Lisa has been aided by the development of an IFSP, and she has regular services to aid her with her CP. Now at 2 1/2 years of age, the hard work that everyone has been doing is starting to show some signs of improvement in her basic skills. In spite of all of the challenges, Lisa is a happy child. Tim and Yuting have had to learn her ways of communicating with them since she often seems pretty despondent. Still, they are learning her every day, and they are thankful for her presence in their lives.
Tim and Yuting are very close, to be sure. Nonetheless, they are worried for Lisa in spite of all of the support they have. Yuting states, "I never really expected to have a child with a disability. I mean, in my family, kids were always healthy. It was a surprise that Yuting had CP, but it's OK. We're strong. We're working with her and all of the people around us. It's so hard some days, though. What will she do in life? Will she ever be able to have a job? I guess we really don't know how severe it is, but it seems pretty tough for her a lot of days. She's such a fighter." Tim follows with, "Yeah, it was a surprise. We never really prepared for this - I still remember the day she was born and all of the feelings that went through us both that day. I was just glad that both Lisa and my wife were OK. We really have to think about having another child. I'm not sure we want to risk it."
* Outline typical developmental milestones for a 2 1/2 year old and indicate the extent to which Lisa is progressing in her development. Write 5 goals that would be found in the IFSP at this point. Be sure to include the physical, cognitive, and socio-emotional domains.
* Given your reading with regard to family systems, what are some ways that parents ordinarily respond to circumstances like those of Tim and Yuting? What influence are Ron and Tom likely to have in the family system? Describe Lisa's microsystem, mesosystem, ecosystem, and macrosystem. Be sure to include all of the service providers (pediatrician, social workers, OT, etc.) in your description.
* Depending upon your answer to the first question, does Lisa require assistive devices at this point? What kinds of devices are available for her - given her ability or inability to crawl/walk, what needs does she have for mobility? What about toilet training? What is a reasonable expectation for Lisa in this area?
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ReplyDeleteBlog Questions (for other group blogs):
ReplyDeleteThomas Mahoney
1. The option of a Montessori school has been given for schooling for Thomas. What are other options for Thomas’ schooling? Given that The Mahoney’s live in the Harrisonburg-Rockingham area, look for other schooling options for Thomas in the area or surrounding states. While it would not be ideal to send Thomas away, look for schools that specialize in ASD and have the tools to help with his diagnosis.
2. What are some ways that Molly and Ian can cope with Thomas’ diagnosis on the ASD spectrum? It has already been stated that there is a negative impact emotionally on the Molly and Ian, but what resources do they have through their community or possibly through IFSP?
Wendy Marianna
1. Sierra has been suffering from depression. This single father that she met at the group might be interested in her, but if she pursues this possible relationship, what effects will that have on her life as a mother? Will it take away from her attachment problem with Wendy? Or is it possible that with another single parent in her life, she can learn to cope better?
2. Is there any other possible reason that Wendy could have this attachment issue? From decision point response, it is made to sound as if Sierra gets help for her depression, Wendy will be “cured” of her attachment issue. Could it be possible that there is something wrong developmentally or chemically in Wendy instead of just in Sierra?
Ahmad Nassar:
1. Ahmad’s parents seem to have had different views about how to raise Ahmad before he was even born. Do you think that they agreed together to consider sending him to a Montessori school? What potential arguments could they have later in Ahmad’s future as he matures? How could his father’s pride in his “all boy” personality spark further disagreements? Do you feel that Sasha will lose her voice in the arguments?
2. Ahmad has been able to master three languages before some children can even master one. What does advanced language development predict for Ahmad’s later cognitive development? Find research that ties early language abilities to maturing cognitive growth.
Terrance Singh:
1. Vasha has been feeling very depressed lately due to the difficulties Terrance is experience. Are there services that Vasha can receive for the feelings she is having? If diagnosed with depression, what kind of medications would Vasha be placed on? Would this effect her care for Terrance?
