Human Development - Case Study Example

sе Study in Humаn Dеvеlорmеnt Introduction This paper is an analysis of a case study topic about Lily, an average sized 10-month old infant who has been diagnosed with Down syndrome. Lily has just learnt to sit unassisted. She is not yet able to crawl and has not yet pulled herself up into a standing position. She is able to grasp objects and wave them around, but has not started to self-feed finger foods. Lily appears to be a very happy child, smiling in response to her parents’ attempts to engage with her. She has started to make some babbling noises but no recognisable words, and does not mimic noises made by her parents. The analysis will consider all aspects of Lily’s case, including her age, her patterns of physical, cognitive and emotional development (given that she has Down syndrome) in comparison to that of a typically developing infant, and how Down syndrome has affected her development. In this regard, a brief overview of Down syndrome and how the condition affects development of infants at around the age of 10 months will be presented. This includes the genetic and/or environmental factors that are related to Down syndrome and how the factors affect the developmental milestones of infants. Developmental milestones of an infant at 10 months As a 10-month old child, Lily can be said to be in the infancy stage. Infancy is defined as the period from birth to the age of 12 months (Ricci & Kyle, 2009, p. 770). By the age of 10 months, an infant will have gone through various stages of development and hence achieved various milestones. According to Swim (2012, p. 35), typically developing infants undergo physical development that occurs in a predictable sequence, beginning from the head and chest and further to the trunk and lower parts of the body. This sequence of development is easily seen as the infant becomes able to control the head, trunk, chest, and then legs that enable him/ her to turn over. In order to crawl, the infant develops control of the lower back as well as the leg muscles. To be able to walk, the infant develops control of the neck, back, shoulders, legs, feet and toes. At around this stage, the infant also gains control of the movement of the arms from erratic waving to be able to reach for something accurately (Swim, 2012, p. 35). Dynamic systems theory is one motor development theory that can be used to explain the various changes that occur in an infant around the age of 10 months. The dynamic systems theory asserts that different behaviours and abilities of a growing baby work together to produce a more effective and efficient system (Sigelman & Rider, 2015, p. 180; Swim, 2012, p. 35). In regard to an infant at 10 months, the ‘more effective and efficient system’ is seen in terms of physical development that encompasses both gross motor skills, or large movements, and fine motor skills, or small muscle movements. Gross motor development encompasses large movements through achievement of milestones such as crawling, rolling and standing (Kyle, 2008, p. 82). In contrast, fine motor development encompasses smaller and more refined movements such as pointing and grasping (finger use) (Kyle, 2008, p. 82). For instance, at around six weeks, infants start to hold their heads erect and steady. At the age of two months, an infant can raise his or her upper body and roll from side to the back position. Beginning from three to four months, infants start grasping objects that can fit in their arms and roll from the back position to side. At the age of six to eight months, babies are able to sit unaided and begin crawling. At eight to ten months, they are capable of pulling up so as to stand and are also able to play with different materials. At around the same time, they start to stand on their own, and then begin to walk (Swim, 2012, p. 35; Kyle, 2008, p. 83). From 12 months onwards, the child is expected to sit from a standing position and walk without assistance (Kyle, 2008, p. 83). At 13-16 months, the child get involved in activities such as arranging cubes to form a tower and scribbling. At 20-24 months, the toddler starts to climb things such as stairs, and at 36 months, the child can begin to jump and use the toilet independently (Swim, 2012, p. 35). Regarding infants’ cognitive development, Jean Piaget’s they of cognitive development can be applied. This theory asserts that there are stages of cognitive development that make, say, four-month old babies cognitively different from two-year old children. Piaget argued that the sequence of development is the same for all children, but the rate at which various changes occur varies from one child to another. Thus, Piaget noted that children develop higher cognitive skills in a systematic way in four stages: sensorimotor, preoperational, concrete operational, and formal operational (Swim, 2012, pp. 37-38). The sensorimotor stage is the stage from birth to two years (Kyle, 2008, p. 81) and is therefore applicable in the context of this paper. Specifically, Piaget noted that infants’ development can be split into four sub-phases within the cognitive development: “reflexes, primary circular reaction, secondary circular reaction, and coordination of secondary schemes” (Kyle, 2008, p. 81). Overall, in the sensorimotor stage, the infant uses motor skills and senses to learn