Special Needs Medical Resources

Rickets results in weak or soft bones in children. Symptoms include bowed legs, stunted growth, bone pain, a large forehead and trouble sleeping; complications may include fractures, muscle spasms or an abnormally curved spine. It responds well to treatment with usual doses of vitamin D and adequate dietary calcium and phosphorus — special dietary changes with supplemented vitamin D, calcium and phosphorus are the standard approach.

The hip bone is displaced from its normal position. In older children this appears as a swollen, painful, visibly out-of-place hip, and treatment involves repositioning the bone by hand or surgery, followed by rehabilitation.

Webbing of fingers or toes, occurring when tissue connects two or more digits — in rare cases by bone. It is mostly an inherited trait or due to genetic factors, and can be treated through surgical (orthopaedic and plastic surgery) and non-surgical methods.

The cause is often unknown; one possibility is interruption of blood supply to the developing limb early in pregnancy. In most cases, children adapt to their physical limitations and live fully functional lives with no treatment at all. Where needed, options include surgery or a routine of regular finger stretches.

Refers to a child missing (or having had amputated) both arms or both legs. The main treatment is prosthetics. Supportive options include medication, nerve stimulation, mirror-box therapy, acupuncture and revision surgery.

India has eradicated polio. In those affected in the past, symptoms include slowly progressive muscle weakness, loss of reflexes, unusual fatigue and at times muscle atrophy. There is no cure, so care focuses on comfort and preventing complications: pain relievers, breathing support where needed, and moderate physical therapy to prevent deformity and loss of muscle function. Polio is very much a condition that can be managed.

Common orthopaedic issues in children include flat feet (most babies are born with them and develop arches as they grow), toe walking (common in toddlers), in-toeing ("pigeon toes"), bowlegs and knock-knees. These can be treated through medication, surgery, regular exercise and physiotherapy.

A loss of muscle function in one or more muscles — in children the commonest causes are cerebral palsy and stroke. It can be accompanied by loss of feeling in the affected area. While there is currently no cure for paralysis itself, muscle control and sensation sometimes return on their own or after the underlying cause is treated. Rehabilitation includes physiotherapy (heat, massage, exercise), occupational therapy for daily living skills, mobility aids, braces and walkers, assistive technology, and adaptive equipment.

A severe visual impairment, not necessarily limited to distance vision, which may call for special education in some cases. Treatment depends on the cause: glasses may resolve the problem, while other cases may need dietary changes, cataract surgery, medication (drops or pills) or corneal transplantation.

Openings or splits in the lip and/or roof of the mouth, causing difficulty in feeding and speaking (speech disorder, stuttering or impaired voice). Surgery can restore normal function with minimal scarring, and speech therapy helps correct any remaining speaking difficulties.

Difficulty in hearing, which typically presents as speech delay and lack of response to everyday sounds. Treatment centres on correcting the hearing loss with prosthetic devices such as a hearing aid or cochlear implant. Speech therapy is a must after correction of deafness; where correction isn't possible, sign language opens full communication.

Developmental dysphasia is a dysfunction in the development of speech and language expression and/or reception, in the absence of other problems such as hearing impairment, muscle weakness or global intellectual disability. It covers disorders of articulation, stuttering, verbal dyspraxia (apraxia), mixed receptive-expressive disorder, verbal auditory agnosia and semantic-pragmatic syndrome. Many children recover to a great extent with time. Speech therapy — along with talking slowly, repeating things, using gestures or drawings, avoiding noisy places, and plenty of emotional support — helps enormously.

A communication disorder — stuttering, impaired articulation, a language impairment or a voice impairment — that affects a child's educational performance. Signs include repeating or elongating sounds, adding extra sounds and words, jerky head movements or frequent blinking while talking. Mild disorders may need no treatment at all; others improve well with speech therapy, where a therapist strengthens the muscles of the face and throat and teaches breath control. If the child experiences nervousness or low mood around speaking, talk therapy helps too.

Damage to the skin or deeper tissues caused by sun, hot liquids, fire, electricity or chemicals, usually assessed by the size and depth of the burn. Treatment depends on severity and may include self-care, medications, supportive care and specialist treatment.

An overactive response by the body's immune system to an irritant, with dry, itchy skin as the most obvious symptom. Stronger or lighter medications are used depending on severity, and the condition is managed well with consistent care.

Most birthmarks are harmless and some fade with time; a few can signal an underlying condition. Some result from excess skin pigment, others from abnormal growth of blood vessels. Vascular birthmarks can appear as coloured patches shortly after birth, sometimes itchy, sore or more pronounced during fever. Where a birthmark is disfiguring or distressing, surgical and laser treatment is available — moles are removed surgically, café-au-lait marks respond well to laser, and haemangiomas that are infected or block airways or vision are treated with medication, surgery or other therapies. Much of the distress around birthmarks comes from myths and misconceptions, not the marks themselves.

