Die opleibaarheid van die kind met Downsindroom
Steyn, Izak Nicolaas
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CHAPTER 1 - POSTULATION OF PROBLEM, PURPOSE, METHOD AND PROGRAM OF STUDY: 1. Postulating the problem - The following problematical questions are investigated in this study:- a. Are there specific skills in which the trainable mentally retarded Down's Syndrome child is inferior to and/or more improved than other trainable mentally retarded groups? b. To what extent can the Down's Syndrome children participate in the same training program when grouped together? c. In which skills do Down's Syndrome children show the greatest trainability? d. Is there a remarkable inferiority or progress in social competence, when compared with trainable Down's Syndrome and other trainable children in the training centre? 2. Aim of study - The following aims have been set for this study: a. to discover in which skills Down's Syndrome children have the great test inferiority and in which skills they show the greatest possibility of improvement. This means the question of the trainability of the Down's Syndrome child; b. to discover the grouping criteria which are used to classify the child with Down's Syndrome and all the other trainable children in the training centre; c. the criteria used by the different centres to promote a trainable child to the following class or group; d. to set a theoretical framework for a training program, which is based on the findings in this study, for trainable Down's Syndrome children; e. to find out what training facilities are available to the trainable Down's Syndrome child and to make some recommendations in this context. 3. Study method - In this study the descriptive method is used. The setting of a theoretical framework about the existing knowledge on the trainable Down's Syndrome child in the training centres is based on the following:- a. Study of literature: The most reliable sources of literature on the topic of this study are found in research results of American and British researchers; b. Empirical research: Questionnaires were sent to all the training centres in the Republic to collect information about the inferiority and/or progress in certain skills in Down's Syndrome children, grouping criteria and training programs for them. The program of study is set out in the last part of chapter 1. CHAPTER 2 - CONCEPTUALIZATION IN GENERAL: The following impediment categories were discussed in the first part of the chapter: motor, sensory, behaviouristic, mental and emotional impediments. The most important points of discussion are the concepts: educability and trainability of mentally retarded children. In the second part of this chapter the concepts: education ("opvoeding"); instruction ("onderwys”); training ("opleiding"); educability (“opvoedbaarheid”); trainability ("opleibaarheid") and untrainability (“onopleibaarheid") are discussed. 1. Educable and trainable mentally retarded - The Mentally Retarded Children's Act (Act No. 63 of 1974) refers to the child in the special class and special school as the educable mentally retarded and the child who is certified as uneducable as the trainable mentally retarded. The child in the institution is referred to as the untrainable mentally retarded. 2. Educability - Educability refers to the child's ability to gain from scholastic activities such as writing, reading and arithmetic and to transfer these skills with insight to practical situations. 3. Trainability - The trainable mentally retarded child's cognitive processes are concrete operational and cannot reach the abstract stage. Trainability therefore implies the possibility of making progress in the following skills: self-help, communication, socialization and occupation. 4. Untrainability - The child's inability to progress from the skills named in par. 3 and to succeed in adaptation to the social environment characterise the untrainable child who receives custodial care in an institution. CHAPTER 3 - DOWN 1S SYNDROME OR MONGOLISM: In comparing a few terms: Mongolism, Unfinished child, Acromicria, G1-Trisomy and Downs’ Syndrome, the latter is preferable, because it prevents a stigma which is sometimes attached to the syndrome and it also gives the syndrome a scientific dignity. 1. Etiology of Down’s Syndrome: 1.1 Endogenic factors - The possibility of studying chromosomal behaviour through the developments of new cytologic techniques leads to the study of the cell nucleus in the metaphase of mitosis during which period an exact counting of the chromosomes and observations on their structural patterns is possible. Through two methods: tissue and peripheral blood culture studies three subtypes of Down’s Syndrome are distinguishable:- a. Trisomy 21: This condition is the result of a faulty division of the 21-chromosome pair. The child with trisomy Down’s Syndrome has three, rather than the normal two chromosomes in pair 21. b. Translocation: Children with translocation Down’s Syndrome have an extra number 21-chromosome which has broken and become attached to the same or another chromosome pair. A parent can carry a translocation without showing any symptoms of disease because the parent still carries the correct amount of genetic material, although some of it is out of place (translocated). c. Mosaicism: A child with mosaic Down's Syndrome has 46 chromosomes in some cells and 47 in other cells of his body. 1.2 Exogenetic factors - Disfunctioning of the Pituitary and Thyroid glands causes a hormonal maladjustment in the mother during pregnancy, which can result in the birth of a Down's Syndrome child. Research has shown that a high percentage of Down's Syndrome children have been born from mothers between 30 and 45 years of age. Bad health and a shortage of vitamine A during pregnancy can also cause Down's Syndrome. 