Generally speaking, people with multiple disabilities are those who have more than one condition affecting them simultaneously. A precise definition remains elusive and complex, but we can offer a description that may help us identify the people we're discussing.
The various deficits that combine are of the following types:
- sensory: damage to the sense organs, especially sight and hearing, resulting in partial or complete blindness and/or deafness;
- neurological: damage to the central nervous system from various kinds of injury, leading to motor deficits (spastic paralysis, hemiplegia, paresis, muscle weakness, etc.) and/or focal disturbances (epilepsy with seizures, or absence seizures, etc.)
- behavioral and psychological disorders (which almost always occur alongside the above).
Despite wide variation in individual circumstances, we see common features:
- delay in developmental milestones;
- learning difficulties;
- behavioral and communication disorders (autism, repetitive behaviors, aggression, etc.);
The causes of these conditions, when known, may have occurred at different stages:
- in the prenatal period: hereditary diseases (far rarer than commonly thought, such as phacomatoses or other rare malformations), but most often maternal infections during pregnancy (particularly rubella, cytomegalovirus, toxoplasmosis) that cause damage to the child, more severe the earlier they occur; we should also mention X-ray therapy, maternal diabetes, and the use of certain medications.
- in the perinatal period: related to birth itself, including neonatal asphyxia, intracranial hemorrhage, and trauma (from forceps or vacuum extraction).
- in the postnatal period: infectious or toxic encephalitis in early childhood, sepsis, severe dehydration, circulatory disorders, trauma, etc.
What can be done to reduce the risk of such damage? While in most cases these events cannot be foreseen or prevented, certain steps can help:
- consult a premarital clinic if you suspect you carry a hereditary disease (rare) or to check for possible Rh incompatibility;
- get vaccinated against rubella and similar diseases;
- avoid certain medications during pregnancy and avoid exposure to radiation;
- observe basic hygiene practices during pregnancy, such as avoiding contact with animals (dogs, cats, etc.);
- if there is someone else in your family who was severely disabled from birth, consult a genetics clinic at a university hospital that offers this service, so you can approach future pregnancies with greater confidence, especially if you are parents who have already had a child born with such a condition.
by Anna Cece, 1986
