Therapeutic Challenges of Children with Intellectual Disability in Odisha

Introduction

Intellectual Disability (ID) is a neurodevelopmental condition characterized by limitations in intellectual functioning and adaptive behaviour, originating before the age of 18. Children with ID often face difficulties in communication, learning, social skills, and daily living. While therapeutic interventions play a crucial role in improving the quality of life and functional abilities of these children, significant challenges exist in delivering effective therapy in regions like Odisha, a state in eastern India with diverse socio-economic and geographical landscapes.

This article aims to explore the therapeutic challenges encountered in managing children with Intellectual Disability in Odisha, blending scientific insight with an accessible narrative for families, caregivers, professionals, and policy-makers.

Current Scenario in Odisha

Odisha is home to a large rural and tribal population, where access to healthcare and rehabilitative services remains inconsistent. According to the 2011 Census, Odisha recorded over 2.6 lakh individuals with intellectual disabilities, a figure likely underestimated due to underreporting and stigma. Despite various government schemes like Samagra Shiksha Abhiyan, Deendayal Divyangjan Rehabilitation Scheme, and District Disability Rehabilitation Centres (DDRCs), service delivery is patchy, especially in rural and tribal belts.

Major Therapeutic Challenges

1. Limited Availability of Trained Professionals

A major hurdle is the acute shortage of trained professionals such as occupational therapists, speech-language pathologists, special educators, and clinical psychologists in the state. While urban areas like Bhubaneswar, Cuttack, and Rourkela have some access, rural regions often lack even basic developmental screening services. This uneven distribution hinders early diagnosis and timely intervention.

2. Delayed Identification and Referral

Early identification of ID is critical for initiating intervention during the brain’s most plastic developmental stages (0–6 years). Unfortunately, lack of awareness among frontline workers (e.g., ASHA, Anganwadi workers), absence of standardized screening protocols in government health setups, and social stigma delay both diagnosis and referral.

3. Social Stigma and Cultural Beliefs

Many families in Odisha, particularly in rural areas, interpret intellectual disability through cultural or superstitious lenses—considering it a curse, sin, or karmic result. This leads to denial, secrecy, and avoidance of formal therapy, resulting in worsening of the child’s condition over time.

4. Inadequate Infrastructure and Resources

Therapy centers in government setups are limited, with most Integrated Child Development Services (ICDS) and Community Health Centres (CHCs) lacking rehabilitative infrastructure. Equipment for sensory integration therapy, assistive technology, or functional assessments is scarce. Moreover, public transport access to therapy centers is difficult for families in remote areas.

5. Financial Constraints

While government schemes provide some support, therapeutic services like occupational therapy, speech therapy, and behavioural intervention are often long-term and expensive. Most are not fully covered under existing insurance or welfare schemes. Families from lower socio-economic backgrounds struggle to afford consistent therapy.

6. Lack of Parent Training and Community-Based Rehabilitation (CBR)

Empowering parents as co-therapists is a proven strategy in ID management. However, structured parent training modules are rare in Odisha. Community-Based Rehabilitation (CBR), though ideal for rural outreach, is still underdeveloped in practice due to poor training, irregular monitoring, and lack of intersectoral coordination.