1. Acceptance of Diagnosis and Handling the Grief 

Parents have many dreams and hopes for the unborn child. They do not expect anything less than the perfect child.

• Diagnosis
• Depending on their experience of previous older children or the children of relatives, they may suspect some problem when the child does not behave like other children. 
• The more severe the problem, the faster it will be detected. Children with severe retardation or severe visual or hearing problems will show their inability to respond as early as the first ten to twelve weeks of life.
• Some conditions like Down’s syndrome can be picked up at birth.
• Communication of Diagnosis
• Very often the diagnosis is given by a busy doctor in a curt and insensitive way. 
• Parents do not even fully understand the impact of what has been said to them.
• Handling the Grief:
• Every family has to complete the grieving for the perfect child they were deprived of before they accept the child with disability. It is only with proper guidance that the family will accept the child and come to terms with the fact that there is no cure for disability but only doing the best possible to bring the child with the problems into the mainstream of society as early as possible. Then only can the family work well with the child to optimize development and mainstreaming.
• All parents react with symptoms suggestive of bereavement or death of the child.
• The first reaction is denial - “This cannot happen to me”
• Next is bargaining - “Will this go away if _____?”
• This is followed by anger - “Why did this happen to me?”
• This is followed by depression, which if unresolved could be lifelong for the family which is not given enough counselling and support.
• Lastly, after this difficult period is overcome, comes acceptance. Some parents, however, remain in a state of “chronic sorrow”. 

2. Subsequent day-to-day Issues 

A great deal of planning and change in the family’s life goals and expectations may have to be made. The family would need:

• help to accept the diagnosis and to clear misconceptions they may have about cause and cure.
• information about access to services, transport and benefits.
• guidance and support.
• help during times of crisis and most of all need help in long-term planning. 

3. Impact on Family

• Child’s disability may preoccupy the family to the detriment of spouse and other healthy children.
• Siblings may be ashamed of their handicapped brother or sister and resentful because they feel ignored by parents.
• Sometimes marriages can be strained and these issues need to be discussed with the couple to sort out responsibilities, schedules, time and money spent on the special child and make reasonable adjustment so that the husband or wife or siblings do not suffer emotional neglect and support.

These feelings are natural and need to be explored. Participation in a parent group will help in understanding that the family is not alone and that many people from all walks of life share the same situation.

4. Individual’s Needs 

• The individual too needs to cope with the demands of family expectations, rejection, self-esteem issues and societal attitudes. 
• These become more as the child’s understanding improves with awareness of a feeling of difference from others. 
• Integration, though the best option, heightens this awareness and should be handled well by the adults in the school.
• Adolescence brings additional difficulties and so does adulthood with issues of marriage and long-term goals. 

These subjects require sensitive handling and must be dealt with at the individual level by specialists in the field.