The Impact of Early Intervention and Special Education on Children with Down syndrome
Introduction
Down syndrome is a genetic disorder that affects children from an early age, causing them to portray cognitive and developmental problems. As one of the most challenging developmental disorders, parents may find it difficult to ensure that they provide the required support during the early learning stages. Down syndrome is a chromosomal condition, which is mainly correlated to intellectual disability and has identifying signs. Intervention at this stage is necessary for a child suffering from Down syndrome. Early intervention is a systematic program that is implemented right from birth up to when the child attains three years (Winders et al, 2006). Early intervention addresses cognitive, physical, social, language, and self-help skills that a child with Down syndrome may require to enhance his/her progression for later life.
Given that a child with Down syndrome is likely to take a significantly longer amount of time to accomplish the required objectives, early intervention methods varies significantly. Moreover, it is crucial to understand the extent to which providing early intervention and special education to children affected with Down syndrome and the positive impact that special education and early intervention have on Down syndrome. It is clear that the influence of early intervention and special education have considerable and paramount influences on the outcomes of children in their early and later years. These interventions impact cognitive development in continuous years of education and throughout their educational lives (school years). This paper establishes how an effective an early intervention program addresses physical, social, cognitive, language and self-help skills development among children suffering with Down syndrome.
Literature Review
Physical Skills
Physical growth refers to the process of how individuals learn to sit, stand, move in place or space, and utilize their palm to perform different activities, including recreation. This growth is determined by the manner in which sensory input is processed in the brain to lead to a focused movement. Gross motor development is the capability of repositioning big muscles, whereas fine motor development denotes the use of hands and figures. Since the majority of children with Down syndrome are hypotonic and have other challenges with postural control, this is a significant focus of their early motor intervention (Buckley, Bird, Sacks, & Archer, 2006).
Neurodevelopmental treatment (NDI)
Neuromotor therapies like neurodevelopmental treatment (NDT) are usually used in helping babies who have mobility impairment. One of the main objectives of NDT is enhancing certain practical actions in children, which is attained by constraining dysfunctional mobility patterns and enabling more effectual mobility patterns. Specific handling and positioning tactics modify the sensory input to the child to provoke functional, goal-oriented movements. Parents and teachers should be encouraged to use these methods in the child’s daily activities. Rules of motor development, control, and learning enhance the child’s functional outcomes (Guralnick, 2010).
Timely assistance to young ones suffering from Down syndrome assist them in learning problem solving and engaging in planning, initiating, and performing movement. It is also important in enabling mobility skills, especially in cases where the children are not in a position to do them own their own. Early intervention and special education also enhances use of different types of stimuli to provoke movement based on the child’s ability to move. Motor interventions should be offered in different settings that comprise indoor and outdoor settings. It is significant to take into consideration the child’s approach to motor learning when preparing and effecting motor interventions (Buckley, Bird, Sacks, & Archer, 2006).
Suitable play activities promote right motor development in children with Down syndrome. Parents and teachers should apply proper carrying and handling techniques for children with Down syndrome, such as carrying some children with their legs together instead of spreading them over the hip. Acquiring pertinent information about the child’s health state, and related health conditions like cardiac and respiratory complications, which may affect motor development plays a significant role in helping parents and teachers to enhance the physical development of Down syndrome children. Observing the child’s health status and tolerance for motor activities during early intervention helps teachers and parents in dealing with any probable physical deficits in children with Down syndrome (Guralnick, 2010).
Parents and teachers need to consider the age of the child when choosing assistive tools. Adaptive equipment helps in sustaining postural alignment and promoting sitting, standing, and movement for young children with Down syndrome. Various assistive devices enhance independent upright forward development for movement for young children with Down syndrome. Utilization of minor limb maintains appropriate alignment in standing and walking for some children with Down syndrome. Integrating sensory activities like movement into other therapeutic methods is important to the overall growth of preschool children with Down syndrome (Buckley, Bird, Sacks, & Archer, 2006).
Different sensory activities are important in supporting the achievement of specific objectives. Teacher and parents should not wait for signs of delay in motor milestones before they start motor intervention for children with Down syndrome. Early intervention and special education helps in preventing compensatory movement patterns that can interfere with following motor development. They also help in preventing the growth of malformations secondary to persistent atypical postures. Early intervention also offers education and support to parents and teachers, such as teaching proper positioning and handling. Physical intervention in babies concentrates on the ability to alter the position of the body, particularly the skull and chest. Development of proper postural control assists in facilitating future growth of specific motor skills (Davis, 2008).
