Developmental Medicine

Developmental Medicine

The Developmental Medicine is a broad speciality division of NIMS SPECTRUM-Child Development Research Centre providing; Neuro-developmental follow-up and early stimulation for neonatal intensive care nursery (NICU) graduates from any hospital, specifically pre-term-low birth weight babies and others with risk factors like prolonged NICU stay, hypoxia, hypoglycemia, septic shock, hyper-bilirubinemia, etc. Evaluation and early intervention for children with Developmental delay, Language delay, communication delay and social deprivation Specific therapy for ten neuro-developmental disabilities like Autism Spectrum Disorders, Visual Impairment, Hearing Impairment, Speech and Language impairment, Intellectual Disability, Attention Deficit Hyperactive Disorder, Learning Disability, Epilepsy, Cerebral Palsy and Neuro-muscular disorders. Specific therapy units mainly include; physiotherapy, audiology, speech therapy, behaviour therapy, special education, sensory integration therapy, etc. Referral services of medical super specialists in paediatrics like; neurology, endocrinology, ophthalmology, ENT, orthopaedics, clinical genetics, Gynecology in the same campus. Counselling services for parents of children with delay/disorder/disability and for adolescents and young adults.

Consultation with prior appointments, please call: 97455 86411 between 9.00am to 4.00pm

  • In a highly competitive school environment as that exists in Kerala, children with disabilities – physical, mental, emotional and social – face tremendous odds. They are often stigmatised and confined to the margins, in ways that can truly curtail healthy development into adulthood. Thus, disabled children are worse off when they belong to economically or socially deprived families; girls who are disabled may be worse off than boys, and so on. According to the State Plan of Action for the Child in Kerala (SPACK) 2004 document, the main goal of the action plan is to provide equal opportunity and conducive environment for the physical, mental, emotional, aesthetic, spiritual and social development of all children.
    This then calls for increased focus on compulsory elementary education, special education for the needy, eradication of illiteracy, education for women’s equality and a special focus on the education of the tribal population. Comprehensive coverage of all the groups in education will have long-standing implications in child welfare and at present Sarvasiksha Abhiyan (SSA) offers the best opportunity for inclusive education of the disabled child. In the Kerala context, it appears that reduction of low birth weight should be the central point of our thoughts and actions, whether it is for reduction of mortality, morbidity, childhood disability or poor scholastic performance. All these cannot be achieved without a public-private partnership.

    The burden of Developmental Delay/Disorder/Disability in Kerala

    On a projection based on a Kerala ICDS block data, at a given time, there would be nearly one lakh children with developmental delay/disability among under-5s in Kerala, with developmental delay (14000), speech delay (22000), vision & hearing problems (15000), orthopaedic related (20000), intellectual disability (6000) and others (3000). The State Initiative on Disability (SID) Kerala, is an ambitious project of the Government of Kerala with provision for early detection of developmental delay using Trivandrum Developmental Screening chart (TDSC)0 – 6 years and Language Evaluation Scale Trivandrum (LEST) 0 – 6 years. Under the Rashtriya Bal Swasthya Karyakram(RBSK) project, there would be District Early Intervention Centres (DEICs) established with appropriate therapy facilities. The question is, is it enough considering the fact that nearly 70% of health care in Kerala is provided by the private sector.

    School Child – School Readiness, Learning Difficulty

    Pre-school years lay the foundation for optimum growth and development in the areas of health, hygiene, nutrition, language development, personality building and social adjustments, besides the physical, emotional and intellectual development. As these form the base for formal education, it is important that school readiness is tested before enrolling the child to Class-1 at 6 years. In order to reduce the burden of learning problems, children with scholastic backwardness or poor school performance need to be assessed for intelligence, environmental deprivation, specific subject problem, poor fit with the school or the teacher or for early evidence of mental illness. Improving study habit has been found to be most useful, but we need a facility in the private sector also, that provide supportive counselling services.

