handicap develops as the consequence of the disability. It is defined as a disadvantage for a given individual resulting from impairment or a disability that limits and prevents the fulfillment of a role which is normal for that individual, depending on age, sex, social and cultural factors.

1. PHYSICALLY ,MENTALLY
&SOCIALLY CHALLANGED
CHILDREN

2. HANDICAPPED CHILDREN
Handicapped child is one
who deviates from normal
health status either
physically, mentally or
socially and requires
special care, treatment
and education.

3. DEFINITION
According to WHO, the sequence of events leading
to disability and handicapped conditions are as
follows
Injury or disease
Impairment,
Disability,
Handicap

4. CLASSIFICATION OF
HANDICAPPED CHILDREN
Physically handicapped
Mentally handicapped
Social handicapped

5. PHYSICALLY
HANDICAPPED
CHILDREN

6. PHYSICALLY HANDICAPPED
CHILDREN

7. BLINDNESS
According to WHO the inability to count fingers in
day light from a distance of 3 meters is defined as
blindness.

8. PROBLEM FACED BY BLIND
CHILD
 Problem of attachment
 Unable to use hand as organ
of perception
 Problem on locomotion
 Dependence on parents and
caregiver
 Behavioral problems
 Less social interaction
 Less playing activity

9. Prevention Of Blindness
 Provide good antenatal
care
 Immunization –
meseals, rubella
 Genetic counseling and
screening
 Prevent infection
 Prevent pre term birth
and
 provide excellent
neonatal care to pre

10. Cont….
 vitamin A supplement
 health education about eye
safety, personal hygiene
and nutrition for health
promotion
 Treatment of causes of
childhood blindness
 Retinopathy of
prematurity (ROP)
 Cataract
 Glaucoma

11. Management
 Physiotherapy
 Orientation and
mobility
instructors
 Mobility aid and
guides
 BRAIL
technology

12. DEAFNESS
A person who is not able
to hear as well as
someone with normal
hearing .
It can affect
one ear or both ears, and
leads to difficulty in
hearing conversational
speech or loud sounds

13. LEVELS OF HEARING
IMPAIRMENT
Mild deafness
25 to 39dB
Moderate deafness
40 to 69dB
Severe deafness - 70 to
89dB.
Profound deafness - 90dB <

14. IMPACT OF HEARING LOSS
Functional impact
Poor Academic Performance
Social and emotional impact
Economic impact

15. MANAGEMENT
 Sign language
 Hearing devices -
hearing aids,
assistive listening
devices and cochlear
implants.
 lip-reading skills
 Speech therapy-
 use of written or
printed text

16. SPEECH HANDICAPPED
 means an impairment of
speech or sound
production, fluency,
voice or language which
significantly affects a
child’s educational
performance or their
social, emotional or
vocational development.

17. TYPE OF SPEECH
IMPAIRMENT
Articulatio
n disorder
Fluency
disorder
-
stuttering
Voice
disorder
Aphonia
Langua
ge
disorder

18. EMPACT OF SPEECH
IMPAIRMENT
 Poor Communication skill
 Less social interactions
 Behavioral problem - children
may feel shame,
embarrassment, frustration,
anger, and depression as a
result of speech impairments.
 Poor academic performance

19. MANAGEMENT
 Early identification of speech
impairment
 Elimination of hearing impairment
 Medical and surgical intervention for
underlying causes
 Psychological counseling
 Avoid making fun of their voice or
speech
 Voice or Speech therapy
 Physical therapy
 Cognitive rehabilitation

20. ORTHOPEDICALLY
HANDICAPPED
 Orthopedic disability occur when
movements in over body are
affected due to disease, injury,
any absence or deformities in the
joints, bones, muscles or an injury
in nervous system
 Loco motor disability means
disability of the bones, joints or
muscles leading to substantial
restriction of the movement of the
limbs

21. MANAGEMENT
 Correction Of
Deformities
 Physical Therapy
 Occupational
Therapy
 Massage Therapy
 Prosthetics
 devices for
positioning and
mobility

22. DEVICES FOR POSITIONING AND
MOBILITY
 Canes
 Walkers
 Crutches
 Wheelchairs
 Specialized
exercise
equipment
 Specialized
chairs, desks,
and tables for
proper
posture
development

24. MENTAL HANDICAPPED
 A mental handicap is an
impairment in an
individual's ability to
function cognitively,
emotionally or physically
due to the presence of a
psychiatric condition. This
condition hinders
someone's ability to
perform a task or
prevents that person from
engaging in an activity
without assistance.

25. Mentally handicap children
include
MENTAL
RETARDATIO
N
CEREBRAL
PALSY

26. MENTAL RETARDATION
Mental retardation is
defined as significantly sub
average general
intellectual functioning,
resulting in associated with
concurrent impairment in
adaptive behavior, which
manifests during the
developmental period”.
(American Association on
Mental Deficiency)

27. MENTAL RETARDATION
LEVEL
Mild - 50-
70*
Moderate
- 35-50*
Severe -
20-35*
Profound
<20

28. EFFECT ON CHILDREN
 Failure to achieve
developmental milestones.
 Deficiencies in cognitive
functioning such as
inability to learn or to meet
academic demands.
 Expressive or receptive
language problems.

