Understanding the Multiple disabilities

When a child is reported with few different types of disabilities then the term multiple disability is used.
For example, a child may have difficulties in understanding, learning, along with controlling their movements, with a loss in hearing and vision along with speech and language impairment.

The effect of multiple disabilities can be more than the combination of two individual disabilities.
Like any other disability, a child who suffers from multiple disabilities should receive help as early as possible. This could be achieved by its early diagnosis and remedial methods through its early intervention and therapies, so that the child can be helped to achieve their potential, and so that their disabilities should not become even worse.

In India, the majority of the children with multiple disabilities are yet to be identified because of the complication of diagnosis owing to the comorbidities.
During the diagnosis process and further during the intervention and therapies, it is required to understand by the parents and professionals working for the child development that the child with the multiple disabilities will be slow to make progress and will have difficulty in understanding, generalizing in comparison to other children. 

Hence, it  becomes very important to keep in mind a few points here-

1. Parents, Caregiver and the therapists should be very very patient in handling such children.

2. Parents should set some realistic goals after having a discussion with the child’s therapist.

3. The goals set should be small and achievable.

4. The goals set for the child should be further broken in multiple small steps as generally these children can learn only in small steps.

5. Each step of one particular set goal should be skilled by a lot of practice and repetition.

6. Each set goal should be revised and generalized creating different scenarios and setups, including different parameters and possibilities.

7. The children with multiple disabilities have difficulty with the muscle movement, with the understanding, with the abilities of vision and hearing, and even the speech and communication is also very difficult for them. So, therapists should design the learning method for such children keeping in mind how much they would be able to understand and would be able to communicate their responses in return.

8. Often, the attempts to communicate by such children may pass unnoticed by even their parents or caregivers as their way of communication may be unfamiliar to them, so generally at first their initial therapies should be focused more on understanding and communicating with them. 

9. For the above mentioned reason, of not able to properly understand and communicate with these children, therapists, doctors may wrongly label a child as being mentally handicapped when they may be not.

10.  Therefore, initially the focus should be to establish communication and to try to assess their understanding and expression to ensure that they’re not wrongly labeled or diagnosed. 

Some examples of multiple disabilities are:

1.Deaf-blindness (Visual Impairment + Hearing Impairment)
2.Visual Impairment + Hearing Impairment + Mental Retardation
3. Visual Impairment + Mental Retardation
4  Cerebral Palsy + Mental Retardation/ Hearing/ Speech/ Visual problems
5. Visual Impairment+Autism spectrum disorders +Speech Impairment 

Children with multiple disabilities may present with a diversity of needs across all areas of development, such as speech and communication, parent–child relationships, cognition and learning ability, fine motor, gross motor and perceptual development which causes severe educational needs that cannot be accommodated in special education programmes solely for children with multiple disabilities.

As learning occurs through vision and auditory hearing methods primarily apart from learning through touch and feel, kinesthetic methods etc, therefore, children with multiple disabilities need therapies and learning methods meeting their needs and that should be provided by skilled therapists, educators, professionals and paraprofessionals of this field who can create appropriate communication and learning opportunities for them.

Due to the lack of knowledge and skills on communication, educators dealing with children having multiple disabilities often miss to notice, or misinterpret the small, slow-paced and quite difficult to interpret interactions of these children, causing frustration for both the educator and the child, even to the parents for that matter.

So, educators and parents dealing with such children often experience significant challenges to deal with these children possibly because of their lack of adequate knowledge on different disabilities and the lack of training on communication, teaching and learning strategies.

In India, the National Association of Blind NAB  does a remarkable work in this area. It provides facility to the families of such children through their dedicated department for Multiple disabilities.

The senior special educator and the training coordinator of NAB who is working in this field from more than two decades Mrs.Poonam Pandey is associated with specialsaathi team as one of the ParentSaathi to spread awareness and create help for people with multiple disabilities.

She will also be a part of an upcoming ParentSaathi talk on 4th December ’22 to mark the world’s disability day(3rd December), with our community. She will be discussing more on multiple disabilities and the related approaches to help such families during our ParentSaathi talk.

Dr.Vikas Dixit is a visually impaired parent having two children with Multiple disabilities (vision impaired + Autism spectrum disorder+ communication Impairment) is also  associated with specialsaathi team as one of the ParentSaathis.

Parents needing help on the multiple disabilities matters may get in touch with the above ParentSaathis. Till then, keep learning more on different disabilities and creating awareness and help with us.

Thanks for reading!!

Author Shilpi Mayank Awasthi