Introduction

One of the latest additions to the hospital services has been the Child Development Clinic, which caters to the needs of physically and mentally handicapped children. The clinic offers comprehensive management by using the services of a specially 'trained Pediatrician, Psychiatrist, Clinical Psychologist, Speech Therapist, Play Therapist, Physiotherapist, Orthotist. Prosthetist, Occupational Therapist and Medical Social Worker, so far 1900 cases have been registered and are being followed up regularly.

Many child-care providers have questions about how brains develop in young children and what they can do to help with this development. Before you had a baby, you probably never gave much thought to the most basic functions that adults take for granted. You cannot remember a time when you could not sit, stand, walk or speak. Now you have a newborn baby in your hands and you just do not know what to expect. This tiny creature is like a blank slate and parents spend many an anxious moment waiting for that first smile, the first sign of recognition, the first day your baby stands up.

A baby is a thing of joy forever. Parents are constantly fascinated and often delighted and surprised as they watch their baby grow up. From the time they are born, babies are constantly learning and growing, gaining new abilities and mastering new skills. Ability is inherent, but a child's immediate environment will determine how the ability develops and grows. Development is an ongoing process from birth to about 18 years i.e. until physical maturity.

The first three years feature amazing development and is a period of unparalleled growth in all areas of your baby's development. While we know that the development of a young child's brain is a "work in progress" that takes years to complete, we also know that development in the early years is quite dramatic and can establish patterns for life-long learning.

The newborn's brain has a long way to go. We now understand that, contrary to previous widely held beliefs, the human brain is not fully developed at birth. In fact, a newbom's brain is about 25% of its approximate adult weight. By age 3, it has grown dramatically by producing billions of cells (neurons and other brain cells) and hundreds of trillions of connections between these cells (synapses). Taken together, they form a complex control center for sensing the world and enabling the baby not only to see, hear, move, taste and touch but also to think, feel, and behave in particular ways. In other words, the baby's and young child's brain is vastly more active and complex than previously known. Neuroscientists are not only trying to learn more about the physical structure and functioning of the brain but are also beginning to focus their attention on the ways in which early nurturing experiences such as holding, feeding, and comforting impact the way a baby's brain develops.

Parents are important! Parents can, and do, influence all areas of their babies' development in countless ways every day. Most parents understand the value of loving; secure relationships and age-appropriate and interesting experiences in fostering children's physical, psychological and intellectual development. They learn about the uniqueness of their babies in terms of temperament, preferences, the way they like to be held, what soothes them when they're upset, how they like to explore the world, what makes them smile. Parents' growing knowledge, combined with their unqualified commitment to their babies' well being, makes them their babies' most powerful teachers and advocates. The more you as a parent learn about brain development, the more you will realize that all of the things that you quite naturally do with your baby in response to his or her unique signals foster healthy development.

Recent census should high percentage of various handicaps in all states. The handicap may be isolate or in various combination like Mental retardation, physical retardation, visual, hearing handicapped, cerebral palsy , Down's syndrome, behavioral problems and so on. All these handicaps have clinical and social importance.

Many of the conditions which are dealt in Child Development Clinic do not have curative treatment. Many people including doctors, paediatricians, are of the opinion that nothing can be done for these children. They are right in the sense that there is no treatment which makes these children absolutely normal like others. At the same time it does not mean that these children should be left like that. With training of parents in physiotherapy, using various appliances and other rehabilitative measures we can attempt to make these children capable of handling themselves and not to be dependent on care givers even for their activities of daily living like feeding, bathing and others. Even the parents are educated here on the various facilities and benefits provided by the government for these handicapped children.

A correct diagnosis for the child after basic work-up goes a long way in giving the right prognosis and genetic counseling to parents so as to prevent such disabilities in future. A good chunk of these disorders have a genetic basis and as consanguinity is very common in these part of country, there is 7-8% chance of recurrence of similar illness in future pregnancies. Hence the parents need to be counseled properly. Correct diagnosis and proper counseling goes a long way in reducing the burden on the family, taking out false belief in parents and prevents doctor shopping.

Handicapped children require multi disciplinary approach for management comprising of Various specialties, services and aids all available under one roof, the family at large need counseling regarding the handicap, its prevention and rehabilitation.