Lollipops And Birds 

Biplab Das on techniques 
to handle spastic children

Make your child dissolve a lollipop in her mouth and then divert her attention to a flying bird. "This is how you can temporarily stop your child's uncontrolled salivation," said Arun Kumar Sinha, assistant director of National Institute for the Hearing Handicapped, answering a query of a father of a spastic child who was born with motor disorders resulting in uncoordinated physiological activities. 

This interaction was part of a seminar-cum-workshop on how to manage a spastic child held at the National Institute for the Orthopaedically Handicapped (NIOH). 

Spasticity manifests in stiffness of muscles and other disorders occurs due to any lesion in the cerebral part of the brain. As the brain's cerebral part is greatly paralysed, the disease is called cerebral palsy. 

"Fifty years have passed since independence but we are still lagging behind when it comes to managing disabled people," lamented Nikhilesh Mitra, education secretary of the state government, while inaugurating the seminar-cum-workshop. 

Out of every 1,000 live births, two are affected by cerebral palsy. "There are about 9.6 million disabled people in our country. Of them, 40-50 per cent are affected with cerebral palsy," said Mitra. This scourge of cerebral palsy robs a child of his ability to evolve into a normal healthy person. 

Parents too do not have the necessary knowledge to detect a child's abnormal behaviour. NGOs are also ill-equipped to handle this sort of cases. "By arranging this seminar NIOH aims to provide parents and NGO workers with necessary information to rehabilitate and manage spastic children," summed up Rupali Sen, coordinator of this seminar and also an occupational therapist of NIOH. 

If parents are unaware of the symptoms of a spastic child, medical intervention is delayed. This impedes the growth of a spastic child into a self-sufficient individual. 

"The first initiative should be taken by parents who later under the guidance of NGO workers can reach government institutions like NIOH that have enough experts to tackle spastic children," said R. M. Jamir, commissioner (disabilities), West Bengal government. "Otherwise, the government alone can do little for this physical anomaly." 

After the inaugural session, participants were shown an array of state-of-the-art exhibits that can transform the life of a handicapped person. A few students of occupational therapy were there to explain the use of the exhibits. Colourful wooden and plastic pecks of different shapes seemed quite interesting. 

To coordinate the movement of the limbs of spastic children, different aids are resorted to. There were colourful rings for eye and hand coordination. 

Music produced by a xylophone, which increased the attention of a spastic child, was also there. A peek board containing numbers, pictures of animals was shown to a spastic child so he could pick up any of those things. An exercise like this enhances thumb and index fingers' perception. 

Before helping a spastic child reach this stage of learning, experts have to overcome a few obstacles. Because of a damaged brain, a spastic child often loses balance when trying to sit or stand. This is further aggravated by stiffness of muscles and deformed bone joints. 

"Infectious diseases like meningitis, encephalitis immediately after birth make a child prone to spasticity," mentioned Dr. Rina Dey of the occupational therapy department of NIOH. "Brain injury from childbirth also predisposes a child to spasticity." 

"But, try to avoid unnecessary surgery. Only a handful of surgeons in our country are competent enough to correct deformities in a spastic child," warned Pankaj Bajpayee, assistant professor of occupational therapy of NIOH. 

Moreover, surgery is not a cost-effective solution. As the parents of affected children mostly come from rural areas, informing them of the early symptoms of cerebral palsy can initiate treatment at its budding stage. NGO workers can visit remote villages and persuade hapless rural people to attend clinics specially run for spastic children.

    December 6, 1999.