It is important to proceed motor interventions associated with postural control as the child grows during the first year. Proper postural control for weight bearing is particularly vital in young children with Down syndrome because of their propensity for extreme joint mobility as well as ligamentous leniency. Poor postural control as an infant may result in the use of compensatory patterns that lead to future problems with motor development (Lotan, 2007). Children should also be in a position to go against gravity to get hands to midline and mouth. They should also develop trunk and head control for suitable sitting position. Transitional movements should also be encouraged to enhance the physical development of children with Down syndrome, for example, rolling, pivoting prone, belly crawling, and getting in and out of sitting (Guralnick, 2010).
Regulated or norm-referenced motor development scales like Peabody Developmental Motor Scales are important in evaluating the growth of useful motor capabilities in kids with Down syndrome. Resistive activities like strength training make the kids energetic and strengthen muscles required for joint constancy and postural reactions. Resistive activities comprise gentle, classified manual resistance, playing with developmentally fitting toys for different weights, and lifting, carrying, and pushing toys ((Lotan, 2007). Vital elements of early intervention for children with Down syndrome aged 12 to 24 months include:
- Posturing patterns
- Grasping strength
- Shoulder firmness
- Finger and thumb control
- In-hand operation
- Bilateral coordination
- Modification of grasp patterns
Social Skills
Interventions intended for social development concentrate on social attention, social relations, affection, and play. A major element of early interventions in social interactions includes assisting parents and teachers to interact with a child that reacts and begins relations in highly unpredictable ways, regularly exhibits less effect (emotional expression) and offers social and communicative cues that are less readable to others. When deciding tasks to facilitate social development for young children with Down syndrome, it is significant to consider both developmental and chronological age (Buckley, Bird, Sacks, & Archer, 2006).
It is necessary for parents and teachers taking care of kids with Down syndrome to use activities that demand their concentration in order to enhance the child’s attentiveness when requesting for actions from the child and positively encourage proper responses to the requests. Since children with Down syndrome usually have a high interest in focusing on faces, which may impede learning new play skills, parents and teachers should consider prospects for experimental play and object handling. Encouraging children who concentrate more on faces to interact with the physical environment like dolls with their peers promotes the ability to interrelate and socialize. Children with Down syndrome respond well to instructions that are specific and not those that are general. Offering opportunities for young children that expose them to various social circumstance in different settings helps in arousing and selectively reinforcing suitable effectual responses. It also enhances language development, improves peer interaction, and promotes generalization of effective responses.
Changing the stimuli often improves the child’s level of prolonged engagement in organized activities. Children with Down syndrome should be trained and motivated to initiate social interactions through selective support, peer modeling, and adult modeling. They should also be given opportunities for initiating activities (Guralnick, 2010).
Language Skills
Early interventions and special education for children with Down syndrome that focus on language development are similar to those for all children that have language delays and disorders. Interventions intended for communication skills in kids with Down syndrome emphasize on oral- motor stimulation, speech, and language. The majority of children with Down syndrome have oral-motor challenges that usually result in feeding difficulties. Many children with Down syndrome display delayed language skills from an early age. The children takes a lot of time before being able to speak, which is not proportionate to their ages. Inability to express themselves in time may be aggravated by speech-motor difficulties. Language development for young children with Down syndrome can be further compromised because most of them have hearing loss (Davis, 2008).
Early oral-motor and parent training shortly after birth enhances communication skills since the majority of kids suffering from Down syndrome have underdeveloped communication skills earlier as well as vocalization and speech. The development of language skill should be a continuous process that is incorporated into all activities by specialists and the family during the period of intervention and all activities of daily life. Developing communication skills through the native language promotes natural interaction and communication between the child and parents at home. This also helps the child to develop a strong foundation in the primary language used at home. A total communication plan that entails communication through signs words facilitates the growth of expressive language. This is significant because the majority of the children with Down syndrome encounter a delay in expressive language that is not proportional to their developmental level.