A chronic lung condition that inflames and narrows the airways, causing recurrent wheezing, chest tightness, shortness of breath and coughing. With adherence to prescribed treatment — inhalers and other medications — asthma can be kept very well controlled and children lead full, active lives.

A group of conditions resulting in too much sugar in the blood. Common symptoms are frequent urination, disproportionate thirst, intense hunger, unusual weight change, fatigue and irritability. All types of diabetes are treatable — through oral drugs, insulin injections, exercise and a proper diet.

The two most common hernias in children — mostly boys — are inguinal hernias in the groin and umbilical hernias at the belly button, caused by a weakness in the abdominal wall present at birth. An incarcerated hernia can cause pain, vomiting and irritability, and the bulge may feel hard to the touch. Surgery corrects the hernia.

A condition caused by insufficient growth hormone. Signs include short stature, low growth velocity for age, increased fat around the waist, delayed tooth development, and looking younger than peers. Treatment includes a balanced diet, plenty of sleep, regular exercise and medication; pituitary tumours, where present, may require surgery and radiation therapy.

Unilateral renal agenesis (URA) is being born with one kidney. It may cause no symptoms at all, and most children with URA have few limitations and live normally — the outlook depends on the health of the remaining kidney. To protect it, contact sports may need to be avoided later, and blood pressure, urine and blood should be tested annually to check kidney function. In the uncommon cases where function declines, long-term dialysis can do the work of the missing kidney.

Seizures are sudden events causing temporary changes in movement, sensation, behaviour or consciousness, driven by abnormal electrical activity in the brain; epilepsy describes seizures that recur over time without an acute illness or injury. Signs may include temporary confusion, staring spells, uncontrollable jerking of the arms and legs, or loss of awareness. Most epilepsy today is treated with medication, which can control seizures very well.

Low birth weight describes babies born under 2.5 kg, and very low birth weight under 1.5 kg. These babies look much smaller, with the head appearing large relative to a thin body, little body fat, and skin so fine that blood vessels show through. The primary cause is preterm birth; another is intrauterine growth restriction (IUGR). Treatment depends on gestational age and overall health: NICU care, temperature-controlled beds, special feeding (sometimes via a tube), and treatment of complications. Catch-up growth can take longer, so many of these babies are enrolled in special follow-up healthcare programmes.

Preterm means born before 37 weeks' gestation. "Late preterm" infants with no other health problems generally do significantly better than those born earlier. Signs of prematurity include small size with a proportionately large head, sharper features due to lower fat stores, fine body hair (lanugo), low body temperature after birth, laboured breathing, and weak sucking and swallowing reflexes. Monitoring may involve breathing and heart-rate monitors, blood tests, echocardiogram, ultrasound and eye exams. Care may include time in an incubator, monitoring of vital signs, tube feeding, fluid replenishment, bilirubin light therapy, blood transfusion, medications or surgery — after which most premature babies catch up and thrive.

Intellectual disability (also called general learning disability) is a neurodevelopmental condition characterised by significantly impaired intellectual and adaptive functioning, affecting certain conceptual, social and practical life skills. It requires a medical diagnosis; children may also show hyperactivity, impulsivity or restlessness. Treatment centres on therapy: special education, behavioural therapy, sensory processing work, developmental social-pragmatic approaches, applied behaviour analysis and even animal-assisted therapy. Specialists who can help include occupational and speech therapists, paediatric neurologists, clinical psychologists, psychiatrists and paediatricians — and with the right support, children live to their fullest.

Learning disability spans a range from mild and moderate to severe and profound/multiple. Common signs include difficulties with reading and/or writing, problems with maths, difficulty remembering, trouble paying attention or following directions, poor coordination, difficulty with time-related concepts and staying organised. Children with learning disabilities can learn effective coping strategies — and the earlier help begins, the greater the likelihood of success at school and in later life. Interventions vary with the nature and extent of the disability. For a deeper guide, see our Specific Learning Disabilities section.

Intersex people are born with any of several variations in sex characteristics — chromosomes, gonads, sex hormones or genitals — that, in the words of the UN Office of the High Commissioner for Human Rights, do not fit typical definitions of male or female bodies. "Intersex" is a general term covering a variety of such conditions. Care may include medication, surgery where appropriate, and — most importantly — ongoing care with support.

This is a broad term as CARA lists it, since a person with a disability may have intellectual, mental, physical or other conditions. We believe CARA's special needs listings would serve families better with more specific terminology — in the meantime, always ask the agency and a paediatrician exactly what is documented for the individual child.