Understanding Childhood Disabilities

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©2006 Publications International, Ltd.

You may have noted with concern that your child didn't roll over or babble or smile when everyone else's children seemed to -- and you wonder if your child has a developmental problem. This article will address those concerns and provide guidelines for raising children who have a disability in the following sections.

  • Causes and Assessment of Disabilities in Children Believing that there may be something wrong with your child is frightening, but let your doctor make the determination before you jump to any conclusions. In this section, you'll read about the common causes of childhood developmental delays, which may be inherited, congenital, or environmental. Although behavioral problems don't occur until a child is older, you may observe certain indications that your child is developing slower than expected. This page includes signs to look for and the next steps to take, like talking to your child's doctor and possibly a developmentalist. You'll read about what to expect from an assessment, plus advice on responding to possible outcomes.
  • Speech Problems and Deafness in Children The development of verbal communication is a milestone in a child's growth process. On this page, we discuss the problems that can delay speech, including environment, hearing, intelligence, muscle control, physical deformation and malfunction of the speech center in the brain. There are guidelines on how to deal with stuttering, how to detect problems and when to consult a doctor. You'll also find information on impaired hearing: common causes for hearing loss and behaviors that may indicate a problem. And we provide some helpful tips on preventing hearing problems for your child.
  • Stimulating Development in a Disabled Child Children with disabilities are capable of learning and developing new skills, just as any other child is. This section deals with stimulating a child's senses to promote growth. The parents' role in the child's development is crucial, and you'll find suggestions on providing a nurturing environment, fostering independence and dealing with setbacks or slow progress. On this page, there are also specific suggestions for stimulating children with a multitude of different disabilities. A number of valuable resources available to disabled children and their parents are also listed.
  • Special Programs for a Disabled Child There are many options available to disabled children for both recreation and day care. Choosing a program for your disabled child can be overwhelming, so we've outlined a list of criteria to help you find the right one. There's special emphasis on your relationship with the professionals who monitor and implement the speical programs -- to keep you comfortable and in control of your child's care.
  • Education for a Disabled Child There are many schools of thought for educating a disabled child. Some experts believe disabled children learn better when they are in classrooms with children at a comparable learning level. Other educators feel a disabled child should be integrated into a regular classroom. We will examine both strategies. Included in this section is a discussion of your child's educational rights (according to the Individuals with Disabilities Education Act of 1993) and the potential risks and benefits of mainstreaming your child.

If you'd like to learn about raising a disabled child, begin reading the first section on the causes and diagnoses of disabilites.

Causes and Assessments of Disabilities in Children

"Normal" childhood development spans many parameters, and often even "abnormal" behaviors will disappear in time. In Understanding Cognitive and Social Development in a Newborn, we describe developmental markers that are currently accepted as "normal." If you believe your child's behavior is consistently falling outside the normal range, you should consult your pediatrician. On this page, we explain some of the causes for developmental problems as well as special evaluations and assessments for disabilites.

Developmental Problems: Possible Causes

Some infants have inborn defects, such as brain damage and incomplete development of the brain, that prevent normal development. Others suffer from conditions or diseases that can be treated once they are identified. One rare inherited metabolic disease, for which infants are tested a few days after birth or at their first visit to the doctor, is phenylketonuria (PKU). Untreated, the disease leads to mental retardation, but early detection and prompt treatment through diet usually ensure development of average intelligence. Another test newborns undergo is for congenital hypothyroidism, which is also rare and also capable of causing retardation if untreated.

Infants born with some defects may not appear abnormal immediately, but most display marked delays in development that their parents observe or their doctors notice. At each checkup, your child's doctor observes your child's behavior as a clue to development. He or she, or an assistant, may also do quick screening tests at certain ages in your child's life. In both the observation and the tests, the physician is looking for possible danger signals.

Other infants, normal at birth, suffer later from incompetent or insufficient nurturing. Environmental problems are often more difficult for a doctor to identify than inborn defects, and they can pose serious hazards to a child's development. Some of the clues that alert the physician are these:

  • Disturbances of eating or sleeping (either insufficient or excessive). Both the quantity and the quality of parental care influence an infant's own regulation of eating and sleeping.
  • Physical symptoms, such as frequent vomiting, diarrhea, and skin rashes.
  • Failure to grow normally in height and weight. An infant deprived of loving nurture may fail to grow in spite of adequate food intake. If a lack of nurturing can be ruled out, the physician investigates suppression of growth factors in the baby's brain.
  • Marked delay or deviation in specific areas, such as motor development, verbal ability, intellectual development, and general learning, or in development of relationships to others, a sense of self, or the capacity to play.

