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Helping children with multiple disabilities

Fri, 09/01/2017 - 10:50 -- geeta.nair

Muskan provides intervention at various levels under one roof

Ahmed Piyarji (6), could not sit for 10 minutes at a stretch and had difficulty seeing things at a distance. Last year, he was diagnosed with low vision and hearing impairment along with cerebral palsy

After sustained special education, speech therapy, physiotherapy, occupational and vision therapy, he can sit up and perform daily activities like eating and drinking with limited assistance. He is also doing well in areas like fine motor and gross motor skill development, socialisation and communication.

Piyarji is a child with multiple disabilities, and needs intervention at various levels. Muskan Foundation, a not-for-profit, came to his aid. Muskan provides a spectrum of services such as early intervention, education, therapy and counselling to children with multiple disabilities with visual impairment (MDVI).

“With the help of vision rehabilitation he has started seeing things more clearly,” says Dipti Gandhi (54), Muskan founder.

Ms. Gandhi says there is poor awareness about multiple disabilities in our country. The term, ‘multiple disabilities’, refers to combination of two or more disabilities. Children with multiple disabilities need an array of services such as occupational therapy, physiotherapy, speech therapy, vision rehabilitation programme and special education but very rarely are all services offered under one roof. Parents have to often cart their children from one remedial centre to another.

The beginning

As a low vision consultant, Ms. Gandhi came across many children with multiple disabilities whose problems were not understood. “Even in a city like Mumbai, while there were many special schools, there was not a single school offering services to children with more than one disability. Not thinking much about how, when or what, I just started a centre with four children and two teachers in 2006 and by February 2009, Muskan Foundation was registered,” says Ms. Gandhi.

Soon after Ms. Gandhi quit her job with National Association for the Blind and in 2003, she started conducting functional vision assessment at a clinic in Andheri. “During this period, I came across many children with varied types of MDVI and my detailed assessment reports began to be taken into consideration by doctors and therapists,” she says.

However, on parents’ request, she decided to start a centre that would provide all the services under a single roof. “The main objective of this venture was to bridge the gap in schools and education centres, which are usually not equipped to handle multiple disabilities along with blindness.”

The foundation commenced its work with four children and just two teachers. Today, it has grown to 77 students receiving special education and 188 children receiving therapy across three centres in Mumbai: at Bandra, Goregaon and Parel (Wadia Hospital). “We provide special education and therapy services to children maintaining a 1:3 teacher-child ratio. We also provide 1:1 teacher-child service in case of severe disabilities,” says Ms. Gandhi.

Multiple interventions

Each child with multiple disabilities is unique, with her own set of experiences, medical condition, style of learning, likes and dislikes. Thus, no two children with the same combination of disabilities can share a programme, says Nupoor Mhatre (25) physiotherapist at the centre.

At Muskan, child-centered plans called Individualised Educational programmes are devised, keeping in mind the child’s special needs. Children are trained with the help of appropriate teaching aids, and equipment such as CCTVs, Braille and tactile books are employed. “Muskan not only teaches the kids, it also offers comprehensive therapies, counsels parents and creates awareness,” says Ms. Mhatre.

Muskan provides a structured assessment, diagnosis and consultation as early as when the child is three months old. A multidisciplinary team assesses vision, hearing, intellectual capacity and physical capabilities of each child. “The apt therapy is selected and complemented with special education. Keeping the child’s age in mind, she is enrolled in an early intervention programme or the special education programme.”

The vision rehabilitation programme has been devised by Ms Gandhi, and Muskan is the only organisation offering this service in Mumbai, says Ms. Mhatre.

“Our children often develop very good receptive communication skills, but lack in expressive communication. With the help of speech therapy, the child learns to communicate his needs, which in turn helps him socialise better,” says Asha Kumar, speech therapist at the centre.

Poonam Mehra has been bringing her daughter Ankita (10) to Muskan for the past eight months. When she was a year old, doctors found she had delayed milestones, speech difficulties, low vision and a behaviour pattern

similar to autism. “However, now she enjoys coming to Muskan and responds positively to music therapy,” says Ms. Mehra.

Like her, Varun Mhapralkar (9), who was diagnosed with low vision, autistic behavior and delayed milestones, has started responding well to the various therapies. “He can now walk on his own, hold a brush and even do his homework with his brother’s help,” says Akshata Mhapralkar, his mother.

The services are subsidised and if someone is unable to afford them, Muskan helps with sponsors. Muskan has a team of 26 paid employees, of whom six are therapists, 16 are special teachers and four look after administration.

Ms. Gandhi’s ultimate goal is to “paint a smile across all these delightful canvases of the almighty and help them live an independent, confident and happy life.”


Muskan Foundation

Founder: Dipti Gandhi

Employees: 26

Funds: Self, CSR, donations


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