2. Clinical diagnosis at birth: Although Down's Syndrome cannot be diagnosed only by a few clinical features without a cytogenetic investigation, these features are especially visible in the first years of life of the Down's Syndrome child. The following physical stigmata are very prominent: hypotonia, disorders in the growth of the skull, a short nose with a flat bridge, anomalies of the palate, a small oral cavity with a protruding fissured tongue, abnormally small teeth, slanting eyes, speckling of the iris, anomalies of the external ears, one rather straight line crosses the palm of the hand instead of the two curved lines of the normal hand, an abnormal space between the first and second fingers and toes, a congenital heart defect and malformed sexual organs. In the last part of this chapter the typical developmental traits of the Down's Syndrome child from birth to opproximately 6 years of age are discussed. CHAPTER 4 - CHARACTERISTICS OF THE DOWN'S SYNDROME CHILD'S PERSONALITY: Firstly in this chapter the mental development of the Down's Syndrome child is discussed. The conclusion is reached that the intellectual development is as characteristic as the slow motory development and that the quality of his intelligence is different in comparison with other trainable mentally retarded children. A significant connection between physical, stigmata and intelligence could not be found, The next discussion is devoted to the connection between subtype of Down's Syndrome and intelligence. Although several researchers found that the mosaic Down's Syndrome child has a higher intelligence than the other two subtypes, insufficient research has been done in this field. It has been found that 95% of all Down's Syndrome children are cheerful, but about 5% are stubborn. Social competence and mimicry lend themselves par excellence in training this child. Language development is discussed to show the Down's Syndrome child's inferiority in this characteristic. In the last part of this chapter it is painted out that the Down’s Syndrome child is also backward in motory and sensory development. CHAPTER 5 - DIMENSIONS OF MENTAL RETARDATION IN DOWN'S SYNDROME: The differentiation between educable and trainable mentally retarded children is discussed in chapter 2. I.Q.-groups between 0 and 80 are discussed here to put the Down's Syndrome child in the mental hierarchy:- 1. Educable mentally retarded (I.Q. 50 - 80) - The educable mentally retarded child can't keep up the pace with the normal school program and has thus been placed in a special class or special school. Although there are Down's Syndrome children who are educable they still have great problems in mastering scholastic, motory and speech skills and non-visual tasks. 2. Trainable mentally retarded (I.Q. 30 - 50) - Although the child in the training centre is uneducable in scholastic skills, progress has been seen in the following skills: self-help, communication, socialization and occupation. 3. Untrainable mentally retarded (I.Q. 0 - 30) - The child who is retarded to such a degree that he can't see to his own needs and safety, must receive custodial care in an institution. CHAPTER 6 - THERAPY AND DOWN'S SYNDROME: This chapter deals with the following therapeutic programs:- 1. Medicinal therapy: a. Thyroid treatment has a positive effect in improving the dry skin, thick rippled tongue, coarse voice and sluggishness. b. Vitamine B12 must be administered with other medicaments to stimulate growth in the Down's Syndrome child. c. Pituitary-hormone treatment stimulate this gland to release growth hormones. 2. Music therapy: An outstanding characteristic of the trainable mentally retarded Down's Syndrome child is his receptivity for rhythm and music. This therapeutic medium must be used by parents and teachers to stimulate the gross motor co-ordination and auditory acuity of the Down's Syndrome child. 3. Speech therapy: language development is the trainable mentally retarded Down's Syndrome child's greatest inferiority. His ability for mimicry is the starting point for acquiring speech skills. The daily therapy sessions must include blowing•, sucking• and chewing exercises to better tongue and lip activities. A few practical implications for the training of the Down's Syndrome child are discussed in par. 6.7. CHAPTER 7 - EMPIRICAL RESEARCH: QUESTIONNAIRE: Different aspects, as well as the course of the empirical research, are discussed in this chapter. The descriptive method is selected as the scientific method for this research project. A questionnaire was composed to gather information on the set classification methods and training programs for the child with Down's Syndrome in training centres in the Republic. Firstly in this chapter the questionnaire is motivated as the most suitable scientific research method to deal with the topic of this study. The composition and application, respondents and returns are discussed afterwards. A prerequisite for significant diversions was set at a minimum return of 70% completed questionnaires. A follow-up letter was sent when the return was 63%. Telephone calls to the remaining respondents lifted the return percentage to 71%, so that the set criterium was reached. CHAPTER 8 - TRAINING FACILITIES FOR THE TRAINABLE MENTALLY RETARDED DOWN'S SYNDROME CHILDREN: In this chapter attention is especially devoted to responses in connection with the total number of trainable mentally retarded Down's Syndrome children in the training centres, different school departments and the average number of children in groups in the centres. 