Sir,
There is an added pressure on the caregivers of children with a developmental disability, especially when it is intellectual in nature.[1] It affects the communication, academic and social skills, which make the child more dependent on the caregiver as compared with a normal child. It was a pleasure reading the article by Nagarkar et al.[2] as the authors have picked up a good topic to work on, that is, to study the clinical profile of mental retardation (MR) in children as well as the prevalence of depression in their mothers in the Indian context.
Since, the authors have included co-morbid conditions such as epilepsy, cerebral palsy, downs syndrome and others. For the same, we would like to have some clarity about the exclusion of the serious medical conditions that the authors have mentioned for a better understanding of the sample characteristics of the present study.
In recent times, there is a shift from the joint family to the nuclear family making the family units smaller.[3] Though the magnitude of responsibility depends on the level of intellectual disability, it is greater for caregivers of MR children in small nuclear families. In our view, the knowledge of the family type of the children with MR in the present study would have helped us in knowing whether the shift from the joint family to the nuclear family burdened the caregivers and whether it increased the prevalence of depression of the mothers. Moreover, whether there was a difference in the depression level among fathers and mothers respectively.
It is also important to note that the families in the present study belonged to low socioeconomic status leading to the increased burden on the caregivers. Going into the future, the institute can help in providing some psychosocial intervention where the treatment package can include a mix of behavioral, supportive and educational techniques that can help in reducing the caregiver burden.[4] Other coping factors that can be included could be stress management, family functioning, and support from a spouse. Caregiver's health can be improved by specific stress management strategies. A prospective longitudinal study can also be planned to see the effectiveness of the psychosocial interventions in children with MR and their caregivers.
Overall, it is a good paper, and we would like to congratulate the authors for the same.
REFERENCES
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