about the environment around him/ her. In the reflexes stage (birth to one month), the infant engages in reflex actions such as sucking objects because sucking brings the pleasure of ingesting. In the second stage of primary circular reaction (one to four months), repeated actions such as thumb-sucking elicit affection in the infant because of the pleasure of repeating the action. In the third stage of secondary circular reaction (four to eight months), the infant repeats actions to achieve the desired result, such as shaking an object to hear the sound that it makes. At this stage, the infant’s actions are intentional but the baby does not always have an end result in mind. In the fourth sub-stage of coordination of secondary schemes (eight months to 12 months), infants are able to coordinate schemes that they have learnt previously. For instance, they may hold and shake and purposely or crawl on the floor to reach a specific toy. At this stage, the infant can also anticipate events and start relating symbols with actions (for instance waving hand to indicate that someone is leaving) (Kyle, 2008, p. 81). Lily’s developmental milestones Lily seems to be developing well in some aspects but not in others due to her condition (Down syndrome). For instance, she is of average size (in comparison to other infants aged 10 months). However, her ability to sit unassisted has been delayed, given that she just learnt to sit without help at about 10 months of age. As noted above, an infant starts to sit unassisted at the age of six to eight months (Swim, 2012, p. 35). Also, Lily is still unable to crawl and pull herself up into a standing position, yet both milestones should be occurring at her current age. The fact that Lily is able to grasp objects and wave them around shows some good development although this milestone has also delayed as it needs to occur when the child is about three to four months old (Swim, 2012, p. 35). The delayed development is also emphasised by the point that Lily is yet to start self-feeding finger foods, which needs to happen when the child is aged eight to nine months (Ahlers & Tallman, 2004, p. 29). Also, Lily appears to be a very happy child, and smiles back when her parents attempt to engage with her. However, although she has started to make some babbling noises, she does not produce recognisable words and does not mimic noises made by her parents. This indicates that Lily has had delayed speech development and seems to have a hearing impairment since she does not mimic the sounds made by her parents. In a typically developing child, babbling is a precursor of language, and at the age of six to ten months, the sounds produced by an infant seem to focus imitatively on the sounds made by people who provide care to the infant (Davies, 2011, p. 157). At ten months, a typically developing child will usually have learnt the commonly used sounds of his or her caregiver’s language (Davies, 2011, p. 157). Down syndrome and its effects on the development of infants Down syndrome is a condition that is caused by extra material on chromosome 21 on the genetic component of a human being (Brown et al. 2007, p. 1038). Usually, each cell in the human body has a nucleus in which genetic materials are stored in genes. Genes contain the codes that are responsible for all inherited traits and are grouped in structures known as chromosomes. Each cell’s nucleus usually has 23 pairs of chromosomes, half of which are derived from each parent. Down syndrome occurs when a person has a full or incomplete additional copy of chromosome 21 (National Down Syndrome Society, 2012). The extra genetic components change the system of development and result in traits that are related with Down syndrome. Some of these characteristics include small stature, low muscle tone, a single deep fold across the centre of the palm and an upward slant to the eyes (National Down Syndrome Society, 2012). Nonetheless, each individual with Down syndrome is unique and may exhibit the aforementioned features to various degrees, or not show any. In regard to development, children with Down syndrome make progress in all developmental areas, just as other children, but normally at a slower rate (Buckley & Sacks, 2001, p. 4). There are differences in terms of how children with Down syndrome achieve their developmental milestones in comparison to children who are developing typically. For instance, some children with Down syndrome may be quite slow to attain the motor milestone of sitting, reaching and walking while others will exhibit little delay in attaining motor skills. As well, there are others who will have more difficulty learning to talk (Buckley & Sacks, 2001, p. 5). A comparison of the developmental milestones of a child with Down syndrome and those of a typically growing child is shown in table 1. Child with Down syndrome Typically developing child Average age Range of age Average age Range of age Gross motor Sits alone 11 months 6 to 30 months 6 months 5 to 9 months Crawls 12 months 8 to 22 months 9 months 6 to 12 months Stands 20 months 1 to 3½ years 11 months 8 to 17 months Walks alone 2 years 1 to 4 years 14 months 9 to 18 months Language First word 23 months 1 to 4 years 12 months 8 to 23 months Two-word phrases 3 years 2 to 7½ years 2 years 15 to 32 months Personal or social Responsive smile 