Frequently, when the necessary nurturing ingredients are lacking, children develop various medical or psychological problems. For instance, if bonding does not occur between mother and infant, it is not unusual to find failure to thrive behavioral problems as well as a disturbed mother-child relationship. This does not mean there is automatically trouble if the ideal bonding process does not take place immediately following birth. Recent studies have shown that mothers of cesarean-birth, premature, or adopted babies can successfully bond later.

Likewise, parents who are aware of their own imperfections and lack of knowledge need not worry that, because of their shortcomings, their baby's ability to develop is automatically damaged. Babies have a strong drive toward normal development that helps them resist "less-than-ideal" environmental factors. Clearly, the ability of infants to develop can be damaged in situations of poor care, but none of us is without flaws. We should do the very best we can for our children, but we need not be perfect to raise fine human beings.

Parents who are concerned about some aspect of their infant's or child's development or, later, about behavioral problems should turn first to their doctor. Sometimes one's inclination is to avoid bothering the doctor, and it is true time is a precious commodity for a doctor. Still, if the doctor seems unwilling to discuss what the parents see as a problem, or refuses for some reason to become involved in the parents' worries, it is wise to choose another physician. If more than average time is required for an office visit to discuss behavioral problems, some doctors charge more, but you can count extra fees as money well spent if you are able to head off serious problems.

Special Developmental Evaluations

Occasionally a child whose problems may be as specific as slow speech development or as general as overall slow development needs the attention of a developmentalist, a pediatrician whose subspecialty is early childhood development. Parents who suspect a developmental lag in either motor or cognitive development, or see signs their baby refuses to be socialized or is withdrawn and depressed, can ask for an evaluation by such a specialist, or their child's doctor may recommend it. The developmentalist, perhaps working with a team of other professionals, such as social workers and psychologists, observes the child performing various functions in a play-like situation to determine the existence and extent of developmental problems. Other specialists may be called in as consultants.

After an assessment, the developmentalist will discuss with the parents his or her findings and recommendations for treatment. Unfortunately, some parents learn their fears of retardation have been confirmed. Others receive the relief of assurance that their child can develop normally, perhaps with special help. Whatever the outcome of the evaluation, parents should strive for a proper balance in their reactions. Hysterical overconcern helps neither their child nor themselves, and trying to insulate themselves against pain and hurt by noninvolvement is likewise an inappropriate response.

Assessing Disability

All children can learn and develop. But children do not learn and develop in the same way or at the same rate. Sometimes parents notice an overall pattern of slowness in a child's responses to the world around her. Parents may notice the child's general physical growth and achievement seem to lag far behind those of other children.

Some children don't seem to develop normal sensory responses. Children with impaired vision, for instance, may not focus or follow with their eyes. A child with impaired hearing may not respond to sounds or may fail to speak or make prespeech sounds, or she may babble later and less frequently than children with normal hearing.

When parents perceive a consistent pattern of delays, they will want their child evaluated by a professional. Part of that assessment includes an effort to determine possible causes of the problem or problems.

Possible causes of developmental problems are many. Early in the development of the fetus, for example, a spontaneous change in the chromosomes or in individual genes may lead to Down syndrome, a disabling condition that causes affected children to develop and grow more slowly than normal children. Premature birth can sometimes lead to developmental difficulties. Certain infections the mother carried may affect the fetus in its early stages and may lead to retardation and other abnormalities. A trauma suffered during birth or shortly before or after birth may adversely affect a child and can lead to such conditions as cerebral palsy. Certain childhood illnesses, such as encephalitis and meningitis, may also leave a child with mental or physical disabilities.

It is not always possible to determine the cause of a disabling condition; some developmental delays are difficult to diagnose. An IQ (intelligence quotient) score below 69 indicates a child may be mentally retarded (90 to 109 is considered average). But the diagnosis of a disability should not rest solely on an IQ test score. A child's adaptive behavior -- his ability to respond to stimuli, to learn and grow -- should also be measured. There are, however, no absolute tests that can tell us how quickly a child with a disability will move through developmental stages, or how much the child will eventually accomplish.

