published_or_final_version / Journalism and Media Studies Centre / Master / Master of Journalism

Examining responses to violations of communication may provide insight into children’s communicative competencies not apparent during reciprocal interactions. In this study, the caregivers of 18-month-old typically developing children, 30-month-old children with autism spectrum disorder (ASD), and 30-month-old children with Down syndrome followed our suggestion to playfully violate communication with their children in two contexts: requesting and social interacting. Caregivers of children with ASD made fewer bids and violations, which their children accepted less often than typically developing children; they also used instrumental behaviors more often when responding. Children with Down syndrome responded to their caregivers similarly to typically developing children, and used more high-level communicative behaviors in the requesting, versus social interacting, context. This study highlights the bidirectional nature of parent-child interactions, and suggests that violations of communication may serve as a “press” to elicit child behaviors not present during reciprocal communication.

The effects of a gymnastic unit on stereotypic, on-task, and off task behaviors of two children with Autism Spectrum Disorders (ASD), and two children with Down syndrome were examined using structured teaching, based on adaptations by the TEACCH model. Structured teaching consisted of individual pictorial activity schedules and work systems. The stereotypic, on-task, and off task behaviors were observed during three phases: baseline, treatment, and post-treatment. / Inter-rater reliability of stereotypic, on-task, and off task behaviors was 82.2%. The results indicated reductions on the levels of stereotypic behaviors of both participants with ASD, while no significant changes were observed in the levels of on-task behaviors for these participants. This was probably due to the fact that the gymnastic unit was fairly structured even before the implementation of the treatment. No effects were found on the levels of on-task behaviors of both participants with Down syndrome.

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 train= ability? 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 approximately 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 pain= ted 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. / Thesis (MEd)--PU for CHE

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 train= ability? 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 approximately 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 pain= ted 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. / Thesis (MEd)--PU for CHE

The purpose of this thesis is to query the legitimacy of offering preimplantation genetic diagnostic (PGD) testing against Down's syndrome on the basis of United Kingdom (UK) law and policies. I will argue that extending PGD testing for Down’s syndrome as a permissible use of this technology does not (straightforwardly) adhere with the Human Fertilisation and Embryology Authority (HFEA) Code of Practice's stated factors which are to be considered when assessing the appropriateness of PGD applications. Indeed, due consideration of the evidence given in the relevant literature about the capacities and quality of life possible for persons living with Down's syndrome would seriously call into question the validity of a positive judgment recommending PGD as a treatment service for Down's syndrome according to the current UK regulatory instruments. I end the thesis by considering why the HFEA's relatively recent decision to limit client access according to an exclusive list of "serious" and therefore "in principle" test-worthy genetic conditions—understood as legitimate applications for PGD—stands to entrench prejudice, stigma, social bias, and unfair discrimination against the disadvantaged social group of persons living with Down's syndrome.

Computer vision techniques for human motion analysis have the potential to significantly improve the monitoring of motor rehabilitation processes. With respect to traditional marker-based techniques, computer vision offers both portability and low-cost. This thesis describes methods that have been designed for the analysis of the motor skills of subjects with Down's syndrome. More specifically, the motion of interest is weight-shifting; this motion plays an important role in the safety of locomotory activities, as well as of other daily actions. From a theoretical viewpoint, the thesis proposes several new concepts for human motion analysis and describes their algorithmic implementation, as well as their applicability to the detection and description of several motion primitives. The thesis introduces the concept of curved bounding box, which is an extension of the rectangular bounding box that is typically used for detection and tracking of rigid motion. This concept is successfully applied to the detection of deformable motion, such as arm, knee and upper body motions. A new technique for identifying subject-representative patterns of motion is also proposed. This technique is based on Motion History Images, which hold both analytical and visualization power.

