Week Three

Lisa is now 18 months of age, and Tim and Yuting have continued to adjust to the reality of Lisa's challenges given her premature birth. Financially, they have had to make some changes in their lifestyle given the hospital bills from the birth and the continued therapies that Lisa has been receiving.

Tim and Yuting have found their way through the difficulties as a stronger couple. They are proud of their resilience and couldn't be more in love with one another. They work and play well together; they enjoy one another, and they are wonderful co-parents. They have close and caring relationships with Yuting's parents especially, Ron and Tom.

* Outline the typical developmental milestones for an 18 month old child including physical, cognitive, social and emotional domains.  See DECISION POINT

* If Tim and Yuting want to place Lisa in daycare, are there specialized daycare services available for children who have significant developmental delays? 

* How do Tim and Yuting go about getting services through Part C of IDEA? What might a IFSP for Lisa include? Propose goals for Lisa. What are the parents' responsibilities with regard to IDEA Part C?  

DECISION POINT ::: Given the answers to last week's questions with regard to the kinds of difficulties that a premature birth can pose, decide how Lisa will present at 18 months. In other words, your group gets to decide on the nature of her specific challenges - does she have cerebral palsy? Does she appear to be cognitively impaired in any way? Does she communicate with her parents in meaningful ways appropriate to her age? What does the relationship between Tim and Yuting predict in terms of long-term outcomes for Lisa?   

Week Two

Everything was moving along wonderfully for Yuting in her pregnancy, and she and Tim were looking forward to their first child. They had a new room almost ready for Lisa, and the baby showers had provided them plenty of the accouterments they would need in the first year. All was going just as they had hoped…until that Friday night that they will not soon forget.

Around 3 in the afternoon, Yuting began to experience a discomfort in her abdomen that she couldn’t quite name, and, at first, she tried to ignore it. An hour or so went by, and, having tried to take a nap, Yuting began to notice that the discomfort started to turn to pain. She called Tim and told him to come home, and then the real pain started. Something was definitely wrong. By the time Tim arrived 20 minutes later, Yuting was in agony. She had another month and a half at least until Lisa was due. As they drove as fast as they could to the ER, thoughts of fear, incredible pain, and despair raced through her head.

Even in their panic, Tim managed to call 911, and the dispatcher alerted the hospital that the two were one their way. With Tim mostly carrying her into the ER, Yuting was immediately taken back to be seen. It quickly became clear that Lisa was going to be born.

* What is the “age of viability” for a fetus?

* What are some causes of premature birth? Does it seem that Yuting was at risk for any of these?

* What usually happens when a baby is born prematurely? Provide a rough outline of the medical considerations, what the doctors typically need to ensure first, and then what kind of care occurs in the NICU. How is it determined that the child is ready to go home? What later challenges are associated with premature birth? Is being born prematurely a causal factor in later difficulties, or is it correlational?

* Describe typical developmental milestones during the newborn period and during the first year of life. How will babies born prematurely meet or not meet those typical milestones? On what circumstances does this depend?

* Find research that looks at parental stress associated with the birth of a child and then with the premature birth of a child. Write a narrative that tells of the kinds of thoughts and feelings that might be present for Tim and Yuting as they experience the premature birth of Lisa and come to realize the reality of the situation.

* Given the fees associated with a “normal” delivery in a hospital, what fees are additionally associated with the NICU?

DECISION POINTS :::

Make a decision about how much of the cost Tim and Yuting will have to bear in terms of the financial aspects of Lisa’s delivery. Let us assume that Tim and Yuting had insurance. What kind of policy? What does it cover? Does it have a deductible? What do Tim and Yuting have to pay? You may also make a determination as to the nature of Lisa’s prematurity – how early was she born (there is some flexibility built into the narrative above), what does this have to do with her length of stay in the NICU, and what is the cost associated with all of this based on what kind of insurance coverage you decide Tim and Yuting have?  

Week One

It was quite important for Yuting to keep her surname, and she never has been one to take convention at face value. When she became pregnant with her first child, she wanted her to carry on her name. So, she let her husband, Tim, choose the first name. Lisa Yoo was about to come into a world where she would be loved dearly and cared for by a strong community that Yuting and Tim have built. Yuting plans on staying at home for several months, and she and Tim have been able to save a significant amount of money so that Yuting’s income won’t be missed. Ron and Tom can’t wait to be grandparents.

Yuting has heard that is you play a certain kind of music for your baby before it is born, it increases the chance that the baby will be musical. Not usually one to fall prey to such claims, Yuting nonetheless finds herself laying down next to the stereo speaker while the CD plays. It relaxes her, and she’s not sure it does anything at all, but she figures it can’t hurt.       

·    

     1) What are the typical developmental milestones for the child in utero? Outline the stages of pregnancy and the threats to optimal development at each stage. When are teratogens most dangerous for the developing child?

·    2) What is the chance that Lisa will suffer from a learning disability? Is there anything specific that Yuting and Tim can do in terms of primary prevention? What is the chance that Lisa will inherit Yuting’s musical aptitude? Is there anything specific that Yuting and Tim can do to encourage such aptitude?

·    3) Based on your answer to question #2, take a stand as a group on the relative influence of “nature” (heritability) and “nurture” (familial) with regard to learning disabilities and musical aptitude.   

4) Is there any evidence to support claims that one can create certain aptitudes in children based on what happens in the external world while the child is in utero? In other words, is there anything to be gained by Yuting sitting with music playing close to her abdomen?