Dr.

Shamanthakamani Narendran
MD (Pead), PhD (Yoga Science)

YOGA THERAPY FOR MENTALLY CHALLENGED CHILDREN

Flow of blood to the brain is enhanced and brain cells are stimulated by yogasanas Inverted poses Psychic union pose (Viparitakarani) Shoulder Stand (Sarvangasana) Fish Pose (Matsyasana) Plough pose (Halasana) Standing poses Hands to Feet pose (Padahastasana) Triangle pose (Trikonasana)

improve concentration
Balancing poses Tree pose (Vrksasana), Half Moon pose (Ardha Chandrasana) Headstand (Sirsasana)

physical flexibility & self confidence

Postures to increase physical flexibility: Surya Namaskars done with coordinated breathing. Back bending poses: Cobra pose (Bhujangasana) Camel pose (Ushtrasana) Wheel pose (Chakrasana) (help enhance their levels of self confidence and also body posture).

Breathing exercises Dog breathing, Rabbit breathing, Lion breathing, Tiger breathing, Cat stretch.

om shanti om
It is tough to teach these kids meditation, even though it is the most crucial aspect of Yoga for better brain functioning. For this reason incantations of Aaah, Uuuh, Mmm, and OM besides loud chanting of longer mantras help bestow the same effect in these kids.

mentally challenged
Subaverage cognitive functioning and deficits in two or more adaptive behaviors with onset before the age of 18. A mentally challenged child is able to pick up things at a far slower rate than normal kids. At maturity that persons capability for understanding and learning will also be far lower than average.

(Intelligence Quotient) IQ!!!

IQ indicates a person's mental abilities relative to others of approximately the same age.

IQ - Equation
Potential that denotes their skill in handling different circumstances is called the Mental Age (MA). Their real age is called the Chronological Age (CA). Calculated by multiplying Mental Age (MA) with 100, and then dividing the number with the Chronological Age (CA) is the Intelligence Quotient (IQ).

IQ = (100*MA) / CA

classification
Mild
educable Moderate Severe and profound handicaps.

classification of mentally subnormal

< 20
20 34 3549 50 69 70 79

Profound mental retardation (highly severe) Severe mental retardation Moderate mental retardation (trainable) Mild mental retardation (educable) Borderline intellectual functioning

Grading of IQ
< 20 20 49 50 69 70 79 80 89 90 109 110 119 120 139 140 + Idiot Imbecile Moran Backward Dullard Normal Superior Very superior Genius

CAUSES
Several biomedical, Sociocultural and Psychological factors.
Prenatal (during pregnancy), Natal (during birth), and Postnatal (after birth).

prenatal causes
Metabolic conditions in the fetus like phenylketonuria, Galactosemia, Mucopolysaccharidosis. Neurodegenerative disorders Chromosomal disorders like Down's syndrome, Klinfelter syndrome Tuberous sclerosis. Cretinism Maternal conditions like drug abuse, intrauterine infections, placental insufficiency or exposure to radiation during pregnancy.

natal factors
Birth injuries Hypoxic, ischemic encephalopathy Intracerebral hemorrhage

postnatal factors
Infections of the central nervous system Head injuries Post vaccination encephalopathies Jaundice Hypoglycemia Iron deficiency Hypoxia Child abuse Malnutrition Autism.

predisposing factors
Associated with an increased risk for mental retardation in the children.
Low socioeconomic status, low birth weight, advanced maternal age and consanguinity of parents

DIAGNOSIS
Complete general and neurological examination must be carried out by the physician. IQ testing should be done. Down's syndrome, cretinism and other conditions should be ruled out. Urine tests for metabolic disease like phenylketonuria and galactosemia are done in familial cases of mental retardation.

SYMPTOMS

Learning disabilities, Disturbed sleep, Hyperactivity, Emotional instability Distractibility, Low frustration tolerance. Short span of Disturbed sleep, attention, Poor concentration, Emotional instability Poor memory, Impulsiveness, Awkward clumsy movements,

 Associated defects of the bone, muscle, vision, speech and hearing are often found in the mentally handicapped children. Congenital birth defects, apart from the neurological system may be found if the cause is prenatal. Convulsions (fits) are common in the mentally handicapped children.

 Investigations to rule out hypothyroidism are also done. Radiological investigations like CT and MRI scans are helpful in revealing brain abnormalities like leukodystrophies, cerebral atrophy, hydrocephalus, tuberous sclerosis and other conditions.

PREVENTION
Genetic counseling: Risk of recurrence in autosomal recessive disorders is high in consanguineous marriages. Parents should be informed about the possibility of prenatal diagnosis. Mothers older than 35 years should have antenatal screening for Down's syndrome. Rubella vaccine should be given to all girls to prevent this infection in first trimester of pregnancy.

 During pregnancy teratogenic drugs, hormones, iodides and antithyroid drugs should be avoided. Mothers should be protected from contact with patients suffering from viral illness. During labor, good obstetric supervision is essential to prevent occurrence of birth injuries.

 Neonatal infection of the central nervous system should be diagnosed early and treated promptly. Jaundice should be managed correctly. Iron deficiency should be treated in the early childhood.

MANAGEMENT
To strengthen areas of reduced function To prevent or minimize further cognitive deterioration. Interventions should begin early and be sustained. Goals should be appropriate and achievable. Approach should be collaborative and multidisciplinary.

 In the teen years, an emphasis should be placed on vocational goals, including social adaptation, and vocational professionals should be part of the multidisciplinary team.

general measures
Requires ongoing health surveillance similar to normal children. Developmental, academic, and psychosocial progress should be monitored. Slower developmental progress should be expected with increasing severity of cognitive-adaptive disability.

 Parents should be counseled together. Diagnosis of the child should be fully explained to them, and also the prognosis. Principles of management should be explained in detail. Parental feelings and the home situation should also be discussed. Mentally retarded child needs the same basic care as any other child.

 Physiotherapy is often also needed. Anticonvulsant treatment is prescribed for seizures. Specific management of metabolic and endocrine disease should be done. Children need warmth, love and appreciation, as well as discipline. Institutionalization should be avoided. Day care centers and schools and integrated schools are useful.

Thank You