Knowing the Vestibular System

Vestibular stimulation is the feedback/stimulus that human body receives due to any of its movement (linear & rotational) in gravity. The intensity of these stimuli range from mild e.g. nodding to severe e.g. sitting on a swing / any amusement ride.

 The vestibular sense is first to develop in the growing fetus, it develops only in 5 months in utero and is stimulated by the movement of carrying mother’s body. It is the only system that integrates sensory senses (acoustic, optic, tactile, smell) with brain activities, proprioception and muscle reflexes & tone.

 The vestibular system comprises of the two components viz. the semi-circular canals, which respond to rotational movements; and the otoliths, which are sensitive to linear accelerations. The vestibular system sends signals primarily to the neural structures that control eye movements and clarity in the vision; and to the muscles that keep us upright in position. The brain uses information from the vestibular system and from proprioception throughout the body to understand the body's dynamics and kinematics (including its position and acceleration) from moment to moment.

The activities of Vestibular Apparatus can be summarized as:

Moving ahead with Special Needs.

Being a parent is very overwhelming experience, it is a never-ending journey of joy, happiness, efforts, love and care. But, if you realize that your child is little less than normal the immediate moment you get surrounded by complex feelings shock, numbness, sadness, denial, blame, fear, confusion, rejection and grief. However, we should Keep in touch with reality and maintain a positive attitude throughout. Your love towards your child will eventually transform and heal your heart and will give you a hope for bright future and will always keep you moving.

Life teaches us at every moment to move on forward without looking backwards. And in the process of living, learning and realization are two things each and every one procures from …their own and others life well. I have been realizing that life at times seem to be too unjust to few people but I guess they are the strongest of us all as they are fighting a silent battle within themselves. Life of children and adults with special needs can be frustrating and sometimes it can be significantly important to get a little pick-me-up to keep from getting discouraged. There are many ups and downs in life and we all need some inspiration to keep us headed in the right direction.

The fact to understand here is a complex phenomenon which exhibits the interaction between features of a person’s body inadequacies/Special needs and limitations and features of the society in which he or she lives. Love, Compassion, sympathy, apathy, technological interventions and the transition between them will help us, families, society at large to create a strong supportive environment to keep us all moving ahead in life in a healthy manner.

Special Needs Education

Children with Special needs or who are differently abled require a specific way of dealing in all walks of life. Education is no different. These children find it very difficult to get accommodated in the traditional set ups & curriculum.  Hence, education modules should be so defined and designed taking into consideration such a child's needs and limitations. Thus, Special Education or special needs education is nothing but ways to the educated children whose learning needs cannot be met by a standard school curriculum. Within this stream of education, the child is involved using individually planned teaching procedures such as Special instructional methodology, techniques and materials and is monitored by a trained professional in a comfortable setting to ensure the comfort of the child. Also, adaptive equipment's and methods such as audio, visual, tactile (touch) and kin-aesthetic (by doing) may be used.

 As it is rightly said "If a child can't learn the way we teach, maybe we should teach the way they learn". Special needs institutions aim to promote the level of personal self-sufficiency in the lives of children to make them more successful. One such schools we are aware of is, SAARTHI School for Special Children in Mumbai. It is a Non-profit organization which provides academic, vocational, medical and psychological support to the exceptional children especially those coming from the lower socio-economic strata. SAARTHI aspires to provide integrated care to the exceptional children of all sections of society. To name a few more are ADAPT, Apang Maitree , Aseema School, Dilkhush Special School , Kshithij etc.

It has only been over the past years that special needs education has been gaining impetus in India and educational facilities provided to children with disabilities have grown gradually. These ones range from development of special schools to Inclusive education in the traditional setup. But have we given it the importance it deserves? Or Have taken the necessary steps to ensure that children with special needs are given the best education and trained on how to venture forth into the real world?

Summer Care for Children with Special Need.

India being sub-tropical country, summers are generally harsh & very humid. And almost everyone hates this and the heat makes everyone extremely uncomfortable; particularly this   time of May as heat & humidity are at its peak all around the country. Growing pollution & less greenery adds to our irritation. Adults are generally cranky throughout owing to discomfort however heat exposure is a cumbersome issue for children as their bodies are more vulnerable especially children with special needs like Cerebral Palsy wherein a child has limited mobility or is immobile.

Children with special needs often find it very difficult to communicate. Thus, keen observation about the symptoms of overheat/ temperature is needed by the guardian /parent. If you observe symptoms such as sleeplessness, excessive irritation, dryness in mouth, dull skin, dislike towards food, loose motions, vomiting, nausea, stomach aches, cramps, giddiness etc immediately consultant your pediatrician.  Over heat exposure, excessive dehydration, exhaustion can be extremely detrimental to the health of children. It may also prove fatal.

