We offer screening services to newborns and infants assumed to be at risk for developmental delays from nearby towns and cities in two pediatric clinics and two Primary Health Centres in Ahmedabad. These children are screened with the help of a newborn screening checklist OR the Developmental Assessment Scale for Indian Infants (DASII), a culturally adapted version of Bayley's Scale of Infant Development (BSID). The natural course of action from this activity, if developmental delay is found, is to counsel parents, provide them with home based plans to look after developmental needs of the baby and to regularly follow up on the development of the child. Back
Children below 5 years are assessed on the attainment of skills and behaviors appropriate to their age groups through detailed observation and examination of developmental milestones in the areas of gross motor, fine motor, vision, hearing, communication, social, cognitive, self help and behavior. Back
Mainstream school going children between the age group of 6-12 years are assessed on functional pre-academic and academic skills to identify interfering factors in skill attainment.
Developmental and functional assessments typically go on for 2 days. The child is observed for at least 2 hours on each day, making the total duration of 4 hours. After collecting complete history and background information, the child is assessed in different areas by a multidisciplinary rehabilitation team. Once the assessment and consequent case conference are over, the parents are briefed about the strengths and weaknesses of the child and an appropriate program is planned out, keeping in mind, the immediate needs of the child and the culture she belongs to. Parents are kept informed at each stage of assessment and planning. Back
Key areas:
Setu offers the following therapies through a centre based multidisciplinary early intervention approach to children with special needs:
- Special needs education: The focus here is attainment of age appropriate concepts and school readiness.
- Occupational therapy: This is aimed at attainment of proficiency in motor skills. Training includes facilitating development of various grasps, improving grip and improving eye-hand coordination and follows Bobath principles to train children on attainment of gross motor skills.
- Language and communication therapy: Children are provided intensive training to overcome hurdles in communication. Activities to facilitate production of sound, correction of misarticulation, oro-motor stimulation, comprehension of regular commands, recognition of familiar things are a few of the tasks under this. Auditory training is also an integral part of this training.
- Sensori-motor Integration Training: This aims at helping children to integrate sensory channels; vision, auditory, tactile, gustatory, olfactory, etc. with motor movements to learn about their environment.
- Group play: Once in a week, children, in groups of 4, play simple games like ball throw, catch-catch, etc., to learn sharing, taking turns and playing with others.
- Behavior modification: This training attempts to decrease maladaptive behaviors a child may have and encourage learning of a positive behavior in place of the deviant one. The approach follows principles of reward and non-reward situations to correct a maladaptive behavior.
- Activities of daily life: The focus of this training is development of skills needed in a child's day-to-day functioning. Parents are counseled for training children in feeding, eating, drinking, dressing and toilet training.
The entire spectrum of necessary therapeutic inputs is made available to these children through ensuring that each of the specialist practitioners meet each child's needs.
Session plans:
Each session in the early intervention centre is 40 minutes in duration. At a time, 4 children with their mothers are attended by one therapist. The therapist goes and works with each child in a 1:1 situation for 10 minutes and for the remaining 30 minutes, the mothers work with their children under the guidance of the therapist. In this way, we are able to provide 1.25:1 adult: child ratio all the time. Setu does not provide individual therapy sessions to children.
Each child has a monthly lesson plan and it is shared with the mother and the family. These plans are followed very strictly at the centre and preferably at home, too. At the end of the month, a follow up of the plan is done and changes are made accordingly.
Mother's role:
Mothers come to the centre for all 5 days in a week and work with their children under the therapists' guidance. This helps the mothers to see new skills, however minor, that her child is learning. It confirms her belief in her child's capacity and helps her to change the family members' perception of the child. This arrangement also empowers the mothers to take care of their children at home and makes them more participatory in their child's learning. Setu also encourages fathers' participation but keeping in mind the responsibilities of earning, not many fathers take active part in the sessions. Back
Children with special needs when admitted in mainstream schools require long term support services for effective inclusion and to continue their education. Through after school remedial support, we attempt to imitate a classroom situation in small groups of 8 children, attended by one special needs educator and an assistant, and work with them on coping skills, group behavior, academic abilities and appropriate peer interactions. Back
These are only for children with high risk of frequent illnesses and for those who live away from Ahmedabad. Typically, the family makes arrangements to stay in Ahmedabad for a week to 10 days. After assessment, a three month plan of activities is developed and shared with the family. During the following week, the mother is trained on specific activities included in the plan so that these are carried on once they return home. A follow up visit is planned at the end of 3 months to evaluate the plan and to modify it for the next 3 months. In some cases, families do stay back for a period of 1- 3 month. We are unable to make residential arrangements for an outstation family at the moment. Back
As parental participation is mandatory in achieving therapeutic goals of the child, Setu sensitizes and trains the parents, especially mothers, to enable them to take care of their children's therapeutic needs. Parents are considered active partners in a process that has as its goal, their child's well-being along with greater acceptance, ownership, participation, and responsibility on the families' part. In order to encourage and motivate parents to work with their children, Setu initiated parent counseling activities with the help of the Sir Ratan Tata Trust in 2005-06. Efforts to create a parent group have not been successful due to limited availability of mothers and other family members. Back
Professional training
Setu provides training programs on early childhood development and intervention as necessitated by the need for qualified professionals with knowledge and experience of dealing with young children with disabilities both by Setu and other organizations providing similar services. Most of the training is imparted in partnership with other organizations to groups of medical professionals, midwives, students and field workers from community based programs. Additionally, there are 3-months distance learning programs on Foundation Course conducted in partnership with the Madhya Pradesh Bhoj (Open) University and the Rehabilitation Council of India (RCI) for in-service school teachers every year since 2005.
Internships
Internships and placements are offered to students, both from India as well as abroad, from a variety of fields relevant to children and disability development. Please click here to read about interns till date. Back
Setu has an active volunteer program tailor made to benefit both, the organization as well as the volunteer. We partner with AIESEC, Ahmedabad to recruit volunteers from all over the world. These volunteers come from a variety of field such as management, psychology, human resource development and research. Setu focuses on organizational capacity and system building through their inputs. Please click here to read about volunteers till date. Back
Setu provides information on various aspects of children with disability and Setu’s work with them. We have prepared pamphlets on developmental milestones and posters on successful individuals with disabilities, both in English and Gujarati, to reach groups of stakeholders and wider population. We also reach out to doctors and rehabilitation professionals to increase their awareness on our work through various meetings. We publish articles in local newspapers, provide representation in visual media and maintain a website to inform people on these issues. Back