Every child and every adult occasionally suffers from physical impairments. Minor or more serious illnesses affect our overall well-being and performance. Infectious diseases are frequent and common, especially in childhood.
Fortunately, today’s medical knowledge is so advanced that a large number of diseases can be cured or significantly alleviated sooner or later.
Despite all progress, there are also a large number of congenital or early acquired organic disorders that cannot be “repaired” despite all medical progress.
This section discusses issues related to these immutable physical disabilities in children.
Although both forms of disability are based on organic deficits, experts distinguish between physical disability and disabilities caused by damaged sensory organs.
What is a physical disability?
Physically handicapped are children and adolescents who have considerable and permanent restrictions in their ability to move.
Both the causes of the physical disability and the resulting consequences for the child concerned and its family are very different. However, the causes of physical disability can be grouped into several groups.
Damage to the central nervous system is particularly frequent in children and adolescents. Spastic paralysis can be caused by early childhood brain damage (e.g. due to birth defects or tumours, infections or accidents).
In addition, congenital malformations of the spinal cord and spinal column (e.g. spina bifida = open spine) or infectious diseases (e.g. polio) are relatively common.
In connection with such cerebral damage, additional seizure disorders (epilepsies) can occur.
Physical disability relatively frequently also affects damage to the musculature and skeletal system. These include muscular atrophy diseases and growth disorders such as skeletal malformations, joint malpositions, curvature of the spine or small growth.
Restrictions in mobility are sometimes caused by chronic diseases such as rheumatism or cardiovascular diseases.
The loss of limbs as a result of accidents plays an increasing role as a cause of physical disability only in older children and adolescents.
What is impairment of the sensory organs?
A handicap in the area of sensory perception mainly affects vision or hearing, while tactile and taste senses are affected much less frequently.
Since the perception of the visible and audible environment plays a particularly important role for the development of children, considerable limitations of these perception abilities lead to comprehensive impairments in many areas of child development.
Limitations in sensory perception exist in various forms. The boundaries between pronounced hearing loss and deafness are fluid, as are the boundaries between significant visual impairment and blindness.
If it is not possible to learn spoken language with the help of technical hearing aids, deaf or hard of hearing people are largely dependent on other senses such as vision in their communication with others. Although they can learn to communicate by means of sign language, they often need a sign language interpreter to communicate with hearing people, as only a few hearing people master sign language.
Just as deaf people are increasingly dependent on optical perception, visually impaired or blind people are dependent on the special training of another sensory perception – the sense of touch – in order to be able to perceive their environment as precisely as possible.
What other effects does the physical impairment have on my child?
Children with physical disabilities have the same range of intellectual abilities and different character traits as children without physical disabilities.
More than healthy children, however, physically impaired children are dependent on help and support from their parents and others.
For most affected children, acting independently, trying out their own abilities or approaching others is clearly more difficult.
This is why it is particularly important to support the children in developing a healthy self-confidence. The focus should therefore not be on the things your child cannot do due to his or her disability, but rather on his or her special abilities and achievements.
All children with physical disabilities will sooner or later become aware of their differences. Often certain experiences, mostly in contact with other people, lead to a painful awareness of one’s own disability. They are stared at with interest, pitied or simply asked by other children: “Why do you walk so funny?” or “Can’t you speak properly?
The fact of being different from others, of not being able to do some seemingly obvious things, of being handicapped, will keep your child busy for a long time and over and over again, causing grief and anger.
Accepting your own disability is a difficult and long-lasting process in which your child needs your support.
Where is my child best supported?
Although children with physical disabilities need comprehensive medical care in any case, they should start with individually necessary support measures as early as possible.
Depending on the type of disability, these may be physiotherapy, occupational therapy or speech therapy treatments and exercises.
Which support measures are necessary and suitable for your child is best discussed with the attending physician or therapist.
You will receive special support in early intervention centres, where you will receive advice and support for the educational treatment of your child in addition to the mediation of suitable therapy measures.
In addition to special outpatient services for handicapped children, there are also care facilities with suitable support offers.
Some institutions also offer integrative groups for both pre-school and school age, in which disabled and non-disabled children are cared for together.
However, as many physically handicapped children and children with severe hearing or visual impairments require special equipment and specially trained carers and teachers, the children concerned are usually taught in special day-care centres and special schools, which respond to the special needs and abilities of the children in small groups. Schools for handicapped children are often designed as all-day facilities and take into account the individual abilities of each child.
Which institution is most suitable for your child can only be decided on the basis of the abilities and needs of your child and the corresponding offers on site.
Doctors, therapists and employees of early intervention centres can provide you with valuable information and recommendations.
What is the best way to help my child?
As parents of a disabled child, you are exposed to extraordinary stress.
In addition to the often very time-consuming care and maintenance of your child, doctor’s appointments and therapy hours must be attended and various exercises – often against the resistance of your child – carried out at home. You will be challenged almost around the clock.
In addition, you also have to come to terms with the fact that you are the father or mother of a handicapped child. This process will take some time and will bind your strength again and again. Through the emotional support of your relatives and friends the processing can be made easier.
Mostly, however, people from your social environment are also unsettled by the unusual situation. Therefore, talk openly with them about what kind of support would really help you.
Many affected people describe contacts to self-help groups of parents of disabled children as particularly helpful, as they can exchange information with people who find themselves in a similar situation. Contact to other parents and help around the everyday life with a handicapped child you can get also on the side www.intakt.info.
So that you can muster enough strength and patience for the care, nursing and support of your child, it is important that you do not put yourself to too much. Therefore, talk to family members and friends or the experts at a counselling centre about possibilities of relief for yourself and your family.
Just like you as parents, your child must also process his or her disability psychologically and learn to accept it. For your child, too, this is a long-lasting process with ups and downs. You can help your child to cope by openly talking to him about your own feelings and experiences.
Disabled children need your parental care more than healthy children. Some learning processes and exercises are very tedious for your child, some even involve considerable physical pain and extraordinary effort. Nevertheless, your child should – within his or her limits – become as independent as possible and independent of outside support.
However, your child will only be able to learn the necessary things if you give him the opportunity to do so. It is certainly difficult for any of us to watch when a child has to work very hard for an activity that could be done with one hand, may even feel pain and may take a long time to do.
But if this is the first time that your child has been able to do it alone, it will be proud of itself and a little more self-confident – and have taken another step towards independence.