1. Occurrence of trainable mentally retarded Down's Sindrome children: Questionnaires were sent to 31 training centres in the Republic. Areturn of 71% (22) questionnaires was obtained. A number of 264 (20,3%) Down's Syndrome children and 1 037 (79,7%) other trainable mentally retarded children are enrolled in 21 (68% respondents} training centres, so that the total number is 1 301 trainable mentally retarded children. 2. School departments: The training centres are organized in the following Departments (the number of centres which have a certain department are given in brackets): nursery class (10}, adaptation class (10), junior class (12), senior class (11). 3. Average number of children in different groups The 68% centres that completed this item in the questionnaire reported an average of 14 children in a group. The conclusion is also reached that the trainable mentally retarded Down's Syndrome child shows the best progress when he receives sufficient stimulation in the early years at home. Ways of maintenance of the centres up to 1/4/75 is discussed in the last part of the chapter. CHAPTER 9 - GROUPING CRITERIA FOR THE TRAINABLE MENTALLY RETARDED DOWN'S SYNDROME CHILDREN: Grouping criteria for the trainable mentally retarded children, general differences in skills between Down's Syndrome and other trainable children and promoting criteria for trainable mentally retarded children are discussed in this chapter. 1. Grouping criteria for the trainable mentally retarded children: Responses show that 27% of the respondent's grade I.Q. as an important grouping criterium. The I.Q.'s of only 36% of the children in the centres are known by members of staff. Chronological age is graded as an important criterium by 73% respondents, mental age by 32%, visual-motor skills by 45% and social competence by 50% of the Respondents. 2. Differences in skills between Down's Syndrome and non-Down's Syndrome trainable mentally retarded groups of children: No difference is noticed in visual-motor skills by 40% respondents. Down's Syndrome children are graded weaker in these skills by 18% respondents. As seen by 5% respondents, Down’s Syndrome children are much better in self-help skills, 10% as better, 40%•as the same and 5% respondents as weaker than other trainable children in the centres. In connection with scholastic work the Down's Syndrome child is seen as the same by 40% respondents, weaker by 10% and much weaker by 5% respondents. Social competence is graded as much better by 18% respondents, better by 23%, the same by 14% and weaker by 5% respondents. 3. Promoting criteria for trainable mentally retarded children: Visual-motor skills are the most important promoting criterium, as graded by training centres. Chronological age is placed second. CHAPTER 10 - A TRAINING PROGRAM FOR THE TRAINABLE MENTALLY RETARDED DOWN'S SYNDROME CHILDREN IN THE TRAINING CENTRE: In this chapter the necessity for a special adapted training program for the trainable mentally retarded Down's Syndrome children, differences in skills between Down's Syndrome children of the same chronological age, psychometric media to determine the functioning of different skills are discussed. Based on this knowledge a training program for the trainable mentally retarded Down’s Syndrome child is set out. 1. The necessity for a special adapted training program for the trainable mentally retarded Down's Syndrome child: A special or adapted training program for the trainable Down’s Syndrome children is suggested by 40% respondents. Another 40% respondents believe that Down’s Syndrome children can take part in the same program (without adaptation) with other trainable children, while 20% respondents did not respond to this item. Information collected from literature and the rest of the empirical research, however, shows without any doubt that the trainable mentally retarded Down's Syndrome child is inferior in certain skills (see par. 10. 2.2) and shows possibilities for improvement in other skills, when compared with other trainable children. The conclusion is therefore reached that a specially adapted program must be set for the Down's Syndrome child to give more opportunity for stimulation in skills in which he is inferior, 2. Differences in skills amongst Down's syndrome children of the same chronological age: Responses show that 45% respondents notice great individual differences amongst Down's Syndrome children of the same chronological age; 32% respondents see no markable differences in skills and 23% respondents did not respond to this item. Individual differences amongst trainable Down's Syndrome children are not denied, but specific inferiorities in motory, auditory, language and tactual skills are present in all the trainable mentally retarded Down's Syndrome children. 3. Psychometric media to determine the functioning level of certain skills: It is concluded that the Stanford-Binet Intelligence Scale, the Merrill Palmer Scale and the Goodenough-Harris Drawing Test (elaborated from the Goodenough-Draw-a-Man Test) can, after adaptation to South African circumstances, be used as intelligence scales to differentiate between educable, trainable and untrainable children. The Vineland Social Maturity Scale and the Gunzburg Progress Assessment Charts must be used to determine the improvement in connection with the following skills: self-help, knowledge of his own body and perception, communication, socialization and occupation. 4. Trainability: Responses demonstrated that the mental age of the trainable Down's Syndrome children is increasable with implementing of a training program which takes the specific inferiorities and improvement possibilities of certain skills into consideration. The Down's Syndrome child is therefore trainable to quite a large extent. CHAPTER 11 - SUMMARY, CONCLUSIONS AND RECOMMENDATIONS: In this chapter recommendations in connection with training facilities, grouping criteria, a training program and other possible research subjects are discussed.
- Education