I am sitting while writing this script, in the corner of the former autopsy room, with open windows on my right and wooden partition behind and on the left, to recollect the last eight years of the Developmental Paediatrics and Child Neurology department, since its beginning on 14th September, 2012. The team in the department consists of a Developmental Neurologist, psychologists, speech therapists, Occupational therapist and a Child Development specialist. It is currently an advanced centre for promoting child development and supporting children who are developmentally challenged.
The Developmental Paediatrics and Child Neurology department started its functioning in a borrowed space from the Forensic department, offered by the then Dean and Head of the department of the Forensic Medicine, Dr Radhakrishnan. The Medical Superintendent, Dr Sojan Ipe got the space redesigned and modified it to locate an out-patient area, rooms for the neuro-development assessment and developmental therapy, office space and a waiting area for families. The medical students of different batches helped to decorate the place to make it a child friendly environment.
Most of the referred children with different neuro-developmental needs come from many parts of Kerala and some from Tamil Nadu, Karnataka and few from other states. There is an increase in the number of non-resident Indians from Australia, Canada, USA, UK, and Middle East countries who seek help for their children.
The Neuro-developmental screening which takes place in the Child Development Centre, has evolved into an organised programme now, with initial neurological consultation, developmental appraisal by a transdisciplinary team and gathering details from the family about the home environment. The screening process involves gathering information on sleep, diet, behaviour, communication skills and assessing the abilities of a child in hearing, vision, language, learning, self-care, motor skills, etc. There are separate observational protocols for each of these developed in the department, which are user friendly.
All children are offered an initial development plan with specific objectives for a Home-Based Learning process. The 2-3 years old children who come from nearby places have an option of joining the weekly Play Group; the older children can join the Early Learning Centre, which provides an environment to promote pre-school skills; the school ready children can join the Learning Resource Centre to receive help for class room based learning in preparation for joining a school. The adolescent girls who are developmentally challenged do receive some help from the Transition Planning Centre. The Family Resource Centre has exhibits of child development displays of all age groups with sample books and toys appropriate for each age group. Parents receive information on parenting, nurturing children, early childhood development, etc from this facility.
The Early Learning Centre and the Resource Centre are located in custom made child friendly spaces with advanced facilities and equipment to help in promoting visual skills, hearing skills, communication skills, sensory motor skills, gross and fine motor skills, social skills, etc. These facilities can take care of the common neuro-developmental needs of children.
The research activities of the department covered sleep disorders in children, Vitamin D Deficiency in developmentally challenged children; Interpretations of Electrical Rhythm Dysfunction; Behavioural phenotypes in dysmorphic syndromes; Premature cranial sutural closure and neuro-developmental risks; Handedness in early childhood and graphic skills, etc. There are twelve publications from the department in peer reviewed journals. The department offers opportunities for students to do their projects under the ICMR student scholarship programme. We have had medical students spending time in the department as visitor-observers during holidays.
The department has evolved a comprehensive medical appraisal of early school going children, to look for developmental departure and to propose learning support, which was tried out at St Peter’s school, Kolenchery. This data has alerted us about some significant neuro-developmental markers which influence the developmental trajectory of children.
The know-how in designing and planning to establish Child Development Centres is currently shared with Bangalore Baptist Hospital to set up a centre.
There are good prospects for this facility to develop into an academic facility for training Paediatricians in this specialty. There are requests for courses on parenting education, capacity building of teachers to become familiar with common developmental disorders which affect learning, behaviour and academic achievement, and to conduct refresher courses for professionals in child development.
The recently introduced On-Line neuro-developmental consultation service can develop into a tele-medicine support service to help satellite Neuro-Developmental clinics to have the benefits of the specialists in this department.
The child development promotion receives a new challenge, when children’s childhood experiences are restricted by the COVID 19 pandemic. Children have remained at home for most part of an academic year with learning support provided through On-Line services. The parenting support in such times was also inadequate as parents were not equipped to engage children for longer hours at home. When children’s social dimensions are not exercised in a peer setting, they are less ready to face the social world in the future.
The child Development facility at MOSC Medical College can be a resource facility to equip professionals to address the needs of children in difficult times such as this!
A child development facility is a place where plans are designed to influence schools, homes, community centres, etc. to promote effective child development promotion activities!
M.C.Mathew (text and photo)
