 2012 Dinesh has come regularly with his mother to Selvi for auditory training and speech therapy. This training was at first quite a challenge as Dinesh still needed to get used to wearing hearing devices and was speedy during the class, though he is very sweet boy who improved a lot with regular therapy. As Dinesh’s mother was very cooperative Selvi recommended a pre-school in the nearby town Pondicherry, which runs a training programme especially for hearing-impaired children, with the aim to integrate them later into mainstream schools. It is a big commitment for Dinesh’s mother to bring her son every morning by public transport to town. We still follow Dinesh to make sure that his ears are clean of wax and that he has no ear-infection, which easily happens while wearing hearing devices. Also we have been able to provide him with high-end hearing aids which were donated especially for Dinesh.


ShadhanaSadhana
was referred to us when she was 2.5 years old. Sadhana was delivered by cesarean section as the time was overdue. She has a one year older sister who has no problems. Unfortunately their father died of a malignant brain-tumor when Sadhana was just two months old. Her mother is still very depressed having lost her husband and being left with two small girls to raise alone. Sadhana is a sweet girl who is very alert even though she is not able to talk or walk due to her incredibly floppy muscles. She appears more like a baby than a two year old, having a big, longish head and low-laying ears. We have advised her mother to come twice a week for regular physiotherapy. At the same time we arranged for a proper medical check-up. As Sadhana has less-pigmented skin lesions in her extremities she was diagnosed with Hypomelanosis, a syndrome which can come along with severe mental retardation as well as abnormalities and malfunction of many organs of the body, including the heart and the kidneys. Further complications, such as epileptic seizures and brain-tumors, could also occur. We did not have the courage to explain all this in detail to Sadhana’s mother.  She is illiterate, just coming out of her depression and is encouraged by the visible progress of Sadhana who has started moving more on her own and saying her first words.

YogaYoga Lakshmi
is a very speedy and smart girl who was born in 2011. There was no birth-cry and her mother had already complications during pregnancy. Yoga Lakshmi was referred to us when she was 3 years old. We remember her as a wild little girl who did not respond to hardly anything. She was beating and biting, was easily distracted and did not look at us. Her hearing was tested and confirmed to be fine, though she still speaks only single words and puts everything into her mouth. It was important to show her parents how to insist on eye-contact and how to encourage Yoga Lakshmi at home rather than beating her. Quickly we found out that Yoga Lakshmi likes sounds and vibration. With a lot of patience and appropriate stimulation we built up a longer concentration span and Yoga Lakshmi now shows significant improvement and has improved interaction with her surroundings.

GopinathGopinath
was prematurely delivered by cesarean in 2011 and was kept for 15 days in the incubator in the emergency ward. Due to injuries in his brain he is severely mentally challenged and though his eyes are normal, visual impressions are not properly processed in his brain (cortical blindness). Gopinath also has a severe autism spectrum disorder. On top of everything else Gopinath has frequent epileptic seizures, despite taking the maximum dose of anti-epileptic drugs.
Gopinath has a two years younger sister who is fine. He had never received therapy and was first brought to us when he was already 4 years old. At first Gopinath made no eye-contact, he was not used to using his hands for playing with things, but was constantly hitting his head with both hands and was very hyperactive, wandering around and often falling due to frequent short seizures. His mother treated him like a baby. .he was carrying him, was dressing and feeding him and he was not toilet trained. We encouraged his mother to address him like a normal 4 year old boy and to involve him actively in his daily routines. Soon Gopinath was able to eat solid food on his own. Gopinath comes three times a week for intensive therapy. We do physical exercises with him. A lot of stimulation is given through touch and vibration, constant eye-contact is encouraged and we have introduced tracking of light and other objects to him. Gopinath makes sounds but says no clear words yet – therefore we repeat simple words like “amma” (mother) and he tries at times to repeat it. Though we see some improvements, Gopinath’s progress is not steady, as he often still has epileptic seizures and changing moods. His concentration span is very short. It needs a lot of patience to work with him and there are days when we hardly can teach anything, though another day he is more cooperative and rewards us with big smiles.

ShakthiShakti
is the second one of twin-brothers born in 2007. While his first born brother was fine, Shakti was only 1kg at birth, had no birth-cry and was therefore in the incubator for several days. Probably due to birth-asphyxia(lack of oxygen during the delivery) Shakti has severe cerebral palsy which results in spasticity of most of his muscles, combined with ataxia (trembling of muscles). Though he is able to move his limbs, it looks kind of bizarre and it is a big effort for him. Even the muscles in the face are affected and he has difficulties eating and speaking, making his articulation unclear. Shakti is intelligent – he is attending a special school in town. His mother who is incredibly motivated and pleasant insisted on bringing her boy for physiotherapy treatment to Deepam. We just could not say no to them. With regular exercise Shakti improved a lot and is now able to walk for some distance with special shoes and the help of calipers and a walker. Once a week he also joins the Deepam children for the swimming pool and the exercises in the water help him to relax his muscles. Shakti is an extremely motivated boy and has a very sweet nature.