29. Cont…
 Psychomotor skill deficits.
 Difficulty performing self care
activities.
 Neurologic impairments.
 Medical problems, such as
seizures.
 Low self esteem depression
and labile moods.
 Irritability when frustrated or
upset.
 Lack of curiosity

30. TREATMENT MODALITIES
 Behavior management.
 Environment supervision
 Monitoring the child’s developmental needs and
problems.
 Programs that maximum speech , language,
cognitive, psychomotor, social , self care, and
occupational skills.
 Family therapy
 Early intervention programs for children younger
than age 3 with mental retardation.
 Provide day schools to train the child in basic skills,
such as bathing and feeding.

31. CEREBRAL PALSY
 It is a disability that
affects ability to control
muscles caused by
damage to the brain
while the brain is
developing.

32. EFFECTS OF CEREBRAL
PALSY
 Abnormal Muscle Tone
 Abnormal movements
 Skeletal deformities
 Seizures
 Speech problems
 Swallowing problems
 Hearing loss:
 Vision problems
 Dental problems
 Bowel and/or bladder
control problems

33. SOCIALLY
CHALLENGED
CHILDREN€

34. SOCIALLY CHALLENGED
CHILDREN
 A Socially handicapped
children may be defined as
a child whose opportunity
for a healthy personality
development and full
unfolding of potentialities
are hampered certain
elements in his social
environment such as
parental inadequacy,
environmental deprivation,
(lack of learning
opportunity) and emotional
disturbance

35. CATEGORY OF SOCIALLY
HANDICAPPED CHILDREN
 Orphan
 Neglected
children
 Children of
divorce or step
parents
 Delinquent
children

36. ORPHAN
CHILDREN
An orphan is a child
permanently bereaved of
or abandoned his or her
parents. a child lost both
parents is called orphan
does not have any
surviving parents to care
for him or her

37. PROBLEM ASSOCIATED WITH
ORPHANS
 Developmental
retardation
 Conduct and sleep
problem
 Personality problem
 Bed wetting
 Disturbance in eating
 Depression
During adulthood
 Antisocial problem
 Drug addiction
 Alcoholism
 Marital problem

38. CHILD NEGLECT
 Child neglect is an
ongoing failure to
provide the right care
and attention to a child's
needs, including food
and a safe environment,
or to a child's emotional
needs including warmth,
security and love. A lack
of these things are likely
to result in serious
damage to the child's
health or development.

39. TYPES OF CHILD NEGLECT

40.  parental mental health
problems such as
depression
 Unstable and abusive
relationships between
parents
 parental history and learned
parental behavior
 lack of knowledge of
children's needs,
 an inability to plan, lack of
confidence about the future,

41. Cont…
 being a teenage
mother,
 Alcohol and drug
abuse in care-givers
 unemployment
 poverty
 a large number of
children,
 high levels of stress
 domestic violence

42. CONSEQUENCES OF NEGLECT
 Developmental delays-
socialize
 delayed physical and
mental growth,
 Neurological impairments.
 poor social skills,
 experience extended
poverty or unemployment
 Face chronic illnesses or
early death.
 cognitive deficits,

43. Cont…
 emotional development
problems –
 Unusual fussiness, fear, or
 Lack of interest in activities.
 Being anxious or avoiding
people
 Difficulty in making friends
 Being withdrawn.
 The effects on behavioral
development
 Anti-social behavior
 Early sexual activity

44. Cont…
 Poor mental health, such as
exhibiting low self-esteem,
anxiety, depression, or suicidal
tendencies.
 Insecure-anxious attachment.
 Attachment difficulties and
difficulty in formation of
relationships in the future
 Affects intellectual ability and
cognitive/ Sudden decline in
academic performance.
 Anxiety or impulse-control

45. Cont….
 Failure to thrive”
 Obviously unhealthy
 Dirty or have poor
personal hygiene or
Inadequately clothed.
 The effects may last into
adulthood and may cause
a person to neglect their
own children later in life.

46. Management
For Parents
 Treatment for
 Substance abuse.
 Depression or other mental
health problems.
 Low self-esteem
 Violent behavior
 realize responsibility regarding
child
 educating and helping parents
to correct their erroneous
thinking and behavior or

47. Cont….
For Child
 Child-centered interventions
include
 pediatric care, mentoring
 Behavioral and mental
health treatment.
 Provide stimulation
programme to emotionally
neglected child
 Develop timely and
comprehensive assessments
or placed in foster home

48. CHILDREN OF DIVORCED OR
SEPRATED PARENTS
 A divorce always affects
children, even adult
children, and divorce is
almost always stressful for
children. And lead to lost
contact with one parent,
create economic hardships,
and increase conflict
between parents For all
these reasons, most
children have a hard time
during the divorce transition.