2. Where can Vasha go/who can she talk to about her concern about the services Terrance is receiving? Are there any other services that are available for Terrance, other than those offered in IDEA and if so what are they?
1. Developmental milestones are a set of functional skills or age-specific tasks that most children are able to do when they reach a certain age range (Boyse, 2010). Pediatricians often use milestones as a way to monitor a child’s development to determine whether or not the child is on track or experiencing any delays. It is important to keep in mind that all children develop differently and may not meet milestones exactly when they are supposed to be reached; the age range that milestones are met often varies quite a bit for this reason. The different types of functional skills that surface throughout development include: gross and fine motor skills, language skills, cognitive skills and social skills.
ReplyDeleteFor a typically developing 2 ½ year old, or 30 month, many of these functional skills should begin to really emerge. When it comes to gross motor skills, upon what the child should already be able to do, they should be able to walk up and down stairs without little or no assistance. The child should begin to run, be able to kick a ball, and stand on their tiptoes. While walking, a 2 ½ year old should be able to carry a large toy, or multiple toys, and should be able to walk while pulling a toy behind them. The child should also begin to put some clothing on independently. The fine motor skills that a child at 30 months should have mastered include the ability to snip paper with scissors, building an 8 block tower, placing square pegs in a peg board, grasping utensils to feed themselves, and grasping pencils, crayons, markers, etc. to scribble spontaneously. The child may also begin to show the use of one hand more dominantly than the other. When it comes to language skills, the child should be able to do the following: use 3-4 word sentences, answer simple questions (what’s your name, where are you going), follow 2 step (simple) directions, be understood/intelligible by those outside of the family, point to objects or pictures when it’s named for them, and recognize names of familiar people, objects, and body parts. As for cognitive milestones, a 2 ½ year old should be able to find objects even when they are hidden, begin to sort things by shapes and colors, and they should begin to engage in make-believe play. Social and emotional milestones should begin to surface in that the child should be more active in interaction with others by this age. They should be interested in playing with others, although they may be reluctant to share—showing some defiant behavior, they should imitate behavior of others, gain an increase in awareness of themselves as separate from others, and begin to demonstrate an increase in independence. Episodes of separation anxiety may persist but should begin to decrease by this age.
Because Lisa has been diagnosed with CP, the ability to acquire and master these skills is strongly affected. Cerebral Palsy is described by a loss of impairment of motor function, therefore affecting body movement, muscle control, muscle coordination, muscle tone, reflex, posture, and balance (Stern & Associates, 2011). With these areas affected, the development of Lisa’s gross motor and fine motor skills is going to be seriously delayed. Lisa’s language development will also be affected because there is a lot of motor control that is involved in the ability to speak. Because she will be unable to engage in the same kind of activities as her peers, as well as having difficulty in communicating with them, Lisa’s social development could also be affected.
1. (con't)
ReplyDeleteAlthough all of these areas may be problematic for Lisa, with proper intervention and help from a team of professionals, Lisa is progressing and will continue to do so as new goals are being made. Below is a chart that displays goals in 3 different domains that have been compiled by Lisa’s IFSP team:
Physical Cognitive Socio-emotional
~Ability to crawl using both sides of the body rather than one
~Ability to grasp utensils
~Ability to grasp and move control stick for a motorized walker/wheelchair
~Ability to sort objects by shape and color
~Gain an understanding of how motorized walker/wheelchair works (how to use control stick) ~interact during play
~Ability to control facial expressions
~ability to form intelligible words
2. Each and every one of us has this idea of the family we hope to create once we are married. In our minds, we create this picture that often includes a loving husband, a two-story house, a supportive family, and three healthy children. The problem is that we often forget that sometimes life doesn’t go exactly how one plans it out. This reading, pertaining to family systems, goes into detail about some of the emotions and feelings that parents might experience when they find out their child has a disability.
