Child Physology_My Observation on Theories for Special Needs Children.

DEMOGRPHIC DETAILS

Joy Jaazaniah, a girl starts out as a happy and healthy baby. She is the eldest of 3 siblings. She is 12 years old now. Normal development like any other child grows. Then, around 6-18 months of life something goes terrible wrong. She loses the ability to speak, she can’t use her hands to play with toys or even feed herself and she may lose the availability to walk. Our local hospital unable to diagnosed. Some doctor say could be Autistic, Cerebral palsy or any rare diseases. We are unable to comprehend with speculations. Her parents did final attempt, blood sample taken; send to Japan to find out what is wrong with her. After several months we found out that she is diagnosed with Rett Syndrome.

Have you heard of “Rett Syndrome” I haven’t until my niece Joy Jaazaniah diagnosed with it. What is Rett Syndrome? Through my assessment I will share how my niece and rest of the girls diagnosed with Rett Syndrome nature, and appearance of this syndrome had impacted physical, cognitive progress and socio emotional by collaborating the two theories.

OBSERVATION SETTINGS

My observation carried out in various situations from the day she was born till today. On a closer observation, a difference is seen from normal child growing and special child like my niece. Rapidly observed during crucial time when I took Child Physiology course. Rett Syndrome is a genetic neurological disorder that affects girls between 6 – 18 months of age. The regression decease leads to a lifelong handicap. My first observation was her floppy legs movements indicate difficulty with balance and coordination. She started too walked on her toes unlike other children. She is unable to express her feel of excitement, anger, sadness or pain. She unable to articulated or says any single words as she grows. Even thought when she was 12 months “Tertiary Circular Reaction” she is able to say first recognizable words. Shaking different toys to hear sounds and searches for object that have been concealed. After diagnosed gradually she had severe communication impairments. She communicates with me through her smiles, facial expression and eye contact. I spend most of my time talking to her, reading spiritual book and children books.

DEVELOPMENT MILESTONES

COGNITIVE DEVELOPMENT

Rett Syndrome is a disorder of the nervous systems, caused by mutation on the MECP2 gene location on the X Chromosome, that leads to development reversals. Joy is unable to demonstrate her intellectual abilities. She cannot verbally communicate; she is able to point to something, understand our conversation, questions and she communicate to us through her beautiful eyes. Non verbal communicators like me required to be attentive to gesture, facial expression, body language, even the look in someone eyes. This will build her confident and feel secure. Her intelligence is difficult to measure due to her motor difficulties and lack of speech. To stimulate her cognitive development we begin with pre-literacy skills exposure and repetition. I make a point spending time reading books, play and watch cartoons with her.  Learning is a good for the brain, no matter what the neurological challenges may be. I also use flash cards for her to know and see her surroundings. She expresses herself when she is hungry and discomfort by crying or make noise. As she able to point to something, I experiment Object Permanence falls under Piaget Stages of Cognitive Development “Sensorimotor”:  4 – 8 Secondary Circular Reactions. Same method hid a toy under a blanket, while she was watching and observing whether or not she search the hidden toy. After several attempt of me demonstrating, I was happy to see she is trying her best to reach out her hand to move the blanket.

PHYSICAL DEVELOPMENT

Children diagnosed with Rett Syndrome tent to display both poor gross and fine motor skills. A child’s motor ability with Rett Syndrome can be significantly impacted by motor Apraxia and Ataxia. Motor apraxia is inability of the body to perform a movement when prompted by the brain. Ataxia, means without order or in coordination. The combination of motor apraxia and ataxia clearly negatively affect the child’s ability to perform many gross skills used in general physical education and other movement settings.

Gross Motor Development

We notice regression on Joy Gross Motor Skill when she was between 12 – 18 months. Her physical Development Milestones regressed instead following the benchmark of any normal child milestone development. She is unable to perform locomotors skills such as hopping, jumping, throwing balls, kicking and catch things. Diagnosed with Rett Syndrome is prone to have a Hypotonia. Lack of muscle tone and therefore may require support from adult. She typically remains standing still with support while watching others performs activities. It will take great amount of strength and co ordination to perform activities. Base on Piaget’s Stage of Cognitive Development, should be “Concrete Operational” stage, however with this diagnosed motor movements can be difficult. Muscles weaknesses, rigidity or stiffness, dystonia is increased muscles tone with abnormal posturing of extremity and scoliosis is curvatures of the spine are other prominent features decline her to move. She needs wheelchair to move around with the support of adult.