Šeimos gydytojai ir bendruomenės slaugytojai bendradarbiaudami su šeimomis, kuriose auga vaikai su Dauno sindromu, savo praktikoje susiduria su pakankamai sudėtingomis situacijomis, kuomet tenka pasirūpinti ne tik vaiko su negalia poreikiais, bet taip pat ir visa šeima. Gimus vaikui su negalia, kai šeima yra pasimetusi ir išgyvena sunkų laikotarpį savo gyvenime, tenka į tai jautriau atsižvelgti ir stengtis jiems padėti prisitaikyti prie naujų gyvenimo sąlygų, nes nėra geresnio būdo padėti vaikui, kaip stiprinti tėvų galimybes tai padaryti jiems patiems. Specialistų bendradarbiavimas su šeima, padedant susiorientuoti pagalbos sistemoje ir atrasti tinkmiausius pagalbos būdus, yra pagrindas siekiant visapusiškos gerovės vaikui bei abipusio pasitenkinimo teikiamų paslaugų kokybe. / Family doctors and community nurses, collaborating with families raising children with Down syndrome, encounter quite complicated situations in practice, when they must take care not only for the needs of the disabled child, but for the whole family as well. After the birth of a child with a disability, when the family is confused and experiencing difficult period, there appears a great need of external sensitivity and assistance for the family to adapt to new conditions of its life, because there is no better way to help the child, as to enhance parents’ ability to do it by themselves. Professionals’ collaboration with the family, by helping to orientate in the support system and to find the most suitable ways of support, is the basis for a comprehensive welfare of the child and for mutual satisfaction with quality of services provided.

No description available.

