Rush! Rush! Rush! Everyone seems in such a hurry for their children to be the first... the first to walk… the first to be out of diapers…the first to learn to read. What IS the hurry?

Every child is different (Phillips 1991)

EVEN a casual observation of children shows that they develop at differing pace and, over time, achieve different levels of skills in various areas. This paper attempts to examine the diversity in the development of children by focusing on situations where there may be low ability. It is believed that diversity is a result of individual factors, parenting situations and the inputs of professionals working with young children.

Development of human beings, especially at the early stages, has been studied with a great degree of fascination and diligence. The genetic specificity of each individual as well as the interaction between the individual and the environment has been of special interest to psychologists, educational philosophers and thinkers. There is no difference of opinion on the presence of these two influences on the development of human beings. However, theories vary about the relative influence of one over the other, i.e. the degree to which the environment would influence the development of genetically endowed characteristics or the degree to which an individual would not only transform the environment but also select the information and experiences which are in tune with his/her genetic compulsions.

In the process of child development, it is fascinating to understand the dynamics between various factors contributing to the early development of children. What the child learns, when she learns it, how well she learns it and how she is able to apply the learning to various situations, depends on the efficiency of the tools she has as well as on the opportunities she has to observe, experiment and interact with objects and people.

Varying influences of the factors and processes as well as their dynamic inter-relationship are extremely complex and exciting to explore.

The development of children takes place in a time frame – time itself propelling growth and maturation of capability. Nutrition helps the physical growth. Sensory experiences are present from before birth. Experiencing, observing, seeing patterns, differentiating, classifying, categorizing, comparing and remembering – all contribute to making sense of every experience. It helps the development of understanding and analysis that forms the basis for cognitive development. The comforting feelings of physical safety, security, affection and respect form the foundation for emotional development.

Sensory and motor experiences are the raw material for the learning of children. As the child acts and reacts on these experiences, her capabilities in each area begin to develop. The child is born with well-developed ability to smell, taste and feel. The child is able to see blurry images in a restricted field and is able to hear sounds locating them in the first few days. With time and experience these abilities grow and mature. Simultaneously, the child’s ability to observe and make sense of her experiences also continues to develop.

Every experience of the child has many dimensions. When the infant’s experiences of feeding with the mother in the first few days are analyzed, it is seen that feasting on food is only one aspect of it. As the child tastes milk, information about its consistency, texture and liquidness slips in with the feed. The infant also hears the mother’s voice. In the background, other people and/or other sounds are heard. The infant starts noticing the differences between sounds and starts associating what she hears with what she feels, smells and sees. Though the infant’s vision is limited at this stage, when close, the mother and other caretakers are within the reach of the child’s vision. The infant is exposed to the comforting smell of the mother, her clothes, fragrance of flowers in the room, the smell of lunch being cooked, the strong odour of vitamin drops on the table and so on.

Just by being held, the infant experiences the size of the mother’s hand-arm-fingers-lap, the texture of her clothes as well as her own clothes, the pressure of her palm as she picks her up, the wetness of the nappy when she pees in it, the warmth, softness and moistness of the facecloth when the mother uses it to wipe her mouth, the cool air from the fan, the weight of the blanket and so on. Along with these multi-sensory experiences, the infant also makes movements. She sucks, sometimes hard, to extract milk, squirms to show discomfort from a wet nappy, screams to indicate a hurting tummy, opens and closes eyes, frowns, yawns, and so on.

While a lot of the above happens automatically, without any thought, research has shown how children start learning from these early moments. Experiments done in the first few hours and days of birth indicate that children associate their mother’s voice with her face; they show confusion when mother’s voice is presented with a stranger’s face (Wright 1970); prefer mother’s voice to other voices and not only learn how to access recording of it but also reverse their learnt response within 24 hours to continue to access mother’s voice (Decasper and Fifer 1993). The seemingly helpless infants’ capacity to learn is remarkably high.

Within the broad framework of a universal pattern of development, each child has a unique journey growing up to be a unique person. In any group of children, both the capabilities of the children as well as the environment are expected to be diverse. When the child’s capability in any area is very low, it has an impact on all areas of development. When the capability of the environment is limited, it also has an impact on all the areas of development. Low or lack of individual capability is seen as disability while low environmental ability is seen as disadvantage. If a continuum of enabling and disabling factors, both within the child and the environment, were to be drawn, a broad picture would emerge for the possible path of growth for each child.

