Visual impairment in children with multiple disabilities in schools for children with special needs in South India

Purpose: To understand/assess ocular and functional vision impairment in children with multiple disabilities with a functional vision assessment battery in addition to standard ophthalmic examinations in an outreach setting. Methods: Seven schools for children with special needs, 243 children in total, were screened for ocular disorders and functional vision impairment through school camps. Results: Among them, 37% had refractive errors needing spectacle correction. With standard ocular testing methods, the visual impairment was around 32%, but when functional vision was assessed, the functional vision impairment amounted to 70% in these children. The presence of functional vision impairment was found to be independent of the associated disability. Assessment of visual capacities such as visual closure, saccade pursuits, optic ataxia, and developmental milestones early on can help in suspecting the presence of CVI. Conclusion: Children with multiple disabilities are more at risk of functional vision impairment, which significantly impairs their ability to function in daily life. A complete functional vision assessment becomes essential to plan early intervention for these children. The significant proportion of vision impairment and functional vision loss in our study indicates the need for coordinated structured programs to address vision?related problems in children with multiple disabilities.

Challenges in the rehabilitation management of a patient with Spinal Cord Injury without Radiographic Abnormality (SCIWORA) secondary to high-voltage electrical burn injury with multiple disabilities: A case report

@#A 22-year-old male who came in contact with a high-voltage wire, with entry point at the head and exit points at the ankles, presented with flaccid paraplegia and loss of sensation of bilateral lower extremities with no radiographic abnormalities. Several burn-related medical complications arose during the admission, as well as episodes of demotivation. Bilateral below the knee amputation was done because of extensive burn injuries of the lower extremities. The rehabilitation management for a patient with multiple disabilities needed to be tailored depending on the limitations and needs of the patient at a certain point in time. Despite the challenges, satisfactory results were achieved, through telerehabilitation and employing a multidisciplinary team approach.

Calidad de vida individual en niños y adolescentes con discapacidad intelectual y múltiple: una propuesta de atención basada en el modelo de Schalock y Verdugo / Individual Quality of Life in Children and Adolescents With Intellectual and Multiple Disabilities: A Proposal for Attention Based on the Schalock and Verdugo Model

Resumen Debido al aumento significativo en el número de investigaciones que buscan caracterizar y potenciar la calidad de vida de la población con discapacidad en los diferentes momentos de su trayectoria de vida, se ha podido evidenciar los escasos avances en torno al estudio de la vida de los niños y adolescentes en esta condición, específicamente, aquellos con discapacidad intelectual y múltiple. El objetivo de este estudio fue analizar el constructo de calidad de vida individual en niños y adolescentes con discapacidad intelectual y múltiple, a partir de una revisión de los trabajos teóricos y empíricos realizados conforme a los postulados del modelo propuesto por Schalock y Verdugo, como marco de referencia para el desarrollo de estrategias de atención dirigidas a promover como fin último, un estado pleno de bienestar para estos niños y adolescentes dentro del contexto colombiano. Se formularon algunas reflexiones de carácter práctico, fundamentadas en un caso, que dieran cuenta de los procesos de atención basados en la evidencia que responden efectivamente a las necesidades de los niños y los adolescentes con discapacidad intelectual y múltiple, sus familias y las instituciones y organizaciones. Para concluir, el modelo de Schalock y Verdugo se ha consolidado como marco de referencia conceptual y metodológico, plenamente actualizado y con gran potencial de cambio para los niños y adolescentes de este colectivo, por cuanto tiene una capacidad de alcance e impacto, que le permite atender oportunamente desde el onto hasta el macrosistema.

Abstract Due to the significant increase in the number of research studies that seek to characterize and enhance the quality of life of the population with disabilities at different times in their life trajectory, it has become evident that little progress has been made in the study of the lives of children and adolescents in this condition, specifically, of those with intellectual and multiple disabilities. This study aimed to analyze the construct of individual quality of life in children and adolescents with intellectual and multiple disabilities, based on a review of the theoretical and empirical works carried out according to the postulates of the model proposed by Schalock and Verdugo, as a framework of reference for the development of attention strategies aimed at promoting a full state of well-being for these children and adolescents within the Colombian context. Some reflections of practical nature were formulated, based on a case, to account for evidence-based attention processes that effectively respond to the needs of children and adolescents with intellectual and multiple disabilities, their families, and institutions and organizations. In conclusion, the Schalock and Verdugo model has been consolidated as an updated conceptual and methodological reference framework with great potential for change for children and adolescents in this group, since it has a scope and capacity that allows it to timely attend from the onto to the macrosystem.