Common developmental problems are delayed speech and/or hearing loss, which are often related. In the next section, you'll read about identifying the symptoms, testing, and treatments for speech problems and deafness.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Speech Problems and Deafness in Children

Your baby communicates with you through non-verbal means with gestures, facial expressions and body language. Learning to verbalize her thoughts, feelings and desires is an important part of her development. Many babies speak their first word around a year, but of course, each baby is unique and it could be quite a bit longer until that first "Mama" or "Dada." (For information on speech milestones, please see Language Development.) Because speech is so closely linked to hearing, difficulties speaking may indicate some hearing loss or deafness. Below, you will read about the different types of speech and hearing problems, their causes, and the appropriate action to take if you suspect your child of having either.

Speech Problems and Stuttering

There are many reasons why your child may talk a little later, or even much later, than other children his age. Few of them are serious, and most kids eventually catch up. For example, most girls talk earlier than most boys. A child's environment can affect the development of speech, too. If your family is not one that talks a great deal, your child will probably be a late talker and will probably talk less than some other children. If he spends days in a child care center or nursery school where one caregiver is responsible for several children, development of speech may be slowed. Competition for individual attention at home may be responsible for late talking, also. For example, if you have two children very close in age, or twins, you may not be able to devote a great deal of individual time to each. The private language twins sometimes develop is more often the result of lack of one-on-one time with a parent than a desire to talk only to each other.

Other factors that affect speech development are a child's intelligence, hearing, and control of the muscles involved in speaking. Speech may be delayed or impaired if the speech centers in the brain are not normal, or any abnormality of the larynx, throat, nose, tongue, or lips exists. Speech that does not develop normally may also be due to partial or complete deafness, mental retardation, brain damage, or malfunction of the speech centers in the brain.

Stuttering and stammering. Children between two and five years of age often lack fluency in speech and may stutter and stammer sometimes when they can't find words to express themselves. Involuntary pauses or blocks in speaking and rapid repetition of syllables or initial sound of a word may occur. These problems can be temporary, occurring only occasionally when a child is excited, impatient, or embarrassed, or they may be chronic, due to muscle spasms or underlying mental or emotional conflicts that may need to be resolved before speech improves.

When it occurs in children two to five years of age, stuttering can be disregarded unless it is still a problem several months after its onset. The child may not even be aware of it unless it is pointed out to him. To help a child who stutters, do not show anger or impatience by refusing to understand, finishing the child's thought, or trying to force him to speak slowly and more clearly. Ignore the stuttering yourself, and don't allow siblings or other children to tease or laugh at the child. Read, sing, and speak to your child as much as you can.

When to be concerned. Consult your doctor if your child speaks only in a monotone or with a marked nasal quality, if his vocabulary and ability to pronounce words seem to be diminishing instead of improving, or if stuttering is severe, constant, or prolonged. In addition to testing the child's hearing, the doctor will perform a physical examination, checking the child's throat, palate, and tongue. If your child is younger than five years old, your physician may refer you to a speech pathologist for evaluation and treatment if he or she considers the stuttering a severe problem, if the child seems to be extremely frustrated in his efforts to speak clearly, or if you yourself need assistance in handling your child's speech development. If your child continues to substitute sounds (th for s, for example) or stutters after the age of five or six, the doctor may suggest a consultation and, possibly, treatment by a speech pathologist.

Ear Infections and Deafness

Deafness, or impaired hearing, is a partial or complete loss of the sense of hearing in one or both ears. A child may be born with a hearing loss, or it may develop at any age. Since children learn to speak by imitation, a child who can't hear speech can't produce it.

Normal hearing occurs when sound waves pass down the ear canal and cause the eardrum to vibrate. Vibrations of the eardrum in turn move the three tiny bones in the middle ear. This motion of the bones transmits the vibrations across the middle ear to the inner ear, where they are changed to electrical impulses carried to the brain through the eighth cranial nerve. The brain interprets these electrical impulses as sound. Damage, disease, or malfunction of any of these structures can result in deafness. Any of the following problems may lead to hearing difficulties, which are likely to lead to learning difficulties.

