Last modified: 2018-09-09
Abstract
Introduction:
Acute medical problems are focused on in syndromic children in the critical early years of life, while developmental deficits are prioritized later. These children need an interdisciplinary team for effective management; however, the data in India is scarce on this subject.
Methods:
Children presented with developmental concerns (November 2017–June 2018) at a child development centre in Mumbai and received an interdisciplinary developmental program for a period of six months (n=130). Fifty-four syndromic cases were identified by obtaining data on clinical evaluations and standardized tests through a retrospective review of reports; out of which 10 cases (average age: 5 years 6 months) had neurological deficits on MRI (sequelae of perinatal injury [n=5], cerebral malformations [n=3], cerebellar atrophy [n=1], corpus callosum atrophy [n=1]). Six children provided history of seizures.
Results:
Subsequent to the program, children showed clinical improvement in attention span (n=6), gross motor skills (n=7), fine motor skills (n=3) and cognitive skills (n=4); and reduced sensory concerns (n=5). Two children improved their Visual-Motor Integration scores. Among the seven children with improved gross motor function, three showed an increase in Gross Motor Function Measure (GMFM) scores (+3.4%, +10.1%, +18.8%). Average change in social quotient on the Vineland Social Maturity Scale was -0.3 (pre-intervention=38; post-intervention=35), due to the lag between the child’s skills and the increased chronological age post-intervention. Receptive and expressive language abilities showed non-significant changes.
Conclusion:
Despite the magnitude of developmental deficits and neurological problems, the study demonstrated positive outcomes (except in language) after a short duration of intervention.