Training and Rehabilitation of Challenged Children

TRAINING AND REHABILITATION OF CHALLENGED CHILDREN
Rehabilitation of challenged children should be approached by combined

and co-ordinated use of medical, social, educational, psychological and vocational
measures for training and retraining the children to the highest possible level of
functional ability. It includes all measures to reduce the impact of disabled and
handicapped conditions and to achieve social integration by active participation of
the individual in the community.
The process of rehabilitation should involve the following aspects:
❖ Medical rehabilitation includes restoration of functions by prosthesis, artificial

limbs, etc.
❖ Social rehabilitation includes restoration of family and social relationship by
replacement in the family.
❖ Educational rehabilitation includes specialized training and educational
facilities, e.g., Braille for blind, sign language for deaf and dumb.
❖ Psychological rehabilitation includes restoration of personal dignity and
confidence during the period of growth and development and in adult life.
❖ Vocational rehabilitation includes restoration of the capacity to earn a
livelihood. This can be achieved by community participation and social
legislation for the challenged individual. The community needs to offer
employment opportunities in shops, factories and other business establishment.
The challenged child needs to be trained for an independent living with special
training and education. In India, there are more than 150 schools and institution for
the challenged children. These include day care centres, special school, (for blind,
deaf and dumb) vocational training centres, special hospitals for crippled children,
etc. These available welfare services of Govt. of India provide support services to
the challenged individuals and enabling the families to assume a large share of
rehabilitation within the family cycle. Non-Govt. organizations are also working
along with Govt. institutions for training, vocational guidance, counselling,
manpower development, research, assistance for supply of aids and appliances to
the handicapped and dissemination of information.
The Ministry of Welfare, Govt. of India has introduced a comprehensive Bill in the
parliament known as “Persons with disabilities” (equal opportunities, protection of
right and full participation) Bill, 1995. It deals with preventive and promotional
aspects of rehabilitation.
The Children Act, 1960, provides for the care, protection, maintenance, welfare,
education and rehabilitation of socially handicapped children.
The following National Institutes are working for the specific disabilities to
provide care and welfare services in various aspects of the challenged child.
• National institute for Orthopedically Handicapped, Bonhooghly, Kolkata.

• National Institute for Mentally Handicapped, Secunderabad
• National Institute for the visually Handicapped, New Delhi and Dehradun
• Ali Yavar Jung National Institute for the hearing Handicapped, Mumbai
• National Institute for Rehabilitation, Training and research, Cuttack.
Nursing management
Nursing personnel play a vital role to assist the family members to cope with
the crisis situation for the challenged condition. Planning and providing care to the
challenged children (especially physically and mentally challenged) in health care
institutions and community are important nursing responsibilities including
parental involvement and community participation. Assisting the family to
strengthen effective relationship and bondage to prevent children from becoming
socially handicapped. Nurses are responsible for creation of awareness in the
society about the prevention of handicaps, the abilities of the child with a handicap
condition and the potentialities present in him/her. Nursing management should
emphasize on three levels of prevention of handicapped individual. Nursing care
for the physically and mentally handicapped children in hospital and home should
emphasize on the following aspects other than the specific problems present in
them.
Nursing assessment
Complete assessment includes history of the condition, thorough physical and

neurological examination, specific investigations, review of developmental
screening, assessment of parent-child interaction and family coping,
socioeconomic status, available support facilities, etc. Nursing diagnosis
• Ineffective family coping and altered parenting related to the challenged

condition
• Anxiety of the parents and family members
• Altered nutrition, less than body requirements
• Potential for infection
• Injury, risk for
• Self care deficit, bathing, feeding, dressing, toileting, hygienic care, etc.
• Communication impaired
• Physical mobility impaired
• Elimination pattern, altered
• Activity intolerance
• Altered sleep pattern
• Sensory alternation, visual/auditory
• Growth and development altered
• Diversional activity deficit
• Knowledge deficit related to continued care
Nursing diagnosis should be made based on subjective data and objective data.
Nursing interventions should be planned on the basis of priority problems

according to short term and long-term goal. Challenged children can be cared in
the general hospitals, special health care setting, community health care centres in
primary level and at home. Day-care centres, special schools, rehabilitation
centres, occupational therapy and vocational training centres also can provide
various services to these children. Nurses are key person for home based or
hospital-based care to guide and assist the parents and family members to promote
optimum health of the children. Nurses are also contributing in the special care
settings for the challenged children to bring them as close to normality as possible,
physically, mentally and socially.

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TRAINING AND REHABILITATION OF CHALLENGED CHILDREN

Rehabilitation of challenged children should be approached by combined

The process of rehabilitation should involve the following aspects:

❖ Medical rehabilitation includes restoration of functions by prosthesis, artificial

• National institute for Orthopedically Handicapped, Bonhooghly, Kolkata.

Complete assessment includes history of the condition, thorough physical and

• Ineffective family coping and altered parenting related to the challenged

Nursing interventions should be planned on the basis of priority problems

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