    Young People – Growth, Reproductive and Mental Health Counselling

    Many of the nutritional, reproductive and mental health needs of the adolescent population are required to be addressed and can be addressed in the primary-care paediatric setting itself if the current system of health-care can be re-organized as per Rashtriya Kishor Swasthya Karyakram (RKSK) guidelines. This restructuring will be more effective for this population if adolescent-friendly approaches, public-private partnership and policy as well as the sectoral linkage between the National Health Mission (NHM) and other national programs are achieved. The dramatic increase in physical growth and development puts greater pressure on the need for nutrients. As both undernutrition (38%) and overweight / obesity (13%) could be present among adolescents, they should be recognized as a priority target group for nutrient supplementation in conjunction with healthy eating habits and physical activity. On the other hand, obesity is associated with the polycystic ovarian syndrome (PCOS) and screening should be done for obesity, menstrual irregularity and signs of clinical hyperandrogenism for early diagnosis of PCOS in an effort to prevent infertility and lifestyle diseases later on.
    A life cycle approach to child development is a philosophy that encompasses all actions essential for preparing for future motherhood, joyful pregnancy and safe delivery and optimal growth and development of children and adolescents that in turn should lead to responsible parenthood. This, in essence, means caring for the most critical nine months of intrauterine growth, the vulnerable first six years of life and the most neglected adolescent period and the same has adequate policy endorsement. This approach becomes even more important for at-risk LBW babies with a chance for impairment (biological) that lead on to disability (functional) to handicap (social).
    We wish to achieve the same through a comprehensive plan of establishing the one and only “NIMS-SPECTRUM-Child Development Research Centre (NIMS-SPECTRUM-CDRC)” with three key divisions namely;

    I. Clinical Child Development Division for Prevention, Early detection and Early intervention for Developmental disorders with a focus on;
    Neuro-developmental follow-up and early intervention for LBW babies
    Assessment and early intervention for developmental delay (0 – 6 yrs)
    Assessment and early language intervention (0 – 6 yrs)
    Assessment and early intervention for Autism (0 – 6 yrs)
    Assessment and intervention for Preschool children (4 – 6 yrs)
    Assessment and intervention for Primary school children (6 – 9 yrs)

    II. Specialised Therapy Division for Developmental delay /disorders/disability
    1. Early stimulation unit for high-risk newborns
    2. Developmental therapy unit for developmental delay
    3. Audiology & Speech therapy unit for speech and hearing problems
    4. Paediatric Physiotherapy unit for Cerebral Palsy and other neuromuscular disorders in children
    5. Sensory integration unit for autism children and special education for the needy.
    6. Occupational therapy unit promoting activities of daily living and appropriate special education techniques for the needy.
    7. Learning disability Lab for children with learning problems.

    III. Comprehensive Health Care Division for Differently abled children
    1. Paediatric Neurology unit – neurological evaluation and medication
    2. Paediatric Ophthalmology Unit – ROP Screening and ophthalmic evaluation
    3. Paediatric ENT Unit – Cochlear implant surgery
    4. Paediatric Orthopaedic Unit – Rehabilitation surgery
    5. Paediatric Genetics diagnosis unit – Special genetic investigations
    6. Paediatric Counselling/Education unit – Psychological interventions
    7. Paediatric Dental Care unit – Dental care and hygiene education
    8. Paediatric Nutrition & Dietetics unit – Management of specific feeding problems
    9. Rehabilitation Nursing Unit – Comprehensive care counselling
    10. Ayurveda & Naturopathy – Alternate systems interventions
    11. Prevention of disability – Health of young adults unit – PCOS clinic

    The NIMS-SPECTRUM – CHILD DEVELOPMENT RESEARCH CENTRE at NIMS Medicity, Neyyattinkara, Thiruvananthapuram, is being established under the guidance of Prof.(Dr.) M. K. C. Nair D.Sc., the founder Director of CDC Kerala and formerly the Vice-Chancellor, Kerala University of Health Sciences. It is visualised as a comprehensive project, utilizing the already existing infrastructure and health care professionals of NIMS, and consolidating the 18 established assessment and therapy units under one umbrella. The established mission of NIMS Medicity to provide high quality, cost-effective, state-of-the-art services to all needy without any discrimination based on paying capacity will be maintained at NIMS-SPECTRUM-CDRC.

    Prof.(Dr.) M.K.C. Nair
    MBBS, MD, D.Sc, Director, NIMS–SPECTRUM–CDRC, Formerly Vice Chancellor, KUHS, Thrissur
    MON- FRI 9:30 am 1:00 pm
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