ReplyDeleteThe passage points out that raising a healthy child can be a difficult task, but parents raising a child with a disability can lead to much more added stress. Having a child with a disability has the potential to change the whole dynamic of a family structure. The news of finding out your child has a disability most often brings about an emotional response from families. Many family members experience depression, anger, anxiety, and/or fear (Families as Systems).
From the reading, it has been found that parents can respond differently to the news of their child having a disability. Although there are medical challenges, disappointment in not reaching developmental goals, and frustration from lack of support, many of the parents, like Tim and Yuting, are still thankful for the child in their lives. For many parents, it took time to accept their child’s disability. From one researcher, it appears that mothers experience more stress and depression while the fathers have greater difficulty with attachment factors (Families as Systems).
Grandparents, such as Yuting’s parents Ron and Tom, can play a major role in the life of a child with a disability. For many, the grandparents were helpful in providing assistance and support to the child while minimizing some physical exhaustion on the parents. The closer the grandparents are with their adult children, the larger the role and involvement they play with their grandchildren. In some situations, the grandparents’ assistance to their grandchild with disabilities helped strengthen their own relationship and marriage (Families as Systems).
There are many pieces that play into how a child with disabilities grows up. The microsystems and mesosystems are often influenced by a child with a disability. There is the home microsystem for a child where they find security, trust, and where their basic needs are met. The next major microsystem for a child with disabilities is their school, where they spend the most time outside of their home. Another major microsystem for a child is their peers. Peers are no less important for those with disabilities, and they grow increasingly important as children get older and have a greater need for social skills. A child-care microsystem is also important in keeping the child and their parents’ content. The medical microsystem that includes service providers like pediatricians, social workers, and occupational therapists is also crucial for many kids who were born with defects or who need hospitalization frequently (Families Within Communities).
The exosystem is also crucial by providing greater opportunities for the child with disabilities, as well as their families. For example, a parent’s employer provides them with medical insurance that is important for them and their child’s well being. While the workplace is the exosystem for the child, it is the microsystem for the parent by providing them with money, insurance, and social interaction and support. The parents’ friends and social groups are also an important part of the exosystem. The macrosystem is the broad patterns of a particular culture such as government policy and financing. This too has a major impact on the services and the microsystem of the child with disabilities (Families Within Communities).
3. According to Lisa’s development and future goals, Lisa will require some assistive devices. Her goals are to grasp utensils as well as grasp and move a control stick for a walker or wheelchair. However, there is no technology that can assist her fine motor skills aside from strengthening exercises. The individual must also have a strong intrinsic motivation to succeed in this task. With the encouragement of Yuting and Tim, it is expected that Lisa will soon become strong enough and acquire enough strength to successfully grasp utensils and a control stick.
ReplyDeleteLisa can also use strengthening exercises to improve the motor ability of her legs. This task many be much more demanding than the grasping of utensils or a control stick. One of Lisa’s goals is to crawl using both sides of her body, however if this goal becomes unobtainable, then Yuting and Lisa should consider investing in a walker. As Lisa matures, being more mobile will increase her sense of independence. This will be important because with her condition Lisa will have heavy dependence on her parents well beyond the normal age of adolescence. There are many styles of walkers available on the market for individuals with similar motor difficulties to Lisa. This may become necessary if her goal to crawl on both sides becomes too difficult.
Before Lisa can become fully toilet trained, she needs to gain motor control on her own by crawling, or with a walker or wheelchair. Until that time, Lisa will need to wear diapers. However, if Yuting or Tim are able to carry Lisa to the restroom and assist her in preparation, she may be ready to being training in several months. The process may take longer than children without the motor challenges or cognitive delays of cerebral palsy. Lisa should be able to stop using diapers within the next few months. Yuting and Tim may have to slowly continue working with Lisa on this for several years. Realistically it is difficult to tell when Lisa will reach full mobility independence, yet hopefully by the age of five years old. Once she is able to master this task, she will be well on her way to using the bathroom without the assistance of her parents.