Down syndrome is another intrinsic factor that will be looked at in this assignment. Downs syndrome was first identified in 1866. It is a genetic condition that occurs because of an extra chromosome. With Downs syndrome there are many intrinsic factors such as specific physical characteristics for e.g. the child has learning difficulties and physical difficulties which are obvious.
It affects one in every 700 births about 1000 babies per year in the UK.
Cunningham C (1982) pg 89 states that ‘figures as high as one Downs syndrome child in every 520 births and as low as one in 1000’ The variations amongst the figures are mainly caused by difficulties in collecting the information. As before chromosomal analysis was available occasional misdiagnosis was made.
Studies done in 1940-1950 identified that over 60% of infants with downs syndrome died in the first year of birth; in the 1950-1960 period the reported rates varied between 40% to 55%. By the early 60’s the rates feel to 25-40%.
Cunningham C (1982) Pg 90
The average life span of a person with downs syndrome was in 1929 around nine years. However now it is common for a person with downs syndrome to live to age fifty and beyond. Along with living longer person with downs syndrome are now able to live fuller, richer lives than they could ever expect in the past. Contributing to the community and being able to form relationships and marriage. Now that people with Down syndrome are living longer, the needs of adults with Down syndrome are receiving greater attention. With assistance from family and caretakers, many adults with Down syndrome have developed the skills required to hold jobs and to live semi-independently.http://www.nichd.nih.gov/publications/pubs/downsyndrome/down.htm
Researchers have established that the likelihood that a reproductive cell will contain an extra copy of chromosome 21 increases dramatically as a woman ages. Therefore, an older mother is more likely than a younger mother to have a baby with Down syndrome, but older mothers account for only about 9% of all live births each year and 25% of Down syndrome births. Se appendix 1
There are 3 main types of downs syndrome:
Standard Trisomy
95% have this type, normally a child has 46 chromosomes in 23 pairs that carry the child’s inherited characteristics- half come from the mothers and half from father. A child with Down syndrome has an extra chromosome from either parent making a total of 47. The extra chromosome is produced from either during the making of the egg or sperm during cell division at conception.
Translocation:
This is a rare inherited condition that occurs in about 2% of children with downs syndrome. The parent passes on abnormal chromosome 21, which contains extra material as well as the normal chromosome 21, the child has the usual 46 in total.
Mosaic Down’s syndrome
This is an extremely rare and only occurs in 2.5% of children with Down syndrome. Some of the cells will have the usual 46 chromosomes and some abnormal cells will have 47. Its effects are less severe and fewer facial characteristics and less learning disability.
www.healthatoz.com
Their are many signs of a child who may have downs syndrome such as, poor muscle tone so the child may appear as ‘floppy baby’ and their joints are over extended and highly flexible. Their facial characteristics appear different too, ‘mouth small,\tongue protruding-palate high and arched, face and head flat-nasal bridge often flattened- hair line low with extra folds of skin, Eyes are slant slightly upwards and outwards. Ears are small’
There are many organisations that can provide support for children and their families with Down syndrome such as
- Speech therapist-Makaton
- Help with feeding and weaning
- Depending upon the physical conditions attached may be heart specialists or other specialists
- Physio and Occupational therapies
- The Downs Syndrome Association
Since the early 20th century many people with Down syndrome were housed in institutions or colonies and excluded from society. However in the 21st century there is a change amongst parents, educators and other professionals generally supporting a policy of inclusion ringing people with any form of physical or mental disability into the general society as much as possible. In many countries now people with downs syndrome are educated in the normal school system and there are increasing higher quality opportunities to mix in ‘special’ education with regular education settings. Despite this change, the reduced abilities of people with downs syndrome pose a challenge to their parents/ families. While living with their parents is preferable to institutionalization for most adults/ children with Down syndrome, however they often encounter patronizing attitudes and discrimination in the wider community.
It is recommended that stimulation and encouragement be provided to children with Down syndrome.
The evaluation of early intervention programs for children with Down syndrome is difficult, due to the wide variety of experimental designs used in interventions, the limited existing measures available that chart the progress of disabled infants, and the tremendous variability in the developmental progress among children with Down syndrome.