  • Ear canal problems that may cause hearing loss include a buildup of earwax, a foreign object in the canal, and an infection known as swimmer's ear.
  • Eardrum and middle ear problems may be caused by an inflammation of the middle ear or a blockage in the eustachian tube, which connects the throat and the middle ear. Middle ear infection (otitis media) occurs most commonly in the first two years of life, especially among children who receive frequent exposure to it in child care centers. The infection often involves a fluid buildup that causes mild to moderate, intermittent hearing loss for as long as nine months, threatening proper development of language skills.
  • Inner ear problems may be caused by injuries or infections.
  • Eighth cranial nerve problems have several possible causes. (This nerve is responsible for carrying all signals from the ears and balance structures to the brain.) A child may be born with a nerve that has not developed properly or that was damaged before birth. For example, if a pregnant woman has rubella (German measles), the virus may infect the eighth cranial nerve in the fetus. After birth, an injury or an infection with a virus (mumps or measles) or bacterium (meningitis) can damage this nerve. Certain medications can also affect this nerve.

Detecting hearing loss. Often, the parents first detect signs of a child's hearing loss. You may suspect a hearing loss if any of the following behavior occurs: An infant older than three months ignores sounds or does not turn her head toward sound; a baby older than one year of age does not seem to understand at least a few words; a child older than age two does not speak in at least two- or three-word sentences; or a child simply does not seem to hear well. These symptoms may also have other causes, so if you think your child may have a hearing problem, see your doctor. He or she may refer you to a center that specializes in speech and hearing. A child with impaired hearing should start special education as soon as the condition is discovered, even if she is as young as one year old.

Take precautions. You may be able to prevent hearing problems for your child by taking proper precautions. Never put any object, including cotton swabs, into your child's ear canal for any reason; you may force earwax to become packed into the canal, or you may damage the eardrum. See that your child has the recommended immunizations against measles and mumps, the side effects of which can cause deafness. If you are a woman of childbearing age, consult your doctor about rubella immunization for yourself.

Regardless of the disability your child might have, you will have to make a special effort to aid their development. On the following page, we provide an outline of steps you can take to stimulate a disabled child's development.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Stimulating Development in a Disabled Child

No two children with disabilities -- even those who have the same type of disability -- are alike. Nor are their needs alike. In this section, we will explore different disabilities and how stimulating a disabled child can aid in the developmental process.

The Role of Parents

Provide love and support. The primary need of a child with a disability is the same as that of all children: the love and support of his parents. Sometimes parents become so absorbed in the need to stimulate their child and to compensate for his disability, they forget the most important task is to love him and take pleasure in him as a human being. When a child sees that his parents enjoy being with him, his sense of self-worth is nourished. That growing sense of self-worth is an important measure of a parent's success in raising a child with a disability.

Foster independence. If you are the parent of a child with a disability, your goals are to foster independence and to help your child develop a sense of self-worth and personal fulfillment. Through therapy and play, you are striving to help your child deal with his disability while realizing his full potential. How much independence your child achieves depends, to a great degree, not only on your child's disability but on how much you let your child do for himself at each stage.

All children reach plateaus in their development -- times when they seem to stop moving forward, or when they may even take a step back. This can be a particularly difficult time for parents of children with disabilities, who have to learn to measure the progress of their youngsters in inches rather than yards.

Focus on short-term goals. When your child reaches a plateau, it is helpful to look back and focus on how far he has progressed. This may also be a good time to focus on short-term rather than long-term goals -- finger-feeding, getting dressed, repeating the first intelligible word or phrase, finally mastering toilet training. When parents focus all their energy on a single, short-term goal, a child with a disability may begin to move forward again. By stopping to observe how the child copes with such challenges, how he adapts to new and greater demands, parents can help themselves to develop realistic expectations for their child.

Children progress best when their parents function as advocates for them, choosing the most appropriate educational settings, setting reasonable goals, and providing a warm and nurturing environment. Parents should view themselves as partners with professionals in planning the care of their children with disabilities.

Stimulating Developmental Potential

From the moment they are born, children begin learning about the world around them. They learn through their movements and through their senses of taste, touch, smell, sight, and hearing. When one or more of these senses are impaired, the child's view of the world is altered, and her ability to learn from it changes. Yet with advances in medicine, technology, and our understanding of how babies grow and learn, we can frequently expect far greater physical and mental development from children with disabilities than was possible even a decade ago. How much development depends upon the extent of the disability, how soon it is correctly diagnosed, and how quickly the child is placed in an appropriately stimulating environment. Children with mental disabilities, for instance, need frequent and consistent stimulation because they often have difficulty focusing their attention and remembering. They may also have perceptual difficulties that make it hard for them to understand what is happening around them and why it is happening.