Children with Down syndrome (DS) are reported to experience difficulty with spoken and written language which can persist through the lifespan. However, little is known about the spoken and written language profiles of children with DS in the New Zealand social and education environment, and a thorough investigation of these profiles has yet to be conducted. The few controlled interventions to remediate language deficits in children with DS that are reported in the literature typically focus on remediation of a single language domain, with the effectiveness of interventions which integrate spoken and written language goals yet to be explored for this population. The experiments reported in this thesis aim to address these areas of need. The following questions are asked 1) What are the phonological awareness, speech, language and literacy skills of New Zealand children with DS? 2) What are the home and school literacy environments of New Zealand children with DS and how do they support written language development? and 3) What are the immediate and longer term effects of an integrated phonological awareness intervention on enhancing aspects of spoken and written language development in young children with DS? These questions will be addressed through the following chapters. The first experiment (presented in Chapter 2) was conducted in two parts. Part 1 consisted of the screening of the early developing phonological awareness, letter knowledge, and decoding skills of 77 primary school children with DS and revealed considerable variability between participants on all measures. Although some children were able to demonstrate mastery of the phoneme identity and letter knowledge skills, floor effects were also apparent. Data were analysed by age group (5 - 8 years and 9 -14 years) which revealed increased performance with maturation, with older children outperforming their younger peers on all measures. Approximately one quarter of all children were unable to decode any words, 6.6% demonstrated decoding skills at a level expected for 7 - 8 year old children and one child demonstrated decoding skills at an age equivalent level. Significant relationships between decoding skills and letter knowledge were found to exist. In Part 2 of the experiment, 27 children with DS who participated in the screening study took part in an in-depth investigation into their speech, phonological awareness, reading accuracy and comprehension and narrative language skills. Results of the speech assessments revealed the participants’ speech was qualitatively and quantitatively similar to the speech of younger children with typical development, but that elements of disorder were also evident. Results of the phonological awareness measures indicated participants were more successful with blending than with segmentation at both sentence and syllable level. Rhyme generation scores were particularly low. Reading accuracy scores were in advance of reading comprehension, with strong relationships demonstrated between reading accuracy and phonological awareness and letter knowledge. Those children who were better readers also had better language skills, producing longer sentences and using a greater number of different words in their narratives. The production of more advanced narrative structures was restricted to better readers. In the second experiment (presented in Chapter 3), the home literacy environment of 85 primary school aged children with DS was investigated. Parents of participants completed a questionnaire which explored the frequency and duration of literacy interactions, other ways parents support and facilitate literacy, parents’ priorities for their children at school, and the child’s literacy skills. Results revealed that the homes of participants were generally rich in literacy resources, and that parents and children read together regularly, although many children were reported to take a passive role duding joint story reading. Many parents also reported actively teaching their child letter names and sounds and encouraging literacy development in other ways such as language games, computer use, television viewing and library access. Writing at home was much less frequent than reading, and the allocation of written homework was much less common than reading homework. In the third experiment (presented in Chapter 4), the school literacy environment of 87 primary school aged children with DS (identified in the second experiment) was explored. In a parallel survey to the one described in Chapter 3, the teachers of participants completed a questionnaire which explored the frequency and duration of literacy interactions, the role of the child during literacy interactions, the child’s literacy skills, and other ways literacy is supported. The results of the questionnaire revealed nearly all children took part in regular reading instruction in the classroom although the amount of time reportedly dedicated to reading instruction was extremely variable amongst respondents. The average amount of time spent on reading instruction was consistent with that reported nationally and in advance of the international average for Year 5 children. Reading instruction was typically given in small groups or in a one on one setting and included both ‘top-down’ and bottom up’ strategies. Children were more likely to be assigned reading homework compared to written homework, with writing activities and instruction reported to be particularly challenging. In the fourth experiment (reported in Chapter 5), the effectiveness of an experimental integrated phonological awareness intervention was evaluated for ten children with DS, who ranged in age from 4;04 to 5;05 (M = 4;11, SD = 4.08 months). The study employed a multiple single-subject design to evaluate the effect of the intervention on participants’ trained and untrained speech measures, and examined the development of letter knowledge and phonological awareness skills. The 18 week intervention included the following three components; 1. parent implemented print referencing during joint story reading, 2. speech goals integrated with letter knowledge and phoneme awareness activities conducted by the speech-language therapist (SLT) in a play based format, and 3. letter knowledge and phoneme awareness activities conducted by the computer specialist (CS) adapted for presentation on a computer. The intervention was implemented by the SLT and CS at an early intervention centre during two 20 minute sessions per week, in two 6 week therapy blocks separated by a 6 week break (i.e. 8 hours total). The parents implemented the print referencing component in four 10 minute sessions per week across the 18 week intervention period (approximately 12 hours total). Results of the intervention revealed all ten children made statistically significant gains on their trained and untrained speech targets with some children demonstrating transfer to other phonemes in the same sound class. Six children demonstrated gains in letter knowledge and nine children achieved higher scores on phonological awareness measures at post-intervention, however all phonological awareness scores were below chance. The findings demonstrated that dedicating some intervention time to facilitating the participants’ letter knowledge and phonological awareness was not at the expense of speech gains. The fifth experiment (presented in Chapter 6) comprises a re-evaluation of the speech, phonological awareness, and letter knowledge, and an evaluation of the decoding and spelling development in children with DS who had previously participated in an integrated phonological awareness intervention (see Chapter 5), after they had subsequently received two terms (approximately 20 weeks) of formal schooling. Speech accuracy was higher at follow-up than at post-intervention on standardised speech measures and individual speech targets for the group as a whole, with eight of the ten participants demonstrating increased scores on their individual speech targets. Group scores on both letter knowledge measures were higher at follow-up than at post-intervention, with nine participants maintaining or improving on post-intervention performance. The majority of participants exhibited higher phonological awareness scores at follow-up on both the phoneme level assessments, with above chance scores achieved by five participants on one of the tasks, however, scores on the rhyme matching task demonstrated no evidence of growth. Some transfer of phonological awareness and letter knowledge was evident, with five children able to decode some words on the single word reading test and three children able to represent phonemes correctly in the experimental spelling task. The emergence of these early literacy skills highlighted the need for ongoing monitoring of children’s ability to transfer their improved phonological awareness and letter knowledge to decoding and spelling performance. In the sixth experiment (presented in Chapter 7) the long term effects of the integrated phonological awareness intervention was evaluated for one boy with DS aged 5;2 at the start of the intervention. The study monitored Ben’s speech and literacy development up to the age of 8;0 (34 months post pre-school intervention) which included two years of formal schooling. Ben demonstrated sustained growth on all measures with evidence of a growing ability to transfer letter-sound knowledge and phoneme-grapheme correspondences to the reading and spelling process. The results indicated an intervention which is provided early and which simultaneously targets speech, letter knowledge and phonological awareness goals provides a promising alternative to conventional therapy, and that integrating spoken and written therapy goals for children with DS can be effective in facilitating development in both domains. This thesis provides evidence that the spoken and written language abilities of New Zealand children with DS exhibit a pattern of delay and disorder that is largely consistent with those of children with DS from other countries reported in the literature. The home and school literacy environments of children in New Zealand with DS are rich in literacy resources and are, for the most part, supportive of their literacy development. The immediate and longer term results of the integrated phonological awareness intervention suggest that it is possible to achieve significant and sustained gains in speech, letter knowledge and phonological awareness which may contribute to the remediation of the persistent and compromised spoken and written language profile characteristic of individuals with DS.