Quality of Life of Parents having Children with Developmental Disabilities.

Background: There are known limitations in functioning of children with developmental disabilities which result in requirements for long term care far exceeding the usual needs of children as they develop, or the expectations of their families as a parent. Thus, while caregiving is a normal part of being a parent, providing the high level of care required by a child with long term functional limitations can become burdensome and may impact both physical and psychological health of caregivers. Researches have hardly investigated the Quality of Life (QoL) in family caregivers of children with developmental disorders as compared to normal healthy children. Objectives: This study investigated QoL in family caregivers of children with Mental Retardation (MR) and autism as compared to a control group (CG). Methods: The sample consisted of 240 parents (40mothers and 40 fathers in each of the three groups) of 120 children having MR, autism and normal healthy children. Diagnostic assessments in children were carried out using Seguine Form Board test, Vineland Social Maturity scale, Childhood Autism rating scale. QOL of parents was assessed by the WHOQOL-BREF questionnaire. Results: Analysis using one way analysis of variance and post hoc analysis revealed that compared with parents of healthy children, parents in the MR and autism group reported impairment in all the four domains of QoL. Little differences were observed between MR and autism groups. Such impairments were found both for fathers and mothers. Conclusion: Compared with parents of healthy children, parents in the MR and autism group reported impairment in all the four domains of QoL. Little differences were observed between MR and autism groups. Such impairments were found both for fathers and mothers. Thus, parents of children with MR and autism seem to display a higher burden and impaired QoL. These finding must be taken into account in policy making to provide better and more specific supports and interventions for this group of diseases. Psycho-social intervention programmes for family caregivers of children with developmental disorders should incorporate building upon specific strategies to enhance their quality of life.

Comparative Efficacy of Cognitive Retraining Techniques and Remedial Training in Children with Learning Disability.

Background : Computer-assisted cognitive retraining approaches that work on the principle of cerebral plasticity are by now established rehabilitation methods for various neuropsychiatric conditions including Learning Disability. Also, remedial education is considered to be an integral part of management of learning disability. Objectives: To compare the efficacy of cognitive retraining techniques and remedial education for enhancing academic performance of children with learning disability. Sample & Methods: Pre-Post experimental design study was carried out with forty children(between seven to ten years of age), with diagnosis of mixed disorder of scholastic skills (ICD-10). Subjects in Group1 (n=20) were given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention, visuospatial skills, visual memory; and verbal learning and memory. Subjects in group 2 (n=20) were given 36-remedial education sessions. Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability, Grade Level Assessment Device(GLAD).SPSS version 12.0 was used for descriptive and analytical statistical analysis. Results: Highly significant improvement was noted in mathematics (p > 0.01) for Group 1. Also, there was significant improvement in Hindi language of Group 2 (p > 0.05). Conclusion: Both-manualized cognitive retraining and remedial education over thirty six hours can help to partially improve scholastic performance in children with learning disability. The findings have implications for combining both the approaches for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.

Neuro-Cognitive Functioning in Children with Learning Difficulties.

Learning difficulties can occur due to complex interplay of factors that may reside in the child’s own constitution, temperament and cognitive abilities and/or in the background and quality of child’s schooling and/ or in family related factors that affect interactions and emotional well being of the child. Aims & Objectives: To study the neuro-cognitive functioning of children with learning difficulties . Method: Forty children studying in English medium schools in Delhi from Grade 2nd to 5th who were reported to be having learning difficulties. The children were divided into two groups (n=20, each.) One of the groups had children having learning disability. The other group had children with learning difficulties but without any diagnosable psychiatric/ emotional/ behavioural problems. All children were assessed for their intelligence, scholastic performance (on three basic subjects- Hindi, English and Mathematics)); Sustained attention; Verbal Working Memory, Visual Learning and Memory; Verbal Learning and Memory , Verbal Comprehension, Visuo-Constructive Ability and Visuo-Conceptual Skills. Conclusions:Both the groups had impairment in assessed neuro-cognitive skills. Children with learning disability had significantly poorer performance on tasks of sustained attention, visual memory and learning , delayed recall and visuo constructive skills. There were no differences among children on other assessed functions.

Efficacy of Cognitive Retraining Techniques in Children with Learning Disability.

Background :Cognitive Retraining(CR) is known to help in reattainment of cognitive abilities following brain injury.Due to high cerebral plasticity in children,CR can perhaps also be used to ameliorate known cognitive deficits in children with learning disability. Objectives: To study the efficacy of cognitive retraining techniques for enhancing cognitive skills and scholastic performance in children with learning disability. Sample & Methods: Pre and Post experimental design study was carried out with thirty children(between eight to ten years of age), with diagnosis of mixed disorder of scholastic skills(ICD-10). Each subject was given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention,visuospatial skills,visual memory;and verbal learning and memory.Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability,Grade Level Assessment Device(GLAD) and Rey’s Auditory Verbal Learning Test(AVLT).SPSS version12.0 was used for descriptive and analytical statistical analysis. Results:Highly significant improvement was noted in total verbal learning, delayed verbal recall,visuo-spatial skills and mathematics(p>0.01).Also, there was significant improvement in sustained attention(time taken and errors),visual memory and immediate verbal recall(p>0.05). Conclusion:Manualized cognitive retraining over thirty six hours can help to partially remediate cognitive deficits in children with learning disability and improve their scholastic performance. The findings have implications for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.