3 months 1½ to 5 months 1½ months 1 to 3 months Finger-feeds 18 months 10 to 24 months 10 months 7 to 14 months Table 1: Major developmental milestones in a child with Down syndrome and a typically developing child Source: Adapted from Selikowitz (2008, n.pag.) Lily’s pace of development can be analysed as follows: Social interactive and social understanding skills: According to Buckley and Sacks (2001, p. 7), these skills are less delayed in children with Down syndrome compared to language and speech skills. Thus, most children with Down syndrome smile, make eye contact and interact by cooing and babbling. This is true for Lily’s case. Motor skills: Lily has just learnt to sit unassisted, a milestone that she should have attained at the age of about six months. She has yet to crawl or pull herself into a standing position. As well, Lily is able to grasp objects and wave them around, but has not started to finger-feed. Hence, Lily has been slow at attaining the milestone of motor skills based on the literature that has been analysed. Speech and language skills: While language areas are active from late infancy (Berk, 2014, p. 124), in children with Down syndrome, these skills are more delayed than non-verbal reasoning and understanding abilities (Buckley & Sacks, 2001, p. 7). Such is an indication of language and speech difficulties due to factors such as hearing impairment that are associated with Down syndrome (Buckley & Sacks, 2001, p. 7; Layton, 2004, n.pag.). This explains why Lily makes babbling sounds but does not mimic sounds made by her parents. The reasons for the differences in achieving developmental milestones are partially influenced by genetic makeup and partially affected by the atmosphere in which children are raised. This includes how parents and caregivers are able to cope to help the child adjust to the challenges of growing up (Buckley & Sacks, 2001, p. 5). Conclusion In conclusion, although Lily has Down syndrome, her developmental milestones in terms of social interactive and social understanding skills have not been much delayed since she smiles, makes eye contact and interacts by babbling. The noticeable aspects associated with Down syndrome which have affected Lily’s development are as follows. First is her motor skills, whereby she has just learnt to sit and is yet to crawl or pull herself into a standing position. She is also yet to start finger-feeding although she is able to grasp objects. Secondly, Lily’s speech and language skills have been delayed, as exhibited by her inability to produce recognisable words and the fact that she does not mimic sounds made by her parents. References Ahlers, J., & Tallman, C. (2004). So easy baby food: A personalized guide to making baby food at home (2nd ed.). Petoskey, MI: Fresh Baby LLC. Retrieved from https://books.google.co.ke/books?id=2omjXg3hh_4C&printsec=frontcover&dq=So+easy+baby+food:+A+personalized+guide+to+making+baby+food+at+home&hl=en&sa=X&ved=0ahUKEwjygvaS_PvLAhWEOhQKHb3eDzUQ6AEIJDAA#v=onepage&q=So%20easy%20baby%20food%3A%20A%20personalized%20guide%20to%20making%20baby%20food%20at%20home&f=false Berk, L. (2014). Development through the lifespan (6th ed.). Upper Saddle River, NJ: Pearson. Brown, J.H., Johnson, M.H., Paterson, S.J., Gilmore, R., Longhi, E., & Karmiloff-Smith, A. (2007). Spatial representation and attention in toddlers with Williams syndrome and Down syndrome. Neuropsychologia, 41, 1037–1046. Retrieved from http://www.personal.psu.edu/users/r/o/rog1/pdf/brown.etal.2003.pdf Buckley, S., & Sacks, B. (2001), An overview of the development of infants with Down syndrome (0-5 years). Hampshire, UK: The Down Syndrome Educational Trust. 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Retrieved from http://www.dsacc.org/downloads/parents/downsyndromedevelopmentalscale.pdf National Down Syndrome Society. (2012). What is Down syndrome? Retrieved from http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/ Ricci, S.S., & Kyle, T. (2009). Maternity and paediatric nursing. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. Retrieved from https://books.google.co.ke/books?id=gaYtFuND7VIC&pg=PA286&dq=Maternity+and+paediatric+nursing&hl=en&sa=X&ved=0ahUKEwjNvNLu_PvLAhUHxxQKHev5AwMQ6AEIGzAA#v=onepage&q=Maternity%20and%20paediatric%20nursing&f=false Selikowitz, M. (2008). Down syndrome (3rd ed.). Oxford: Oxford University Press. Retrieved from https://books.google.co.ke/books?id=LVCUfihoAZYC&pg=PT58&dq=down+syndrome+and+hearing+impairment+at+ten+months&hl=en&sa=X&redir_esc=y#v=onepage&q=down%20syndrome%20and%20hearing%20impairment%20at%20ten%20months&f=false Sigelman, C.K., & Rider, E.A. (2015). Life-span human development (8th ed.). Stamford, CT: Cengage Learning. Retrieved from https://books.google.co.ke/books?id=aqHEAgAAQBAJ&pg=PT207&dq=Dynamic+systems+theory+and+infant+development&hl=en&sa=X&ved=0ahUKEwiKk_TN_fvLAhXCzRQKHXCJC_4Q6AEILzAD#v=onepage&q=Dynamic%20systems%20theory%20and%20infant%20development&f=false Swim, T.J. (2012). Infants & toddlers: Curriculum and teaching (8th ed.). Boston: Wadsworth Cengage Learning. Retrieved from https://books.google.co.ke/books?id=kKksURjxGykC&printsec=frontcover&dq=Infants+%26+toddlers:+Curriculum+and+teaching&hl=en&sa=X&ved=0ahUKEwj865bR_PvLAhVEUBQKHUNjAcEQ6AEIGzAA#v=onepage&q=Infants%20%26%20toddlers%3A%20Curriculum%20and%20teaching&f=false Read More