49. EFFECTS OF DIVORCE OR
SEPERATION ON CHILDREN
Infants
 Loss of appetite.
 Upset stomach — may spit up more. More fretful or
anxious.
Toddlers
 More crying
 Sleeping Problem
 May feel anger
 May worry when parent is out of sight.
 May withdraw, bite or be irritable.
 Temper tantrums

50. Cont…
Preschoolers
 Feels uncertain about the future.
 May feel responsible.
 May hold anger inside.
 May become aggressive and angry
toward parent he/she lives with.
 May have more nightmares.
 Experiences feelings of grief because
of sudden absence of parent.

51. Cont….
Early elementary
 Feels unfaithful and feels a sense of
loss.
 Feels rejected by the parent who left.
 Ignores school and friendships.
 Worries about the future.
 Complains of headaches or
stomachaches.
 Experiences loss of appetite, sleep
problems, diarrhea, urinary
frequency.
 Learning problem in school

52. Cont….
Preteens and adolescents
 Feels angry and disillusioned.
 Feels abandoned, that parent is leaving
him/her not the other spouse.
 Shows extreme behavior (good and bad).
 Involved in high-risk behaviors (drugs,
shoplifting, skipping school).
 Anti social behavior
 Drug or alcohol abuse
 Problem in maintaining relationship.
 Worries about financial matters.

53. MANAGEMENT
 Not expose child to conflict
between parents
 Listen to child and provide
emotional support
 Child should be reared to
respect to both parents
 Child should taught that both
parents are nice people but are
separating because of they
have different views about life

54. PREVENTION
OF
HANDICAPPED
CONDITION IN
CHILDREN

55. PRIMARY PREVENTION
 Genetic counseling
 Genetic screening
 Reduction of
consanguineous marriage
 Pregnancy planning
 Rh incompablity
 Immunization of mother and
baby
 Vitamin A prophylaxis
 Improve nutritional status of
mother and child

56. Cont….
 Prevention of iodine and folic
acid deficiency
 Provide essential care in
prenatal, Intranatal, postnatal
period
 Prevent maternal and neonatal
infection
 Prevent birth injury, asphyxia,
hyperbilurubinemia
 Special care to high risk mother
–abortion, premature birth
 Encourage to kick bad habits
such as smoking or alcohol
abuse.

57. SECONDARY PREVENTION
 Careful history
 Regular medical supervision
and developmental
assessment
 Tereatment of particular
handicap condition
 Correction of deformity
 Physiotherapy and exercise
to improve physical
condition
 Occupational therapy

58. Cont…
 Speech therapy to
improve communication
ability
 Prosthetics
 Special care for mentally
handicapped children with
warmth , love , tolerance,
discipline, avoid criticism
 Counseling and guidance
 Referral for welfare
services

59. REHABILITATION OF HANDICAP
CHILDREN
 Medical
rehabilitation
 Social
rehabilitation
 Educational
rehabilitation
 Psychological
rehabilitation
 Vocational
rehabilitation

60. WELFARE OF
HANDICAPPED
CHILDREN

61. WELFARE OF HANDICAPPED
CHILDREN
 Persons with disabilities bill
(equal opportunity, protection of
right and full participation)-
1995,introduced by ministry of
welfare and Govt of India and it
deal with preventive and
promotional aspect of
rehabilitation
 Children Act 1960- provide for
the care protection, maintenance,
welfare, education, and
rehabilitation of socially
handicapped children.

62. Schemes for handicapped
children
 Deendhyal disabled rehabilitation scheme
 Assistance to disabled person to purchase or
fitting of aids and appliance
 National handicapped finance and development
cooperation
 Scheme for implementation of person with
disabilities act 1995(sipda)
 Scheme for incentive to employees in the private
sector for providing employment to person with
disabilities

63. National institute for handicapped
 National institute for orthopedically handicapped
Calcutta
 National institute for mentally handicapped
Hyderabad
 Ali yavar Jung National institute for hearing
handicapped Mumbai
 National institute for rehabilitation, training, and
research Calcutta
 National Institute for visually handicapped new
Delhi and Dehradun

65. NURSING MANAGEMENT OF
HANDICAPPED CHILDREN
 Ineffective family coping and
altered parenting related to
handicapped condition
 Anxiety of parents and family
members
 Altered nutrition less than body
requirement
 Potential for infection
 Self care deficient
 Communication impaired
 Physical mobility impaired

66. Cont…..
 Altered elimination pattern
 Activity intolerance
 Altered sleep pattern
 Sensory alteration, visual/
auditory
 Altered growth and
development
 Diversional activity deficit
 Knowledge deficit to
continued care of
handicapped children

67. Conclusion
 handicap develops as the consequence of the
disability. It is defined as a disadvantage for a
given individual resulting from impairment or a
disability that limits and prevents the fulfillment
of a role which is normal for that individual,
depending on age, sex, social and cultural
factors.