Recent studies indicate that 66 to 89% of children with Down syndrome have a hearing loss of greater than 15 to 20 decibels in at least one ear, due to the fact that the external ear and the bones of the middle and inner ear may develop differently in children with Down syndrome. Many hearing problems can be corrected. But, because of the high prevalence of hearing loss in children with Down syndrome, an objective measure of hearing should be taken to establish hearing status. In addition to hearing disorders, visual problems also may be present early in life. Cataracts occur in approximately 3% of children with Down syndrome, but can be surgically removed.
Approximately half of the children with Down syndrome have congenital heart disease and associated early onset of pulmonary hypertension, or high blood pressure in the lungs. Echocardiography may be indicated to identify any congenital heart disease. If the defects have been identified before the onset of pulmonary hypertension, surgery has provided favorable results. http://www.ndss.org/content.cfm?fuseaction=InfoRes.Generalarticle&article=28
Having downs syndrome condition can have many extrinsic factor affecting the child’s individual needs and behavior as due to the child looking different. A lot is identified in Brain, Mukherji (2005) that because autism and Aspergers are hidden illness and from just seeing a child with these conditions it may appear to us that the child is just ‘ naughty’ or ‘ disruptive child’ but where else with down syndrome because it is more obvious condition it is mire widely accepted and understood by society. ‘Down syndrome unlike autism has an accepted explanation’ (2005) pg 174
The way others behave towards a child with any special needs can have a massive input to the way that child may behavior and react. Also the child’s self esteem and self-concept can lack as if they know they are different and then are treated differently
The attitude and behavior of the adult/ caregiver is very essential as to how the children will respond to a child with any sort of special needs. As children intend to copy the behaviour of those around them as stated by behaviorist theories such as Bandura.
Also other behavior psychologists such and Skinner explained motivation in terms of reinforcement theory. Where behavior is shaped and sustained by the consequences, the individual receives. So positive reinforcement for behavior that want to keep and negative reinforcement for behaviour that want to reduce or eliminate.
Most educators and early year’s settings follow most these approaches for dealing with behaviour management.
Children with special needs and disabilities can show wide range of behavior problems. So it is essential that the parent/ carers involved in caring for that child know the strategies and ways of dealing with that child’s particular needs. For e.g. child with downs syndrome may have tantrums like any 2 year old but they might have them when they reach 4 years. The behavior may be more disruptive and harder to control as the child would be bigger in size and strength. Such behavior may puzzle those watching so it is important that the parent/ carer has full awareness of each child’s condition and individual needs, because not every child would have the same symptoms as another child with that conditions
Selikowitz M (1997) pg 91
So encouraging a flexible, safe routine that the child is aware of, ensuring to limit changes and providing a lot of support and encouragement is essential for those who care for children with special needs. Also praising good behavior where appropriate and discouraging or ignoring bad behavior is also a good strategy when dealing with children’s behavior. But the key to all this is to make sure their is consistency.
Porter L (2003) Pg 30
It is also important to identify what causes or triggers behavior problems. So in order to analyze this it is essential to identify the ‘antecedents, behavior and consequences’ for each incident. This method is known as the ABC of dealing with behavior which is another strategy used by many professionals in childcare settings. As once there is a pattern identified their can be support plans made to support that child’s individual needs.
Time out method can also be used but depending on the age and stage of the child.
Hassold T, Patterson D (1999) pg 117
Also with autism and Aspergers the condition can be confused with ‘elective mutism’ or to ‘attachment disorder’. Autism also seems similar to ‘specific language disorders’ with some social problems. So all these options need to be ruled out before child can get a diagnosis of autism or Aspergers. However with downs syndrome it is more obvious due to the child’s appearances, so the condition can easily be recognized.
Cohen B Bolton (2001) pg 16
Also another extrinsic factor due to the intrinsic illness of Down syndrome or autism/Aspergers may be the stress that families have to get through when their child is diagnosed with these symptoms. Some as early as from birth (downs syndrome) but some diagnosis takes place later, such as autism may be as late as when their child is 5/6 years old. So this could cause a lot of shock, grief and confusion to the families involved. This could lead to divorces, families breaking up and so on. However according to Selikowitiz M (1997) pg 12 reports that many parents have stressed that having a child with special needs such as ‘down syndrome only brings them closer’
Having a child with intrinsic conditions such as autism, downs syndrome and so can have not only intrinsic factors but also intrinsic factors affecting not only the child but the whole family. So it is essential that the society supports these families and individuals.
