NGO & Disability School for Mentaly Retarted, Handicapped and Disabled Children with Residential Facilities ngo's in india, disability school, special schools india
Handicapped Schools in India Residential Schools in India Disability Schools India Special Schools India Special Schools India
NGO for Children with Cerebral Palsy, ADHD, Autistic, Aspergers, Mentally Retarted, MR, Down Syndrome


MOTHER AND CHILD WELFARE AND RESEARCH FOUNDATION INDIA is a NON-PROFIT secular organization, with RESIDENTIAL FACILITIES, Fully Equipped with the Pre school and School Session, providing Education and Training to all kinds of CHILDREN and ADULTS with Behavior Problems and Multiple Disabilities like Autism, Slow Learners, Aspergers, ADHD, Mental Retardation, Down Syndrome, Hearing, Speech and Visual Impairment, etc.



Name of Student:


Date of Birth:


IQ Level/Class (as per psychologist report):


Blood Group:




Languages Spoken & Mother Tongue:


Childhood History (if child is MR what is level, Mild, Moderate, Severe):


Family History of any Retardation / Disability (any parent's family members having the same syndrome):


Immunization History (mention all doses given, any pending doses?):


Developmental Milestones (talking, walking at what age, etc):


General Behavior:


Tell us about your Child
Motor Functional Activities
(Fine & Gross Motor Skills, etc.)
Eye & Hand Co-Ordination:


Are there any particular time in the day, when the child's behavior is more severe, if yes, when is it? Does it happen regularly? Who is the most affected? :


Was the child asked to do something, or was the child refused something, prior to the Behaviour, if yes, please specify, What do you or others generally do, immediately to calm the child:


Was the child asked to do something, or was the child refused something, prior to the Behaviour, if yes, please specify, What do you or others generally do, immediately to calm the child:


Please provide us with the Complete Medical History / Disorders, etc. of the Child (also Pre Natal / Natal / Post Natal, Complications, etc.):


Medication History (allopathic / homeopathic medicine in the past / current prescribed by a physician & name of physician/doctor):


Hobbies / Sports / Games / Likes and Dislikes, etc.:


Past time Behavior / Leisure Activities, etc.:


Problems in Speech / Physical Movements, etc.:


Nature, Name and Full Address of the School he attended earlier (Special / Integrated / Normal, Dates, Class till, etc.), How was his Attendance ?:


How is his Interaction with People, be it Friends, Neighbors, Relatives at Social Gatherings, Strangers, etc. (if any) :


Did the child ever get any EPILEPTIC ATTACK, FITS, etc. (if any kindly provide full details with medication) :


Major Emotional & Behavioral Problem of the Child:


Type of Family (joint/nuclear & number of persons, time spent by parents and siblings):


What kind of Help/Support/Guidance are you looking for from us
(in brief, like want them to be independent, basic education via national open school, etc.):


Anything you would like to inform us about, (about his toilet training, about his fooding habits, obsession, ocd, favorite food, other remarks etc):


Is your Child Toilet Trained?:

                    Yes      No

Fathers Name:




Caste (Punjabi/Sindhi/Marwari/Bengali/Assamese/Christian/Muslim,etc):


Mothers Name:




Caste (Punjabi/Sindhi/Marwari/Bengali/Assamese/Christian/Muslim,etc):


Full Residential/Postal Address:








Telephone ( & city code):


Mobile ( & city code):


Facsimile ( & city code):


How did you get to know us:






                    handicapped child


The best way to find yourself is to lose yourself in the service of others - Mahatma Gandhi


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Mobiles: +(91)-98308 88888, 98300 28888, 98310 28888, 9330028888 Landline: +(91)-(33)-4007 8889