Medical assistance
Adarsh believes that the medical problems that children with challenges face cannot be ignored by special schools on the ground that 'disability is not a medical problem'. At Adarsh we believe that the correct position is that 'disability is not only a medical problem' and that, therefore, unless the medical problems of the affected children are also attended to simultaneously with therapy , development of skills and academic training , the rehabilitation of the child gets delayed/affected to that extent. It has, therefore, been our effort to associate experts in several medical disciplines in which our children need help from doctors. We have a panel of distinguished medical practitioners of various disciplines. We take advice from them on all medical problems, arrange for periodical and special examination of children by the concerned specialist and even help in arranging for surgery and post surgical assistance.

PANEL OF EXPERTS

1. Dr Abraham K Paul MD ( Ped), DCH 
Pediatrician, Cochi Hospital, Ernakulam

2. Dr Deepak Sharan
MS Ortho, DNB Ortho, Dip.Ortho, MSC Orthopedic Engineering (UK),

3. Dr. S.Sachidanada Kamath, MD (Ped)
Pediatrician, Welcare Hospital, Ernakulam

4. Dr. Chalam Das, MD (Psychiatry)
Child Psychiatrist

5. Dr. Neena Shilen MD (Pediatrician), FAAP (USA)
Developmental Pediatrics (Sunrise Hospital)

6. Dr. Biju Raju, MS., FNB (Vitreoretinal Diseases)
Eye Surgeon, Rejnini Eye Clinic, Vyttila, Ernakulam.

7. Dr (LT.Col) MathewsT. George, MS
ENT Surgeon, SHRAVAN, Vyttila, Ernakulam

8. Ms.Prabha Ranganathan, M Phil (Psychology)

9. Shri.Biju Nirmal Jacob- MPT ( Physiotherapy)

RISK BABY UNIT

Growth and Development are the two complementary processes peculiar to children, which influence the quality of life in their later life. Advances in the peri-natal care and the establishment of neonatal nurseries have improved the survival chance of many newborns that would otherwise have succumbed. This, however, tends to increase childhood developmental delays, speech problems, behavioral problems, attention deficit and hyper-kinetic disorders and scholastic backwardness. Very often, these problems are identified late, may be at school going age by which time the rehabilitation measures that can be taken, are not able to bring out the best in the child. Hence, if special care/ intensive care services are available in a hospital, it should be mandatory that neonatal follow up and early stimulation service are also made available.
In an increasingly competitive world it is essential to ensure that a child grows and develops to its full developmental potential. Even for a normal healthy newborn, parenting skills are necessary. Medical science has developed to such an extent that it is now in a position to save the lives of a number of a very low birth weight babies, asphyxiated and sick babies. This highlights the need for A "Risk baby Unit", where a trained Clinical Child Developmental Therapist adopts early detection practices for developmental delay, subsequently leading on to early intervention therapy. There are many sophisticated, scientific methods for the assessment of development in children, simple screening procedures which can be used by the community by field workers and can be propagated even among illiterate mothers.

A child is said to have developmental delay when he/she does not attain the specified developmental milestones at the excepted times?

Adarsh was able set up such a RISK BABY UNIT in August 2005 in association with Child Developmental Centre, Trivandrum at 3 major Hospitals in Ernakulam District, namely Ernakulam Medical Centre (2 days), Lakshmi Hospital (2 days)  PVS Hospital (1 day). In these hospitals, this unit works under the close supervision of Neonatology and Pediatric departments.

What does the Child Development Therapist do ?
Determines the existence of a developmental delay
Identifies the strengths and needs
Develops strategies for intervention
Determines progress on significant developmental achievements
Serves as a medium for reporting to parents about the child?s progress
Counsels parents

For this, the Therapist uses various assessment tools, they are:

Trivandrum Developmental Screening Chart (TDSC)
Denver Developmental Screening Test (DDST)
Neurological Evaluation- Amiel-Tison Passive Angles Method
CDC grading for motor milestones (Child Development Center-Trivandrum)
Developmental Observation Cards (DOC)
Assessment of Hearing loss in Early Infancy


The objectives of this unit are:

1. Stimulating the child through normal developmental channels
2. Prevention of developmental delay
3. Prevention of Asymmetry and Abnormalities

   To prevent atrophy of muscles
   To prevent deformity of joints
   To prevent contractures of joints
   To decrease the tone of muscles
   To prevent the tightening of tendons

4.Detection of transient abnormalities and minimization of persistent abnormalities

NEW BORN HEARING SCREENING PROGRAMME
ECHO CHECK AUDITORY SCREENER

A New Born Hearing Screening Unit has been set up as a joint project of Adarsh and Indian Academy of Paeditrics Childhood Disability Group. This unit is for checking the hearing ability of newborn children and for further corrective action when needed. The initial check is done through a sophisticated portable machine called "Echo Check Auditory Screener?, which helps to screen the hearing ability of newborn babies as well as children. By this programme it is intended to get all newborn babies routinely screened before they get discharged form the hospital. A trained person visits the selected hospital on a particular day. Arrangements are also made for follow up action in case it is needed. At present Adarsh had made this facility available at the following hospitals:

 Lekshmi Hospital, Aluva
 Shaji Hospital, North Paravur
 KMK Hospital, Aluva
 CDEIRC, Vyttila, Ernkaulam

The babies get screened by the screener, ( manufactured by Otodynamics, Hatfield, U.K) before discharge from the hospital. Protocol followed is based on NHS (U.K) protocol. If the initial test reveals anything abnormal, it is repeated after 2 weeks.

An abnormal result may be got if the middle ear is not aerated as may occur in the first few days of life or, if there is cerumen in the ear canal (the reason why the test is repeated after 2 weeks). If the second test also is abnormal , the baby is subjected to BERA test for confirmation of hearing loss and also for quantification of hearing loss. An abnormal OAE result by ECHOCHECK indicates abnormal cochlear function. Almost all cases of hearing loss in newborns are due to a cochlear pathology.

WHY EARLY SCREENING?

The incidence of hearing loss in general infant population is 0.2 -0.4% (incidence in high risk newborns is 1.5 % - 15%). If hearing loss is present, it should be detected and remedied before the baby is 6 months old, lest the baby should develop impaired speech and language, due to the hearing impairment.

Hearing Screening is a must in the following situations:
Neonates
Birth weight less than 1500gms
Hyper-bilirubinaemia at a serum level requiring exchange transfusion.
Bacterial meningitis.
Apgar scores of 0 to 4 at one minute or 0 to 6 at 5 minute.
Mechanical ventilation lasting 5 days or more.
Ototoxic medications
Family history of hereditary childhood Sensory neural hearing loss.
Intrauterine infection (TORCHS)
Cranio-facial anomalies.
Stigmata or other findings associated with a syndrome known to include a sensory neural and / or conductive hearing loss.