Hesperian Health Guides

Caring for the Severely Disabled Child

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HealthWiki > Disabled Village Children > Chapter 33: The Child with Several Severe Disabilities > Caring for the Severely Disabled Child

In deciding how to care for and work with the child who has a combination of severe disabilities, it is important to evaluate as best you can both her disabilities and possibilities. Especially in the very young child, this may not be easy. You must be ready to see new signs and change your evaluation. This, in turn, may change your plan for working with the child, so as to best help her to develop whatever skills and responses are possible.

In evaluating and planning activities with the child, try to be realistic. Do not expect too much, because this can lead to disappointment. But at the same time, do not expect too little.

For example, a child with a serious physical disability who is also deaf and/or blind may appear to be mentally slow simply because her ability to experience and respond to things around her is very limited. The child may, in fact, have a lot more mental capacity (or possibility) than she appears to have. It would be wrong not to look for ways of reaching, developing, and appreciating her mind. However, this may take great patience and creativeness by those caring for her.


  1. To help her to be physically comfortable, clean, safe, and well-fed.
  2. To help her with positioning and exercise to prevent further deformity, and to make caring for her easier.
  3. To help her learn whatever basic skills she can—in developing head and hand control, and in some form of communication. Also, help her learn to interact with others in a way that her needs are met and her behavior is acceptable.
  4. To make caring for the child easier and more enjoyable for those who are responsible for her.
  5. To assure her that she is loved.

a child in a seat that supports his body and head while a woman feeds him.
Special seating can help the severely disabled child by supporting him in a position where he has better control.

Much of the information and suggestions in Chapters 34 and 35 on early stimulation and development may be helpful for the multiply disabled child. Look for areas of development where the child seems to be most ready or to have possibilities. Then work out a plan of activity, stimulation, and rewards that will take the child forward one small step at a time. Some of the suggestions included in Chapter 40, “Ways to Improve Learning and Behavior,” may also help. However, you will need to apply them with much patience and repetition.

To help meet the needs of the multiply disabled child, you will also find useful information in the chapters on the different disabilities that affect the child.

Special seating and positioning, discussed in Chapter 65, may help the child to have more control of her body. This can make feeding, basic communication, and other activities easier.

A baby is being helped to roll over
A child who is slower than most in learning to use her mind and body needs extra help. Learning to twist and to roll, and to lift up on her arms and turn, are important early developmental steps. Here a rehab worker first helps ‘loosen up’ a child by slowly swinging her hips from side to side.
a woman holding a baby bottle while a child turns to look at it.
Then she encourages the child to lift up and turn to follow an object she wants.

CAUTION! Breast feeding is healthier than bottle feeding. It is usually better to use a toy or rattle to draw the child’s attention rather than a bottle.

This page was updated:21 Nov 2019