Case Study - Chua Gek Teng Joyce (Group A)

1a) What would you reveal to Mrs Kong regarding your professional view about children with Down Syndrome and their future in Singapore? (4 Marks)

I feel that it is important to first acknowledge and reassure Mrs Kong’s concerns and worries. The reason being that I understand that it is not easy for any parent to come to terms with their child being diagnosed with a disability. After all, which parent will not wish for his or her child to grow up strong and healthily. Therefore, I think Mrs Kong should be told that no one is at fault of her child's disability because it can happen to anyone. According to Down Syndrome Association Singapore (2009), the disability occurs to ‘one in 800 live births’.

Next, I will fill her in about what I know of Down Syndrome. It is a genetic disorder due to an extra pair of chromosome. Mrs Kong should also be warned that ‘children with Down Syndrome may have physical impairments and developmental delay ranging from mild to severe’ (Down Syndrome Association Singapore, 2009). That can explain why Nicky is a bit slow in his learning and has difficulties sitting upright. However, these are conditions that can be improved with early intervention. Children with Down Syndrome are also at risk of other medical conditions like congenital heart defects and Hirschsprung's disease. As to why there were no facial signs indicating that Nicky has the disability, Down Syndrome Association Singapore (2009) wrote that the physical characteristics of children with Down Syndrome ‘vary from child to child. Most importantly, each child will inherit its own family looks and characteristics.’

The future for children with Down Syndrome is a positive one as long as they receive the necessary medical care together with the right social and educational support. They need to also be ‘given the opportunity to partake fully in all aspects of community life’ (Down Syndrome Association Singapore, 2009). According to BabyCenter (2009), ‘many children are now successfully attending mainstream schools’ and ‘most…reach all the usual milestones…but they do it at their own pace’. It would also help to inform Mrs Kong that children with Down Syndrome needs to feel loved and valued by their family which helps them ‘thrive well into adulthood, into their 50s and beyond, living full and active lives’ (BabyCenter, 2009).


bi) What would you advise Mrs Kong about enrolling Nicky into the centre's toddler class? (2 Marks)

To advise Mrs Kong about enrolling Nicky into the centre’s toddler class, there should first be adequate staffing and it would be best if one of them has had experience working with children with Down Syndrome. Alternatively, if Mrs Kong is agreeable, class teachers can liaise with Down Syndrome Association who has services to help support and foster working relationships among schools, students and families. This said, great emphasis is placed on home-school partnership in which either parties are updated regularly about the child. They can also discuss and reveal strategies used so as to maintain some form of consistency both at home and in school. Mrs Kong should understand that though there are its advantages of putting Nicky in mainstream classrooms, professionals of Down Syndrome should be consulted. This will further help Nicky reach his fullest potential because classroom teachers are not experts of the disability. I will definitely encourage Mrs Kong to let Nicky start school as soon as possible because early intervention will help improve his condition and decrease the possibility of secondary disabilities (Lim & Quah, 2004).


bii) What would you advise Mrs Kong about Nicky's diagnosis of having Down Syndrome? (2 Marks)

According to Mayo Clinic Staff (2009), a physical examination and 'a chromosomal karyotype' can be used to confirm Down Syndrome in a newborn. As Mrs Kong mentioned, a doctor has diagnosed Nicky’s disability through a blood test but has yet to make any appointment for further assessment. I will recommend her to do so as soon as possible. In this way, she can have a better understanding of Nicky's condition which includes the severity of his disability and if other additional medical problems were present. With the knowledge, she will then be able to find out how Nicky can be helped and supported. His caregivers and teachers can also plan for early intervention through Individual Family Service Plan or Independent Education Plan.


c) What would you disclose to Mrs Kong about special education, special school and inclusive education in Singapore? (6 Marks)

I will disclose to Mrs Kong that special education is actually interventions that help ‘prevent, eliminate, and/or overcome obstacles that might keep an individual with disabilities from learning and from full and active participation in school and society’ (Lim & Quah, 2004, p.30). Currently, there are 20 Special Education (SPED) schools in Singapore. They aim 'to provide the best possible education and training to children with special needs so as to enable them to function optimally and integrate well into society' (Ministry of Education, 2009). To do so, these school not only engage teachers trained in the area of special needs but also have paramedical professionals available to support the children.

In response to Mrs Kong's uncertainty about whether there are any special schools in Singapore that will take in Nicky at such a young age, I can suggest to her some schools that do. For instance, the Rainbow Centre takes in children as early as 2 months old and Kits4Kids Special School begins taking in children at 18 months of age. The former adopts the Early Intervention Programme for Infants and Young Children (EIPIC) which ‘aims to facilitate the development of gross motor, fine motor, perceptual-cognitive, language, socialization and self-help skills, depending on the level of the child’ (Rainbow Centre, n.d.). On the other hand, the latter adopts ‘the Piaget’s theory where children learn through concrete and hands-on activities...Individual Education Plans (IEPs) are also carefully planned and discussed with the team of teachers for each child to meet his long term goals and short term objectives' (Kits4Kids, 2009).

Inclusive education is a ‘belief that students with disabilities should be integrated into general education classrooms’ and ‘the emphasis is in providing the necessary support so that they can participate in a meaningful way in the ongoing classroom activities’ (Lim & Quah, 2004, p.31). Though this is not widely practiced in Singapore but the government is taking measures for it to happen by having it small-scale at the moment. I am positive that in the near future as more awareness is created about the different disabilities, inclusion will become a common practice in the country. After all, in the case of Nicky, ‘early intervention, lifelong education and training and inclusion with the mainstream is a holistic approach to managing Down syndrome' (Down Syndrome Association Singapore, 2009). He will need more than just support from his family but also from the community.


References
BabyCenter, L. L. C. (2009). Down's syndrome. Retrieved August 11, 2009, from http://www.babycenter.com.sg/baby/health/downssyndrome/#10

Down Syndrome Association Singapore. (2009). All you need to know about Down Syndrome. Retrieved August 13, 2009, from http://downsyndrome-singapore.org/content/view/35/113/

Kits4Kids Singapore. (2009). Programmes for both children with special needs and mainstream children. Retrieved on August 11, 2009, from http://www.kits4kids.org/prg_overview.htm

Lim, L., & Quah. M. M. (2004). Educating learners with diverse abilities. Singapore: McGraw Hill.

Mayo Clinic staff. (2009). Down syndrome: Tests and diagnosis. Retrieved August 14, 2009, from http://www.mayoclinic.com/health/down-syndrome/DS00182/DSECTION=tests-and-diagnosis

Ministry of Education, Singapore. (2009). Special education in Singapore. Retrieved on August 11, 2009, from http://www.moe.gov.sg/education/special-education/

Rainbow Centre. (n.d.). EIPIC - Early intervention programme for infants & young children. Retrieved on August 11, 2009, from http://www.rainbowcentre.org.sg/special_education.html


A Little Sharing
I just wanted to share some of these articles that I came across when doing my research for references. The experiences that these parents went through knowing that their child was diagnosed with Down Syndrome, how they came to accept and cope with their child's disability really strikes out to me!

http://www.babycenter.com.sg/baby/health/suspecteddownsyndrome/

http://downsyndrome-singapore.org/images/stories/my%20baby%20booklet%20%28english%29.pdf

http://downsyndrome-singapore.org/images/special_child_series_-_kyle_wee.pdf

Signing off,
Chua Gek Teng Joyce (Group A)