Focus on the impaired sense. In many cases, a child's abilities can be improved by stimulating the impaired sense. Children with muscular dystrophy, Down syndrome, and cerebral palsy often can benefit from a physical therapy program that exercises all their muscles. Exercising the legs and feet of children with severe cases of spina bifida prepares them for walking with braces and crutches. Children with hearing impairments can learn to use their residual hearing with the help of high-power hearing aids and auditory training that increases and expands their listening ability. Children with severe visual impairments can sharpen their other senses to help compensate for their lack of sight while they learn about their world. Children with Down syndrome and cerebral palsy may also benefit from vision, speech, and occupational therapies.

Work with a therapist. Stimulation programs geared for children from birth to age three have demonstrated that even children with severe disabilities can learn, grow, and participate in the world around them. Parents can lead many of the exercises in such programs themselves, but they almost always benefit from the supervision of a trained therapist. Your local health department, public school, or state department of disabilities may have an appropriate infant stimulation program or may be able to recommend a trained therapist who can visit your home regularly to help your child and teach you appropriate exercises and play. University teaching hospitals and private agencies that serve children with disabilities may also be good sources of information.

Use play to explore. Play is an important way of learning for all children. Children with disabilities who can't move around to explore on their own can still learn about their neighborhoods through trips with the family. Within the home, children can be carried or guided from room to room to touch, feel, see, smell, or hear various objects. Children with impaired vision can use their hands, faces, feet, and other parts of their bodies to explore and learn. Children with impaired hearing need constant language stimulation and, like all children, need to hear explanations for what is happening around them. Pictures in books and magazines are another way of exposing children with disabilities to places, people, animals, and ways of life outside their immediate experience.

Toys provide another means of understanding our bodies and the world. Children with disabilities may have trouble playing with conventional toys, but parents can often adapt them to their child's needs or create appropriate play objects. Many communities have toy libraries (known as Lekoteks) that serve as resources by providing specially designed or selected toys for children with disabilities.

However much a parent tries to provide for their disabled child, there is only so much they can do on their own. On the next page, we'll look at what options are available to provide the other necessities for disabled children.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Special Programs for a Disabled Child

Sooner or later, a disabled child will likely attend a special program, like a camp or day care program. Here are some guidelines on choosing a special program.

Choosing a Special Program

Many disabilities have national associations, such as the March of Dimes for genetic disorders, that provide information and recommend programs or resources. Many of those associations have local chapters and parent-support groups.

If you are lucky enough to have a choice of programs, how do you choose the one that is best for your child? You should base your decisions on how comfortable you are with the professionals in the available programs and the therapies they present. Some therapies are less well known and not as widely available as other therapies. Frequently, educators differ on the subject of learning sequence; some educators of the deaf, for instance, believe in introducing sign language to children almost immediately, while others believe children should have strictly auditory-oral training before any signs are introduced. Because the opinions and methods of professionals differ, investigate a number of programs before committing yourself and your child to a particular one. If you consider a private program with private therapists, remember that the cost of a program is not necessarily an indication of its quality or appropriateness.

While factors of cost and convenience will certainly influence your decision, parents should also consider other factors:

  • How long can the program serve your child?
  • Is it a new program using experimental techniques or an established program that uses widely accepted therapies?
  • How well trained are the therapists who will work with your child?
  • Who supervises the therapists' work?
  • What does the therapist expect of you?
  • Does he or she seem willing to share his or her expertise with you?
  • Does the therapist want you to understand his or her methods?
  • Does the therapist seem capable of establishing a good rapport with your child?
  • If the program is new, will it continue to receive funding, or do sponsors need to raise funds each year?
  • How many children does the program currently serve, and what is the ratio of staff to students?
  • Are children with multiple disabilities combined in classrooms with children who have only one or two clearly defined disabilities?

Professionals' expectations. Perhaps the most important factor in choosing a program is the expectations of the professionals involved. Each child is different and brings to the program his own determination to succeed. Parents may see strengths and recognize progress professionals miss. If the professionals' expectations are too low, your child may not proceed as quickly as you feel appropriate. And if their expectations are too high, your child may feel frustrated.