Brinquedos Educativos Associados à Contação de Histórias Aplicados a uma Criança com Deficiência Múltipla / Educational Toys Associated with Storytelling Used with a Child with Multiple Disabilities

RESUMO: Este estudo teve por objetivo analisar os efeitos dos brinquedos educativos associados à contação de histórias na interação de uma criança com deficiência múltipla. Participou do estudo uma criança de dez anos com diagnóstico de deficiência múltipla (paralisia cerebral e deficiência visual). Foi empregado o delineamento de sujeito único, no modelo AB, para verificar e avaliar as variáveis do estudo, sendo a variável dependente as habilidades de interação com os brinquedos educativos. A variável independente caracterizou-se pela aplicação de brinquedos educativos associados à contação de histórias e estratégias adicionais. Como materiais, foram selecionados oito brinquedos do kit da Instituição LARAMARA para cegos, que atendiam ao objetivo da pesquisa. O treinamento baseou-se na contação de histórias seguidas pelo uso de estratégias adaptadas em diferentes situações, totalizando seis sessões para cada brinquedo, divididas em duas etapas, linha de base (A) e intervenção (B). Todas as sessões foram filmadas, analisadas e pontuadas de acordo com a folha de registro, para mensurar a interação do participante com os brinquedos. Como resultados, pode-se demonstrar que, nas fases de linha de base, o participante não interagiu com o brinquedo. Entretanto, quando foi introduzida a intervenção, houve aumento no número de interações com os brinquedos educativos, pois o participante conseguiu manipulá-los e dar função a todos os brinquedos. Em síntese, o uso dos brinquedos educativos associados à contação de histórias pode ser uma possibilidade de intervenção para pessoas com deficiências múltiplas de modo a oferecer mais interação com o brinquedo.

ABSTRACT: This study aimed to analyze the effects of educational toys associated with storytelling in the interaction of a child with multiple disabilities. A ten-year-old child diagnosed with multiple disabilities (cerebral palsy and visual impairment) participated in the study. The single subject design in the AB model was employed to verify and evaluate the study variables of the study, the dependent variable being the interaction abilities with the educational toys. The independent variable was characterized by the application of educational toys linked with storytelling and additional strategies. As resources, eight toys were selected and adapted from the kit of the LARAMARA institution for the blind, which met the research objective. The training was based on storytelling followed by the use of adapted strategies in different situations, totaling six sessions for each toy, divided into two stages, baseline (A) and intervention (B). All sessions were filmed, analyzed and scored according to the rubric gauging, to measure the participant's interaction with the toys. As results, it can be demonstrated that, in the baseline phases, the participant did not interact with the toy. However, when the intervention was introduced, there was a significant increase in the number of interactions with educational toys, as the participant was able to manipulate them and give function to all the toys. In summary, the use of educational toys associated with storytelling may indicate a possible intervention for people with multiple disabilities with the intention of offering more significant interaction with the toy.

Impact of low vision care on reading performance in children with multiple disabilities and visual impairment.

Background: Lack of evidence in literature to show low vision care enhances the reading performance in children with Multiple Disabilities and Visual Impairment (MDVI). Aim: To evaluate the effectiveness of Low Vision Care intervention on the reading performance of children with MDVI. Materials and Methods: Three subjects who were diagnosed to have cerebral palsy and visual impairment, studying in a special school were recruited for the study. All of them underwent detailed eye examination and low vision care evaluation at a tertiary eye care hospital. A single subject multiple baseline (study) design was adopted and the study period was 16 weeks. The reading performance (reading speed, reading accuracy, reading fluency) was evaluated during the baseline phase and the intervention phase. The median of all the reading parameters for each week was noted. The trend of the reading performance was graphically represented in both the phases. Results: Reading speed increased by 37 Word per minute, 37 Letters per minute and 5 letters per minute for the subject 1, 2 and 3 respectively after the intervention. Reading accuracy was 84%, 91% and 86.4% at the end of the baseline period and 98.7%, 98.4% and 99% at the end of 16 weeks for subject 1, 2 and 3 respectively. Average reading fluency score was 8.3, 7.1 and 5.5 in the baseline period and 10.2, 10.2 and 8.7 in the intervention period. Conclusion: This study shows evidence of noticeable improvement in reading performance of children with MDVI using a novel study design.