Rehabify
In brief
Children with Duchenne muscular dystrophy (DMD) can go to school, learn, play and make friends. Because muscles get weaker over time, school needs some planning, and that plan needs to change as your child grows. Therapy helps keep joints flexible, keeps your child active in a safe way and supports independence. It does not stop the condition. At Rehabify in Bengaluru, Dr. Dharshan N A, a physiatrist, helps families plan therapy and school support alongside the child's neurologist.
Why planning matters
DMD affects the muscles used for walking, climbing stairs, getting up from the floor and, later, lifting the arms. Children with DMD tire more easily than their classmates. Small changes at school can save energy for learning and play, and lower the chance of falls.
Plan before problems start. A meeting with the class teacher and school head at the start of each school year, or when something changes, works well for many families.
Getting around school
- Classroom on the ground floor, or close to a lift, so your child avoids stairs
- Short routes between the classroom, toilet, lunch area and pickup point
- Extra time to move between rooms, with a friend to walk alongside
- A second set of books at home so the school bag stays light
- Safe floors, with care on wet or crowded corridors where falls are more likely
- A wheelchair or scooter for long distances, such as school trips or sports day, even while your child still walks in class
Seating, toilets and rest
- A chair at the right height so feet rest flat and your child can stand up without strain
- An accessible toilet close to the classroom, with grab rails, and permission to go when needed
- Rest breaks during the day, and a quiet place to sit
- Help with heavy tasks, such as carrying trays or moving furniture
Some children avoid drinking water at school so they do not need the toilet. Watch for this, as it can cause constipation and other problems.
PE and play
Children with DMD should stay active, but the type of activity matters.
- Usually encouraged: swimming, gentle cycling, walking, and play at your child's own pace
- Usually avoided: repeated jumping, running downhill, trampolines, heavy lifting and any exercise that strains the muscles
- Stop when tired. Your child should be allowed to sit out without being singled out
- Warning signs of too much: muscle pain or extreme tiredness the next day, or dark urine after exercise
Ask the PE teacher to give your child a role in team games, such as keeping score or coaching, when running is too hard.
Learning and attention
Some children with DMD have difficulty with reading, memory, attention or speech. This is part of the condition for some boys, not a sign of laziness. If you or the teacher notice problems, ask for an assessment by a psychologist or developmental paediatrician. Support such as extra time, short instructions and a seat near the teacher can help.
Writing and exams
As the arms and hands tire, writing can become slow. Ask about:
- Extra time in exams and class tests
- Using a laptop or tablet
- A scribe or reader where allowed
- Copies of notes instead of copying from the board
Most exam boards in India offer concessions for students with disabilities. The Rights of Persons with Disabilities Act, 2016 supports inclusive education and reasonable adjustments at school. Ask the school how to apply, and keep copies of medical letters.
Therapy outside school
- Daily stretching of the calves, hips and knees, usually done by a parent at home
- Night splints to hold the ankles in a stretched position during sleep
- Safe, regular activity, such as swimming
- Standing and positioning to protect joints and posture
- Equipment at the right time, such as a lightweight manual wheelchair and, later, a powered wheelchair
- Regular checks of the heart, breathing, spine and bones, arranged with your child's neurologist
Many children with DMD take steroid medicines prescribed by their neurologist. These can affect weight, mood and bone strength, so your rehab plan takes them into account.
Talking with your child
Children notice when they cannot keep up. Talk openly, using words that suit their age. With your child's agreement, some families help the teacher explain to classmates why your child uses a chair or sits out of some games. Being part of the group matters as much as any piece of equipment.
How Rehabify helps
Dr. Dharshan N A checks strength, joint range, posture and walking, plans stretching and splints, and advises on equipment and safe activity. With your consent, he writes a letter for the school with suggested changes. He works with your child's neurologist and refers for heart, breathing or spine checks when needed. Follow-ups can be at the clinic or by video consult.
When to get help urgently
Medical emergency
Call 108 or 112 or go to an emergency department if your child has trouble breathing, a weak cough with a chest infection, chest pain, fainting, or a fall with severe pain or a possible broken bone. After a fall or fracture, sudden breathlessness, confusion or drowsiness is an emergency. If your child takes steroid medicines and is vomiting or very unwell, seek urgent care and tell the team about the steroids.
Common questions
Should my child go to a regular school?
Many children with DMD attend mainstream schools with the right support, such as ground floor classrooms, rest breaks and exam help. Some families choose a special school or a mix of both. The right choice depends on your child, the school's facilities and how willing the school is to plan with you. The doctor can help you think it through.
Can my child take part in sports day?
Often yes, with changes. Your child might join shorter events, take part in a wheelchair, or help with scoring and announcements. Avoid events with repeated jumping or straining. Talk to the PE teacher well before the day so your child is included rather than left out.
How much stretching is needed?
Most children need daily stretches of the calves, hips and knees, held gently for a slow count. Your physiotherapist will show you how and how long. Doing it at the same time each day, such as after school or before bed, helps make it a habit that lasts.
When should we think about a wheelchair?
Many children start using one for long distances, such as school trips or shopping, while still walking at home and in class. Starting early saves energy and keeps your child out with friends. The doctor helps you choose the right chair and plan the change at your child's pace.
What should the school know in an emergency?
Give the school a short written note with your child's diagnosis, medicines, your contact numbers, and the doctor's details. Include that falls may cause fractures, that breathing problems need urgent care, and that steroid medicines should be mentioned to any emergency doctor. Update it every school year.
Sources
- [1]
World Health Organization (WHO). Rehabilitation fact sheet
- [2]
Centers for Disease Control and Prevention (CDC). Care considerations for Duchenne muscular dystrophy: a guide for families
- [3]
American Academy of Pediatrics (AAP). Clinical report: Cardiovascular health supervision for individuals affected by Duchenne or Becker muscular dystrophy, 2005
This guide is for general education and does not replace a consultation. Read how we write and review guides in our editorial policy.