Speech and language therapy helps in reinforcing and maintaining vocalization and verbal interaction. Sign language has no negative impact on language skills. When sign language is involved as a communication tactic, parents and teachers should learn the same signs and apply them often to help the child develop language. It is important to note that the signs and oral vocabulary that a child is taught should have useful and cultural value to the child. Amplified sounds from a hearing aid and other hearing devices are effective for kids with Down syndrome that experience hearing challenges, particularly the ones with lasting or persistent hearing loss. Amplification may occur in the form of hearing aids or an FM system (Davis, 2008). Components of intervention that enhance language development in children with Down syndrome include the following:
- Guide individual relation between children and caregivers
- Examination of the parent and child with feedback provided
- Providing verbal and written material on how to enhance the ability to communicate effectively
Facilitation of sensorimotor function and feeding should be done immediately after diagnosis. Satisfactory assessment and intervention for oral-motor functions promote adequate nutrition, which is important for development because oral sensorimotor complications results in feeding difficulties. Good oral sensorimotor function enhances the growth of speech skills. Methods that assist in stimulating communication development entail activities that enhance tracing auditory stimulation, familiarizing voices, and vocalizing when spoken to. The use of language stimulation activities improves the language development of children with Down syndrome (Buckley, Bird, Sacks, & Archer, 2006).
Continuous oral-motor activities enhance the growth of sufficient energy, firmness, and verbalized-motor mobility for eating and verbal communication. Regular oral-motor intervention addresses the muscle-based issues that impact the child’s oral expressive output. Children’s opportunities for linguistic relations with other children in the form of playgrounds, day care, and therapeutic groups help in stimulating and generalizing language skills in children with Down syndrome. The child’s involvement in organized activities with other children of the same age enhances language skills, communication success, and offers opportunities for linguistic interaction with peers. Language interventions in early years increases vocabulary, receptive and expressive language skills and improve creation of motor speech and appropriate oral-motor activities to enhance speech production and respiratory control.
Cognitive Skills
Cognition refers to the processes of the brain that enable individuals to recall, reason, perform an action, and react. Mental procedures are multifaceted, varied, and highly interconnected. Interventions aimed at cognitive development concentrate on overall and specific cognitive skills, such as concentration to the environment, information processing, and memory (Kishnani et al., 2010). Enhancing mental capabilities by introducing activities that help children to obtain cognitive skills starts as early as possible. Moving an object gradually in front of the child’s eye enable it to follow the object as it moves, which enhances simple learning and mastery. Mentioning the child’s name several times and telling the child the name or label of objects in view creates repletion, which strengthens the learned responses of a child (Cologon, 2013).
Children with Down syndrome learn several behaviors through observation and imitation. Introducing them to group learning experiences is significant in helping them to model or imitate other children and adults, which enhances cognitive development. Including opportunities for interaction with other children in prearranged and semi- structured activities exposes them to chronologic and developmental age peers, which enables them to improve their mental abilities. Offering children opportunities for generalization and exploration helps them to learn faster and adopt to school environment effectively. Positive reinforcing stimuli that take place after a behavior increases the possibility of the behavior happening again, which promotes cognitive development. If stimulus and response are paired, the child strongly learns the association between them (Kishnani et al., 2010).
Self-help Skills
Early interventions and special education aimed at promoting the growth of children’s ability to take care of themselves are important for families with children with Down syndrome. These skills enable a child to function more autonomously. Self-help skills comprise glooming, feeding, and toileting. The development of self-help skills should be continuous in the life of a child to promote autonomy in all aspects of growth. When selecting tasks to enhance the development of independency, it is important to put into consideration developmental and chronologic age. The development of independency is determined by mental and physical capabilities of children. Consistency in approach to teaching self-care is necessary since use of different methods may confuse the child and deter learning. Development of self-help skills is normally delayed in kids that require much recurrence in mastering self-care skills in comparison to those who grow normally. Kids with Down syndrome need to be given enough support to enhance their motor control for self-care activities. For instance, for self-dressing, the child may be expected to sit in a chair with arms if he/she does not have enough postural firmness. Developmentally appropriate opportunities for self-care enhance both autonomy and progression of skills like providing clothing without fasteners until the child masters buttoning and zipping.
Feeding
Making meal times distinct, for instance, at a table and with no other interruptions like the television assists children with Down syndrome to learn feeding themselves. Consistency in mealtime and premeal time routines and chances of learning from observing others at mealtime assists in facilitating the learning process. It is necessary to assist children with Down syndrome to sit in a comfortable position when eating. Establishing timely appropriate support enhances children’s ability to eat on their own as they grow. Parents and teachers should use equipment based on children’s physical and mental capabilities. They should consider the need for specialized adaptive equipment to facilitate self-feeding for some children. Using a spoon with a thicker curved handle enables the child to control the spoon better. A cup with two handles motivates a more symmetrical posture when drinking. Use of cups with spurted lids should be prevented or limited because they may delay the development of lip closure (Cologon, 2013).