Fine Motor Development

Loss of purposeful hand movements; the grasp used to pick up small objects is repetitive hand motions like wringing or constant placement of hands in mouth also clasped behind the back or held at the sides. Even thought she was able to feed herself a cracker or, passing an object from one hand to another and pick up a tiny object unfortunately she can’t do any more as days goes by.  She wants to move and perform the task, but seems to be unable to tell the body to do. Her floppy arms and legs are the result of neurological problem rather than lack of exercise. Lately I bought a dog “Shih Tzu”. Upon my observation I notice her eye contact constantly looking at the dog and smiling. I took my dog place on her lap. She slowing left her hand and strokes the dog with a smile. It is really a great achievement for me.

COMMUNICATION AND LANGUAGE DEVELOPMENTAL MILESTONE

Neurological problems like Rett Syndrome affect the muscles needed for speaking. Without ability to communicate through speech or hand movement she unable to express her needs and wants. Her non verbal communication is more on facial expression and body language. She understands basic sound of native language but she unable to response. She expresses herself by making sound and through her eye contact as well crying when discomfort.

SOCIO-EMOTIONAL DEVELOPMENAL MILESTONES

Many children with Rett Syndrome go through a period of social withdrawal as part of their regression period. While growing up she cries frequently, avoid eye contact; she don’t like to go out in public like shopping mall and restaurants. Noise often irritates her. She shows no interest in surrounding. She preferred to be alone at home and play with her fingers.  Social interactions are challenging for children with Rett Syndrome at all stages. At the age for two she started to lose grip associating with her peers and isolated herself by playing alone. Music also has been found to be an affective motivation tool. I bought some nice soft music to stimulate her mind; motivating tool that increase social engagement and receive positive response from her. Sociocultural Theory : Lev Vygotsky “Zone of Proximal development and Scaffolding” applies in my family and I confronted as face challenges every day. However, we often find ways to overcome challenges to create positive environment and learning tools to help her. Meeting her unique behavioral by supporting creative positive social skills. Creating opportunities for social interaction and exposing her to the surrounding. Keep motivating her and give her hugs of love each time she manage to adapt to the environment.

She needs a lot of “Scaffolding” support in Medical Concern. She is prominent to seizures. In additional to seizure, child with Rett Syndrome often have Gastroesophageal reflux, constipation, scoliosis and abnormal breathing and poor circulation. All these potential medical issues can cause delays in the motor domain. She need constant observation, care and support to go through daily life this in world.

THEORIES

Cognitive-Development Theory JEAN PIAGET

Relating his theory on Rett Syndrome child on Piaget stages of cognitive development apply differently compare to normal child. Joy relates more on Sensorimotor Substages. Rett Syndrome is a disorder of the nervous systems (Neurological Disorder) that leads to developmental reversals. Hypotonia, loss of transitional movements, excessive saliva and drooling, floppy arms, legs and showing head growth beginning at approximately 5 – 6 months of age. Believing nature and nurture interact to yield cognitive development for special child like Joy. It is easy to relate Piaget theory for normal children, how are we going to relate to special children diagnosed not only to Rett Syndrome also Autistic, Dyslexia, ADHA and many more. Special need children are significantly requires intensive accommodations and special learning approach as well environment to suit their needs. How can we excel Piaget theories Sensorimotor, Preoperational, Concrete Operational and Formal Operational to our special need children?  It is something for me to brain storm, designed for our potential special needs children.

Sociocultural Theory: LEV VYGOTSKY

Vygotsky has developed a socio-cultural approach to cognitive development.Vygotsky (1978) sees the Zone of Proximal Development as the area where the most sensitive instruction or guidance should be given - allowing the child to develop skills they will then use on their own - developing higher mental functions. Vygotsky also views interaction with peers as an effective way of developing skills and strategies. He suggests that teachers use cooperative learning exercises where less competent children develop with help from more skillful peers - within the zone of proximal development. “Scaffolding” support help child to enhance skills to leave independence. Special Children need a lot of support to accomplish certain tasks. As a caregiver we need to be aware of their capabilities and motor challenges of a child. She can easily become frustrated or disinterested with an activity that challenging. Finding out what motivates the child enables the child to stay more focuses on the task. When we are assisting a child we also need to be sensitive on their movement, any pain sensation any reaction for improvement. It is also good the keep tract on child milestones. How long does a child need our support. We being with simplest form of an activities or skill help the child process the task and have a success before we moving on to a more complex skill.