When the growth of ability, including physical structure and its function, is disrupted at a very early stage, sometimes before birth, its impact on learning is global. As children receive information from all the senses and movements, information from one source validates and confirms the other, resulting in multi-sensory integration. Growth in each area takes place in harmony and low or no ability in any one area often delays the development in other areas.

Development of hearing and vision contributes greatly to the child’s understanding of the environment. Lower or no visual ability restricts movement and handling of things. It does not arouse the curiosity of the child the way the sight of a doll or a toy car does, when there is vision. This deprives her of the opportunity to handle and know about shapes, sizes, dimensions, smooth and rough texture, cold and hot surfaces and so on. So the child is not appropriately able to use even the abilities that she has.

When the ability to hear is not developed at all or is underdeveloped, the child relies on her ability to see and move around. The biggest impact of this disability is likely to be on the development of language, speech and easy communication. All of these are very important medium of learning within the first year of life. The child starts using names of things, asking for things, and begins to understand simple language very early. By the age of two plus, the child and her caretakers rely a great deal on language to describe objects and events as well as to clarify thoughts and concepts.

The biggest impact of difficulty in moving around is the way it restricts the child’s world and therefore her ability to have varied experiences. The infant, who is unable to turn her face or is unable to turn over at the appropriate developmental stage, is able to see things in restricted field, limiting her exposure and understanding. She will not even be aware of the presence of things that are not within the immediate visual field and do not make a sound.

When the child is not able to crawl over she not only remains under-developed in motor skills but also does not learn about distances, textures, speed, etc. She does not get the experience of problem solving through avoiding objects on the floor. She also remains unexposed to the colours, shapes and names of the vegetables that mother is buying at the door. A child who is unable to play with objects does not learn about them fully. Her concepts remain unclear. The need to learn and know is so strong that a young child fights to grab these experiences.

Motor skills give children a sense of physical security which is essential for the growth of emotional security. The ability to freely move around leads to a sense of independence and self-confidence. These are important factors that promote learning.

Sometimes, all the sensory and motor abilities are intact but the ability to attend to and understand the environment is limited. When this is so, children are not fully able to comprehend and absorb all the dimensions of objects and events. They are not able to compare, i.e. see similarities and differences, categorize, i.e. group things according to any given characteristic, observe the sequence and pattern of events or remember what they have learnt for later use.

They may, therefore, not be able to, for example, appreciate the difference between a spoon, a knife and a pencil very quickly. Learning the special function of each may happen after multiple experiences with each of these objects. A toddler with lower cognitive ability may not automatically perceive the difference between various sounds and may take longer to differentiate between the ring of a door-bell and the telephone. She may also take longer to learn to speak appropriately despite the speech mechanism being in place.

A child with lower cognitive ability may not be able to use the learning from one situation to another. This lack of generalization results in all learning tasks becoming new tasks – the child not getting the benefit of previous learning. This delays the process of learning in all areas. It impacts not only the development of ‘purely cognitive functions’ but also the development of motor skills, effective use of language and age-stage appropriate emotional maturity. Often there is not only delay, but the concepts seem too complex to comprehend at all.

How disability in one area affects the pattern of development is unpredictable. This is often confusing and the caretakers, teachers and those who come in contact with the child are unable to interact with the child at an appropriate level. For example, a child who is not able to hear or see well may give an impression of being slow in learning because her responses are not quick enough. On the other hand, the hearing difficulty of a child may not be appreciated fully if the child is using visual clues and expectation from her may be higher than appropriate.

A lower ability in any one area impacts on children’s social relationships and the process of socialization. Children may feel isolation, lack of confidence and anxiety. Children almost always end up with less social contact and this hinders their process of learning.

The birth of a child with a disability is an unanticipated event. No family – regardless of race, ethnicity or socioeconomic status – is immune to disability, yet almost all are poorly equipped to cope with its occurrence (Seligman and Darling 1989).

Parents are the primary environments for children. In the first few years of life, for most children, the abilities, inclinations and situation of the parents have the greatest impact on their learning.

Parents are often the first to notice any problem that their child may have. In an environment where achieving milestones first is important, parents anxiously wait for the infant’s abilities to develop. They watch closely and get concerned when the child does not seem to be doing what others her age are doing. Sometimes their fears turn out to be unnecessary. At other times the problem turns out to be long-term and serious.