This has not been the case as before those with special needs were excluded from the ‘normal’ people and living. The medical mode of Disability viewed that disability was due to the out come of disease or trauma or health condions, which has no cure. It was believed that disabled people are completely dependent upon others and cannot fully participate in society. This view was held up 1970’s to the early 80’s.
Then the social model was that it looked at the wider context in which impairment becomes disabled, \ i.e. it is socially created problem, as society prevents disabled people from living full and participatory lives. This view links in with children and humans right and it as taken may centuries to be accepted and acted upon.
Today it is widely accepted that all children have individual needs. This is defined in the Warnock Report 1978.
Also due to federal laws (Public Law 94-142) which are in place to ensure each state has as a goal that "all handicapped children have available to them a free public education and related services designed to meet their unique needs." The decision of what type of school a child with Down syndrome should attend is an important one, made by the parents in consultation with health and education professionals. A parent must decide between enrolling the child in a school where most of the children do not have disabilities (inclusion) or sending the child to a school for children with special needs. Inclusion has become more common over the past decade. http://www.nichd.nih.gov/publications/pubs/downsyndrome/down.htm
So due to the government stressing the importance of accepting those with special needs has promoted the society to try and accept people with special educational needs and disabilities. Regarding what their individual needs may be. So over the past few decades, beginning with Section 504 of The Rehabilitation Act of 1973, continuing with the education for All Handicapped Children Act (public law 94-142) which was passed in 1975 and resulted in special educational services in separate classrooms as the model for helping children with disabilities. The individualized Plan (IEP) became the blueprint for each child’s educational program for the school year. In 1997 legislation was passed for individual with Disabilities Education Act amendments. (IDEA 97) Due to this legislation communication between schools and outside agencies developed which benefited the child as they were supported in the areas where they may have lacked. This awareness is still ongoing as the government issued the white paper valuing people: as strategy for learning disability for the 21 st century. This paper was published on 20th march 2001. It is the first white on learning disability for thirty years and sets out a positive and challenging programme of action for improving services. Hassold T, Patterson D (1999) pg 145
The governments latest strategy for special educational needs is their aim to ‘bring all the relevant services together’ Children Now 25 feburary-2 march (2004) Pg 19
So in conclusion there has been no real cure found for children with Autism, Aspergers or Down syndrome and many other intrinsic illnesses. However the main progression since the 19th century is that there is a lot of ways proved that can provide help in dealing with children with their condition, also support groups, organizations that parent/carers, children can access. But the inclusion of those with special needs not only in education but as respectable human beings in society as been the view and has taken great strides since the 19th century and will now hopefully only keeping progressing. People have now started to realize that those with intrinsic illnesses also have extrinsic factors affecting their condition and behavior.
References
Cohen B, Bolton (2001) Autism the facts, Oxford University Press
Cunningham C (1982) Down syndrome an introduction for parents, Souvenir press LTD
Hassold T, Patterson D (1999) Down syndrome a promising future together, Wiley & Sons INC
Jordan R, Powell S (Understanding and teaching children with autism, John Wiley & son Ltd
Mukherji, Brain (2005) Understanding child psychology
Oliver M (1996) Understanding disability, Macmillan Press
Porter L (2003) Young children’s behaviour second edition, Paul Chapman Publishers
Selikowitz M (1997) Down syndrome the facts second edition, Oxford University Press
Tait T, Genders N (2002) Caring for people with learning disabilities, Arnold
Websites used:
Early Years Intervention program retrieved 29th march
www.kidshealth.org.uk
Federal Law retrieved at 27th march http://www.nichd.nih.gov/publications/pubs/downsyndrome/down.htm
Down syndrome Chart retrieved 2nd April
http://www.nichd.nih.gov/publications/pubs/downsyndrome/down.htm
Down syndrome chart retrieved 2nd April
www.mother35plus.co.uk/down
Autism retrieved 23rd march
www.nas.org.uk
Down syndrome facts retrieved 19th March http://www.ndss.org/content.cfm?fuseaction=InfoRes.Generalarticle&article=28
Journals used:
Children Now 25 feburary-2 march 2004
Appendix 1
According to the National Association for Down syndrome, "80% of babies born with Down syndrome are born to women younger than 35. The average maternal age is 28 years old." The likelihood of a woman under 30 years of age giving birth to a child with Down syndrome is less than 1:1000, but increases the older the woman gets (see chart above), with an incidence of about 1:60 at 42 years of age.
Both the charts taken from different websites identify that woman over 35 have more chance of having child with Down syndrome.