Take following precautions for enabling Children with Special needs to lead a healthy summer:

• Wear light clothing: Wear light clothes of heat friendly fabrics such as cotton so that your child feels comfortable. Full sleeves clothing will help you protect from sunburns.
• Avoid getting out from 10 am to 4 pm: Schedule the doctor’s appointment or therapy session for your child accordingly.
• Adequate Ventilation in the room: See to it that your child stays in a room where air is getting circulated properly.
• Sponge your child if he/she can’t move or give then bath before bed.
• Stay hydrated/Drink enough fluids: In summer, the body loses more water so everyone needs need to drink enough water. Avoid carbonated drinks as they make one even thirstier. The healthy choices could be coconut water, lemonade and fresh fruit juices.
•  Use Cooling mattress, cooling pillow or other helpful ‘temperature’ inserts which are made up of specific materials that promote temperature control
• Never leave your child alone in a car.

Other general summer Health Care tips such as vaccination, maintenance of hygiene, appropriate diet, use of sun screen etc.  have been shared in our earlier blog. General summer healthcare tips remain same for all and they work for all. However, a special care must be taken as the special need child can face prolonged health challenges even brain damage. 

Speech & Language Therapy.

Individuals with Cerebral Palsy & Autism especially children require intervention of Speech and language therapists (SLTs) in the course of their treatment so that they can improve their communication skills & learn to effectively communicate with others .In case of Cerebral Palsy a lot of children have difficulties with their speech .In fact Speech disorder is basically an associative condition with CP.As far as Autism is concerned Some do not speak, while others love to talk but have difficulty during conversations and/or understanding the tone & variations  of language and nonverbal indications when talking with others.

Speech and language therapists (SLTs) are health professionals who work along with parents, teachers, nurses, occupational therapists and doctors and offer treatment, support and care for children and adults who have difficulties with communication, or talking. It also affects a child’s ability of drinking, swallowing, eating and breathing as they all conflicts with proper communication skills in case of Cerebral Palsy.Speech-language therapy is so planned and designed to manage the mechanism of speech & usage of language of & by an individual. The Therapy begins with evaluation of the individual by a speech-language pathologist. The aim is to assess his/her verbal aptitudes and challenges. The pathologist sets goals for treatment after the evaluation. In every case, the primary goal is to help the person communicate in more useful and functional ways which may include learning/mastering spoken language and/or learning nonverbal communication skills such as signs or gestures. Overall the therapy helps the Child with articulation, listening, language development, Vocabulary enhancement, comprehension of words and improvement in conversation skills

The therapy can be provided in one-on-one, in a small group or in a classroom setting. Therapists who work with children have additional specialized training. Games, songs, blocks, Legos, flashcards etc. are the part of normal therapy exercises which makes the session interactive & Child friendly. However active involvement of parents with the child at home & in completion of assignments prescribed by the therapist is equally important for the child’s development and making him/her more independent also in enabling them to lead more fulfilling life.

Signs of Sensory Processing Disorder

Sensory Processing Disorder formerly also called as Sensory Integration Dysfunction severely affects individuals’ sensory preferences in way that it interferes with their normal, everyday functioning especially Children. Sensory issues can be categorized as hypersensitivity (over-responsiveness) and hyposensitivity (under-responsiveness) to sensory stimuli. The symptoms of sensory processing disorder exist on a vast spectrum from very mild to severe. Children with sensory processing disorders are initially fussy babies which grow anxious as they get older. Few signs/symptoms of Sensory Processing Disorder are as follows:

Over sensitivity to stimulation: The Child overreacts to or does not like touch, noise, smells, etc.
 A child might get annoyed or cover his/her ears, run away or start crying in anticipation of certain sounds or while hearing them. At times A child might be on the different end of the spectrum and would prefer very loud noises and keeps the TV, radio or music loud. Some children might not like being touched

Avoid crowds/ gatherings: If your child does not like going out in places with many people around can be an indication of SPD.  Such children show unexpected sudden mood changes and temper tantrums in crowded places. They get irritated with being touched by others, noises, etc. They avoid/ dislike standing near others.

Discomfort with Clothing: The child might extremely irritable when you dress him/her; The tags, the fit of the dress, the texture of the fabric seems to make him/her uncomfortable in clothes.


Food Preferences: Children with SPD are very choosy in what they eat. The texture, taste, smell & temperature of food matters them a lot. some might prefer eating crispy food others might like soft texture foods like jellies etc.