Often there is a long delay before a diagnosis is made. Once a diagnosis is made, parents describe their feelings as despair, numbness, and sense of unreality, pain and depression. Kubler-Ross’s theory of stages of grief is well-known. After the initial shock, parents go through denial, bargaining, anger, grief and acceptance (Kubler-Ross 1969). Professionals have also found that parents may have mixed feelings, experiencing all these emotions at various times in all stages. When parents are the primary environments for young children their mental state significantly affects children. When parents are depressive, attachment disorders and behaviour problems are seen in young toddlers (Yarrow et al 1993). This impacts their learning.

While parents cope with their emotions, another complex situation arises from the reaction of those around – family, neighbours, people in the marketplace, in the hospital, on the bus and so on. When the child’s disability is obvious, in the most positive situations, people want to help but feel uncomfortable and do not know what to do. In other situations, a disability continues to carry a stigma where people feel that a person with disability is somehow not quite the same nor equal. One of the parents of a child with disability expressed a desire not to bring her child to a special school saying, ‘Who would like to bring their children to your school. My older son goes to a… (name of a well known elite school).’

This discrimination in early childhood shows up in the form of other parents not being sure of the effect of the disabled child’s behaviour on their children. When a negative effect is feared, the child with disability does not get to participate, not only because of her disability but also because of the anxiety of other parents. The parents of the child with disability are often over-protective and anxious, further reducing the possibility of play with other children and the learning that would automatically happen with such play.

Economic disadvantage too impacts children’s development. It is well documented that children from economically disadvantaged families achieve lower levels of learning. It was found that children coming from families whose socio economic status was low, entered school with fewer academic skills than their more advantaged peers (Stipeck and Ryan 1997). An important factor is that their enthusiasm for learning was found to be no less than their peers. Also that substantial gaps in cognitive and academic competencies persisted in later school years.

Similar results have been found in India where the achievements of children from urban disadvantaged families going to government schools were found to be lower than their advantaged peers going to private schools (Chakrabarty 2002). The achievements of children from an underdeveloped rural zone were also found to be much lower than their more privileged peers from the urban zone (Govinda and Varghese 1993).

When the child has both individual disability and environmental disadvantages, the impact on learning is almost always substantial.

Some of the delay or disruption that a young child faces because of disability and other disadvantages can be reduced by early understanding of the issues and by providing an appropriate environment. A great deal of learning happens in the first few years. In this context it is useful to understand the importance of intervention programmes or programmes designed for enrichment of children’s environment.

The most urgent need for families where a child may have a disability is to get early intervention and support. This should be both in the form of help from professionals from specialized fields as well as inclusion in regular early childhood programmes, i.e., anganwadis, balwadis, nursery schools, programmes run by ICDS – any programme that is designed for young children.

Typically a child with disability starts with medical intervention. However, the medical needs are often minimal and longer-term intervention is needed in the form of stimulation of early learning in areas that may be directly affected by the disability or where the child is not achieving because of secondary impact.

The impact of an individualized intervention programme is high. Parents as well as professionals working with young children have innumerable stories to tell about how things changed once they started receiving help. This is not surprising. What is surprising is how few families have access to such services. As mentioned earlier, the diagnosis itself is often delayed. After diagnosis, it may take the family a while longer to look for help. When they start looking, it may take a long time to find skilled and appropriate help.

In the more developed countries, where many specialized services are widely available, parents express frustration and fatigue of going from institution to institution and department to department while effort is made for appropriate placement. In India, both in the public and private sector, little help is available outside the hospital framework. In the hospitals, only medical attention is given and for therapy only the medical model is adopted which is insufficient to ensure that the child is able to use his learning outside a hospital situation. Few hospitals have developmental clinics.

Even when help is available the families from disadvantaged background, who are in the greatest need, are unable to access it. The need to work, the loss of earning if the day is spent in hospital, the expense of travel and treatment, the lack of understanding about the nature of the problem, the lack of explanation and often the unsympathetic attitude of the professionals (one doctor in a huge government hospital insists that only those children wearing disposable diapers can be brought to his table) makes it difficult for parents to access the facilities.

In India, preschool programmes have mushroomed all over the country. It is not uncommon to find government run balwadis and anganwadis even in interior villages. There is a need for children with disabilities to be included in these programmes.

The impact of general pre-school programmes is not fully understood but the positive impact of model interventions are well established. A review of the Indian programmes for early childhood education (ECE) indicates that it is only ‘programmes of a certain quality that can be expected to impact and facilitate learning’ (Kaul 2002). In a recent paper, Magnuson reports that the ‘bulk of evidence suggests that attending centre based care in the third and fourth years of life promotes children’s academic outcomes and cognitive development even when the quality of the programme was not established’ (Magnuson et al 2004). Headstart, a well known federal U.S. government programme for disadvantaged preschool children, has been evaluated extensively and was found to have long lasting academic benefits several years after the completion of the programme. In the same paper, Magnuson reports that in cases where there is a disability or disadvantage, the effect measured were higher and they stayed longer too.