Your Relationship with the Professionals

Most professionals welcome and encourage active parental involvement in decisions affecting the child. However, professionals are human, with human emotions and responses. While it is safe to assume most professionals who deal with children with disabilities have an interest in seeing them well taken care of, professionals may bring to their work certain prejudices and preconceptions that do not serve the interests of all children. You will have your own opinions; express them. You should be able to talk openly with professionals about your concerns and questions. If the therapist is too busy for or resists such discussions, or if you find such meetings unproductive and unsatisfying, you should consider finding a new program or therapist. While it is in the interest of the child to have continuity of care over the long run, it is best to change programs if you believe your child is not adequately served.

Another major consideration for parents of a disabled child is when and where you will send your child to school. We will review the options available in the next section.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Education for a Disabled Child

As children with disabilities move into the toddler stage, parents may wish to consider preschool or nursery school. Should you send your child to a special school where she will be with other children like herself and where teachers are trained to deal with your child's disability? Sometimes no special school exists, or it is very far away, requiring your child to make the lengthy trip to school each day or to become a resident at the school.

Mainstreaming your child. Even when special schools are close, you may consider mainstreaming your child -- sending her to a regular nursery school class. Many experts believe young children with mild to moderate disabilities do better if they are kept in a normal environment for as long as possible. Young children are usually more accepting of differences than older children and adults are, so a child with a disability will not necessarily feel odd or left out in a regular nursery school. Many nursery schools are willing and able to accept children with mild to moderate disabilities. Some are also willing to accept children with more severe disabilities.

Certain philosophies of education lend themselves more readily to integrating children with disabilities. If you cannot find a school in your area that has had experience with children with disabilities, you may wish to approach a Montessori school or other school with a nontraditional approach to nursery school education.

If you are considering mainstreaming in a school that has had little or no experience with your child's disability, take time to observe and to talk to the director and the teachers who will have your child. Be honest about your child's deficiencies and her needs. Ask about the school's attitudes toward disabilities in general and toward your child's disability in particular. How do teachers normally handle problems of discipline and teasing? How do they handle questions other children will ask about your child? Do you feel the teachers' expectations are reasonable and consistent with your own for children in general and for your child in particular?

If you decide to mainstream your child, be prepared to serve as a resource person for the school. You may want to visit the classroom and talk to the children about how a hearing aid works, why your child wears braces, or why she looks or talks the way she does. Be prepared for some frustration, especially in the beginning, as parents and other students work to understand your child and how to relate to her. Plan to observe school routine fairly often. If your presence upsets your child's routine, enlist the aid of friends to observe. When you observe, don't focus solely on your child. Parents of children with disabilities are frequently -- and pleasantly -- surprised when they observe how much like other children their child is.

Your Rights Under the Law

The Education for All Handicapped Children Act went into effect in 1978 and was replaced by the Individuals with Disabilities Education Act (IDEA) in 1993. The law requires states to provide a free, appropriate education to all children with disabilities regardless of the severity of their disability. Under the law, each child has an individualized education program (IEP) that indicates what kinds of special education and related services the child will receive. Parents have the right to participate in every decision related to the education of their child, and they have the right to challenge and appeal any decision regarding the identification, evaluation, or placement of their child.

The IDEA covers children with disabilities from ages 3 to 21 years, except in states that do not provide public education for children younger than age 5 and older than age 18. However, you may find many local school districts that provide programs for children younger than three years of age even when they are not required to by state law. Many of those programs receive federal funding.

While the law has tried to provide for the education of most children with disabilities, it has not standardized the quality of education, which can vary widely from state to state and from one school district to another. Even within school districts, certain disabilities are better served than others. Further, government budget cutbacks have had particular effect on educational programs, many of which have been truncated or eliminated altogether. Be aware that your best-choice program may not be available in your area. Many school districts provide information on what is available, as well as guidelines for parents that describe their children's educational rights. If your local district cannot readily provide you with information and a copy of applicable laws, contact your state board of education.

Raising a disabled child brings unique challenges for the parents. But there are many resources out there which can provide assistance and much knowledge available about stimulating development -- which means that a disabled child now can progress more than he may have a decade ago. And, as with any child, you can share the joy of accomplishments together!

©Publications International, Ltd.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

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