Play Activities: Some children might be overly fearful of swings and other playground equipment’s; some might dislike his or her feet to be off the ground.  Some children might be very fidget and unable to sit still and enjoy movement-based play like spinning, jumping, etc. They Often harm other children and/or pets when playing, i.e. doesn’t understand his or her own strength. Children with tactile issues avoid touch sand while playing and even dislike walking barefooted on the grass.

Sensory processing issues are multifaceted and wide ranged phenomena’s. If a child exhibits few of the above stated symptoms does not mean that the Child is suffering from SPD. However, If you suspect that your child has SPD consult a medical expert for further evaluation, diagnosis & treatment.

Facts About Cerebral Palsy

1. What is the history of Cerebral Palsy?
William Little, a British surgeon in the 1860's first identified Cerebral Palsy then known as ‘Cerebral Paralysis’. He raised the possibility of birth asphyxia as a chief cause of the disorder. Sigmund Freud in 1897 suggested that difficult birth was not the only cause but rather only a symptom of other factors on the fetal development. Modern research has shown that 75% of cases were not due to birth asphyxia supporting Freud’s view even though through the 19th and 20th Centuries. Little’s view was the accepted explanation.

2. What is Cerebral Palsy?
Cerebral Palsy is a life long physical disability (group of conditions ) due to brain damage that are characterized by chronic disorders of movement &  postures; Cerebral Palsy is a syndrome characterized by combination of  the following conditions :
a. Motor Disorder.
b. Medical Conditions.
c. Sensory Impairments.
d. Hearing Disabilities.
e. Attention Deficits.
f. Language & Perceptual Deficits.
g. Behavioral Problems.
h. Mental Retardation.

3. What are the causes of Cerebral Palsy?
a. Poor oxygenation of brain during pregnancy & labour
b. Intrauterine viral infections
c. Birth asphyxia
d. Severe untreated jaundice, hypoglycemia
e. Premature infant with complications
f. Post-surgical vascular complications
g. Traumatic brain injury

4. What are the different types of Cerebral Palsy depending on the type of tone and movement?
a. Spastic (increased muscle tone) 60 to 70%.
b. Ataxic (balance and coordination) 10 to 15%.
c. Athetoid (involuntary, uncontrolled) 10 to 20%.
d. Mixed type.

5. Name the body parts involved in different types of Cerebral Palsy.
a. Hemiplegia (One arm & leg of the same side).
b. Diplegia (both legs were involved than arms).
c. Quadriplegia (all form extremities involved).

6. What are the other professionals Pediatrician refers to and for what evaluations?
a.  Speech Therapist.
b.      Physical Therapist.
c. Occupational Therapist.
d. Neuro-Psychologist.
e. Psychologist.
f. Special Education Teacher.

7. What is Multi-Handicapping Syndrome?
a. A child who has the following or combination of the conditions:
b. Neurological.
c. Sensory impairments (loss of vision/ hearing, etc.).
d. Growth.
e. Gastro-enterological Tract problems (feeding, i.e., no closure of mouth, swallowing could be a problem).
f. Respiratory problems (common in quadraplegia).
g. Orthopedic problems (contractures and deformities).
h. Osteoporosis due to poor nutrition, disease, no weight baring.

8. Are there any problems associated with Cerebral Palsy?
a. Seizure Disorders (fits) 33% - 50%
b. Discrepancy of Skeletal Growth
c. Deformities of hand, feet & pelvis
d. Contractures at joints
e. Mental Retardation 50% - 70%
f. Learning Disorder 60% - 70% (
g. Attention Deficit Hyperactive Disorders/ Behavioural problems
h. Speech deficits/ shallow breath
i. Dysarthria - 50%
j. Feeding difficulties – swallowing problems, mouth closures, tongue moments.
k. Sleep disturbances.
l. Auditory Impairments 25% to 40%
m. Visual Impairments 40% to 50%
n. Tactile defensiveness, hyper sensitivity to touch
o. Sensory Motor Difficulties

9. Can Cerebral Palsy be cured?
No; there is no known cure for CP, but treatment can improve the lives of those who have the      condition. It is important to begin a treatment program as early as possible.

10. What are the Psycho Social Intervention needed from the child if diagnosed with Cerebral Palsy?
a. Identify strengths and need of the family and child.
b. Community Services available in the locality.
c. Recreational Services available in the locality.
d. Financial status of the family and if support is required.
e. Respite care facilities available.
f. Parent Support groups.
g. Counselling Centre in the locality.

11. What are the needs of person with Cerebral Palsy who turn into an adult?
a. Maintenance Therapy (by care giver).
b. Receiving arrangements (disabled friendly).
c. Self-advocacy & Employment (self-help and advocacy).