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A)This is the most common question that we as professionals have to answer and also the most tricky one, answering this is like looking into the wishing glass and telling the future and answers to this is the source of the biggest confusion and disenchantment with professionals ,some doctors will tell you looking at the child at birth that nothing can be done and this child will never be able to do anything in life causing immense depression to parents who are young and have just started life together on the other end of the spectrum are parents who have been told that everything is okay and the child will be absolutely normal be a little slow in achieving their milestones, there are others who have lost a lot of time, effort and a lot of resources over claims by professionals that they will be able to make the child sit/stand /walk in 3 months /6 months most of these claims are usually false and cause depression/resentment in parents

The usual answer to this question that I feel is being truthful and telling that –WE DON’T KNOW!!!

The problem is that this is very difficult for professionals to accept this fact but the truth is as parents/individuals you don’t know what is your future going to be 5 years from now, where will you be 5 years down the lane ,what will be your income 5 years from now, what will be the physical status of your health 5 years from now
Just as this is so difficult to tell and predict such is the difficulty that professionals have in answering this question and any definite prediction is going to fall into either of the two categories a) over positive b) over negative

The best method is assessing where the child is today and then make 6 monthly goals or yearly goals after sitting with the team of professionals wherein each professional knows what is expected out from him/her this is just like the school does when we send our kids to them ,gives them daily lessons and assesses them weekly/monthly/quarterly/half yearly and yearly and just as we don’t know whether some child who has been sent to school will turn out to be an great leader or a plumber we don’t know what will your child become when we assess them the first time we can make valid assessments only when we see them and assess them regularly

The answer then is

Sit with the team of professionals
Find out what level your child is –TODAY
Find out his strengths and also his weakness ie – IDENTIFY THE PROBLEM AREAS
Make 6 monthly and half yearly –REALISTIC GOALS
Assess with the team-AT REGULAR INTERVALS

There is a scale/tool called as the GMFM which can help us to assess them at 6 monthly intervals and tell us where have we gone, in addition we also have developed in conjunction with SGPGI ,LUCKNOW a new method of assessment called as Diffusion Tensor Imaging(DTI) , it tells us at regular intervals what are we looking at today and at 6 months reassessing WHERE WE HAVE REACHED
So we have 3 methods of assessment

Repeated clinical assessment
Repeated video assessment
Repeated diffusion tensor imaging assessment

Having multiple tools of assessment helps us validate all the tools against each other making better assessments.

All that we have said earlier is true for children below the age of 6 years ,once they have crossed this age making a statement will become easier ,we can say with a reasonable degree of confidence where this child is going to be 5 years from now this is because the curves in the GMFM scales flatten out, the brains plasticity or growth potential is smaller and the children start showing their true potentials

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