It is not easy for children with disabilities to participate in a pre-school programme. In an environment where professionals in the field of early childhood care and education are not knowledgeable about the disabling condition and its requirement in day to day functioning, it is not surprising that there is reluctance to take in a child with disability. Developing the knowledge and skills of the professionals would reduce this reluctance.

One of the biggest requirement of the pre-schools a decade or so ago was that the child must be toilet trained before entering a pre-school programme. The use of diapers has reduced this problem to an extent, but affordability remains a problem.

The staff of the Early Intervention Programme of AADI (Action for Ability Development and Inclusion), Delhi found that pre-school programmes are reluctant to admit children until they are able to walk. It was found that parents too were concerned about the safety of the child if she did not walk. The parents of other children were concerned that their child would start copying the unusual movements of a disabled child. All these concerns are valid. Solutions can be found by providing a safe mobility equipment (a buggy, an adapted tricycle, etc) and by talking to parents and children. With many disabilities, walking ability is delayed and in some situations it may not develop at all. With skillful handling, the child would still benefit greatly from the pre-school programme.

When a child is unable to communicate, it becomes a block to enrolling in a pre-school programme. However, when the child has some method of communicating her essential needs, it was found that pre-school workers were willing to work with the child. On the part of children, often no negative reaction is seen at this stage. Children below the age of four are either unaware of the disability or do not perceive it negatively. In this sense, early inclusion is easier and could pave the path for reduction in negative feelings among children at a later stage. On the part of parents, it is found that they are concerned about full integration of the child. They are therefore reluctant to use anything (AFOs, hearing aids, etc.) that draws attention to the child.

With all these concerns, it is found that children with moderate or severe disabilities are rarely seen in the pre-school programmes in India. Children with mild disabilities are taken in but though they are physically included, little attention is paid to them. They remain at the back of the class learning what they can. In a worse scenario, the teacher suggests that the child be taken out of the programme. This often happens a few months after the child being taken in.

All children need a stimulating and safe physical and emotional environment to grow up in and learn from. Children are born with varying abilities. Some need more help than others while growing up. As a society, an appreciation of this diversity and the ability to cope with it is needed. It is important that children requiring more help receive it within the framework of what provisions are made for children. This will be socially more appropriate as well as being efficient and cost-effective.

References:

V. Chakrabarty, ‘Education of Urban Disadvantaged Children’, in R. Govinda (ed), India Education Report. Oxford University Press, 2002.

A.J. Decasper and W.P. Fifer, ‘Of Human Bonding: Newborns Prefer Their Mother’s Voices’, in M. Guavain and M. Cole (eds), Readings on the Development of Children. Scientific American Books, 1993.

R. Govinda and N.V. Varghese, Quality of Primary Schooling in India: A Case Study of Madhya Pradesh. International Institute of Educational Planning, Paris and National Institute of Educational Planning and Administration, 1993.

E.B. Hurlock, Child Development. McGraw-Hill, 1978.

V. Kaul, ‘Early Childhood Care and Education’, in R. Govinda (ed), India Education Report. Oxford University Press, 2002.

E. Kubler-Ross, On Death and Dying. Macmillan, 1969.

K.A. Magnuson, Meyers, Rhum and Waldfogel, ‘Inequality in Preschool Education and School Readiness’, American Educational Research Journal 41(1), Spring 2004.

C.B. Phillips (ed), Essentials for Child Development Associate. Council for Early Childhood Professional Recognition, 1991.

M. Seligman and R.B. Darling, Ordinary Families, Special Children. The Gulliford Press, 1989.

Stipeck and Ryan, ‘Economically Disadvantaged Pre-schoolers: Ready to Learn But Further to Go’, Developmental Psychology 33, 1997.

D.S. Wright and A. Taylor, Introducing Psychology: An Experimental Approach. Penguin, 1970.

M.R. Yarrow, Cummings, Kuczynski and Chapman, ‘Patterns of Attachment in Two- and Three-Year-Olds in Normal Families and Families with Parental Depression’, in M. Guavain and M. Cole (eds), Readings on the Development of Children. Scientific American Books, 1993.