Dressing
It is necessary to motivate children with Down syndrome to dress themselves when they seem ready. When teaching self-dressing, it is significant to use outfits that are suitable to the children’s physical and mental abilities. A child normally starts by learning how to undress before being able to dress him/herself. Parents and teachers should offer enough support and positioning to assist children when dressing. Early proper positioning and use of appropriate support enhance the child’s self-dressing development when ready. Several techniques that can be utilized to facilitate training self-dressing skills include the following:
- Creating simple alterations to clothing to increase autonomy
- Wearing dresses that are not tight
- Altering ways of dressing for children to learn faster
- Applying a backwards chaining tactic, such as the guardian completing the first steps, and teaching children the last step. After learning the last step, the child is trained on the last two steps.
Toilet training
A child with Down syndrome should be developmentally prepared before he/she can be taught how to use a toilet. Physical and mental maturity is important elements in assisting a child to use a toilet. Toileting is normally effective in cases where children’s systems that support movement have developed sufficiently. Regular elimination in a child is a sign of increased bladder and bowel control. It is necessary to allow the child to familiarize with the bathroom and toilet before beginning toilet training. When introducing toilet training, it is necessary to be consistent about the bathroom to be used if there are many bathrooms in the house. The potty seat or toilet should be of a suitable size and shape to hold up and enable the child to move in a flexible manner. Children with Down syndrome usually have related conditions that can make toilet training more difficult, such as low muscle tone (hypotonia), which makes bladder control more challenging (Cologon, 2013).
Conclusion
Specific handling and positioning tactics modify the sensory input to the child to provoke functional, goal-oriented movements. Rules of motor development, control, and learning enhance the child’s functional outcomes. Early intervention and special education also enhances use of different types of stimuli to provoke movement based on the child’s ability to move. Early intervention and special education helps in preventing compensatory movement patterns that can interfere with following motor development. They also help in preventing the growth of malformations secondary to persistent atypical postures. Early intervention also offers education and support to parents and teachers, such as teaching proper positioning and handling.
Offering opportunities for young children that expose them to various social circumstance in different settings helps in arousing and selectively reinforcing suitable effectual responses. It also enhances language development, improves peer interaction, and promotes generalization of effective responses.
Early oral-motor and parent training shortly after birth enhances communication skills since several kids with Down syndrome lags behind communication skills as well as vocalization and speech. A total communication plan that entails communication through signs and spoken words facilitates the growth of expressive language. Speech and language therapy helps in promoting use of words and verbal interaction. Good oral sensorimotor function enhances the growth of speech skills. The use of language stimulation activities improves the language development of children with Down syndrome. Regular oral-motor intervention addresses the challenges associated with muscles, which influence children’s ability to express themselves verbally. Children’s opportunities for linguistic relations with other children in the form of playgrounds, day care, and therapeutic groups help in stimulating and generalizing language skills in children with Down syndrome.
Children with Down syndrome learn several behaviors through observation and imitation. Introducing them to group learning experiences is significant in helping them to model or imitate other children and adults, which enhances cognitive development.
Early interventions and special education aimed at assisting young ones to acquire independency are important for families with children with Down syndrome. These skills enable a child to function more autonomously. Self-help skills entail glooming, feeding, and toileting.
References
Buckley, S., Bird, G., Sacks, B., & Archer, T. (2006). A comparison of mainstream and special education for teenagers with Down syndrome: Implications for parents and teachers. Down syndrome Research and Practice, 9(3), 54-67.
Cologon, K. (2013). Debunking Myths: Reading Development in Children with Down syndrome. Australian Journal of Teacher Education, 38(3), n3.
Davis, A. (2008). Children with Down syndrome: implications for assessment and intervention in the school. School psychology quarterly, 23(2), 271-281.
Guralnick, M. J. (2010). Early intervention approaches to enhance the peer-related social competence of young children with developmental delays: A historical perspective. Infants and young children, 23(2), 73.
Kishnani, P. S., Heller, J. H., Spiridigliozzi, G. A., Lott, I., Escobar, L., Richardson, S., … & McRae, T. (2010). Donepezil for treatment of cognitive dysfunction in children with Down syndrome aged 10–17. American Journal of Medical Genetics Part A, 152(12), 3028-3035.
Lotan, M. (2007). Quality physical intervention activity for persons with Down syndrome. The Scientific World Journal, 7, 7-19.
Winders, P. C. (n.d.). Gross motor development and Down syndrome. Retrieved from: http://www.ndss.org/Resources/Therapies-Development/Occupational-Therapy-Down-Syndrome/