Early intervention plays an important role in developing and improving children with Down syndrome, the intervention starts from the earliest weeks after the child’s birth. According to the Federal law number 29 which was published in 2006, people with Downsyndrome share equal rights like any UAE citizen, especially when it comes to the rights of health, education, and employment.
 
Early intervention offers all types of support for the family and the individuals who are involved in the child’s life. The intervention focuses on investing in the early stages of the child’s life because in these stages the child learns to develop his cognitive, linguistic, fine and gross motor skills, in-addition of hisautonomous skills (relying on oneself), the intervention also prepares the child for educational inclusion. This early intervention helps reduce the government and the family’s financial expenses.

Family counseling is one of the most important services the association offers, the counseling sessions start either from pregnancy or after the child’s birth and it keeps going for the whole year.

  • Direct family counseling sessions

When a family realizes that they are having a child with Down syndrome, they go through many emotional phases such as sadness, denial, helplessness, anger, and

fearfulness, family counseling can reduce these negative emotions and can help families be more accepting and it could also guide families into finding happiness, stability and understand each family member’s responsibility.

Both professional and humanistic relationships are offered by the association to the family, to help them find the perfect solutions for their emotional and psychological distress, so they could learn to have better coping mechanisms in a shorter period of time.

Many programs were offered to provide the social and mental support to the child and his family, to make the child more independent and to help the family find good solutions for the hyperactivity and behavioral issues the child might come up with, and to also help the family understand the future dilemmas they might come across as child with Down syndrome grows older.

Along with direct family counseling the association offers other services to the family such as:

  • Awareness workshops and conferences and training lectures
  • Entertaining social programs that help the families to exchange experiences and information and help them bond and feel more relatable.

إحدى المهن الصحية التي تقوم على التقييم والتشخيص ووضع الخطة العلاجية، وتشمل الأطفال والبالغين بالإضافة لكبار السن المتوقع حدوث قصور في أدائهم الوظيفي أو إعاقة بسبب حادث أو اضطراب أو مرض.

يعد العلاج الطبيعي من الخدمات المهمة والمفيدة  للأطفال من ذوي متلازمة داون، فعادة ما يكون لديهم ضعف في العضلات  والتوتر العضلي  يصاحبه عدم ثبات بالمفاصل. ومن الممكن أن تؤثر هذه العوامل  على تطور الطفل الحركي مثل: الدحرجة، الجلوس، الحبو، والمشي.

 يساعد العلاج الطبيعي الأطفال من ذوي متلازمة داون لتجنب أنماط حركية خاطئة من خلال تعليم الطفل أفضل الطرق الصحيحة الممكنة له من خلال تقوية العضلات اللازمة لذلك.

تشمل خطة العلاج الطبيعي :

  • برامج تحتوي تمارين محددة
  • نصائح لوضعية الجسم الصحيحة
  • تمارين للتوازن
  • العمل على تجنب حدوث أنماط حركية خاطئة تعويضية

يبدأ التدخل المبكر من عمر ثلاثة شهور بمعدل جلسة أسبوعيا مع اختصاصي العلاج الطبيعي الذي يقدم العلاج والنصائح العلاجية للأهل، والتمارين اللازمة للطفل

OTis one of the health professions concerned with evaluating and treating patients from different age groups who have problemsin performing their jobs and their daily activities,

whether these problems are caused by any illnesses, injuries, physical disabilities, psychological disabilities, developmental and/orbehavioral disorders. OT aims to elevate the health of individuals and groups through various methods of treatment which includes beneficial activities, therapeutic exercises and tools, assistive technology devices, these methods work together to increase the autonomy of the patients andenable them to perform their daily functions and rehabilitate them. (Jordanian Association for Occupational Therapy)

Occupational therapy mainly aims to increase the autonomy of people with Down syndrome in the following areas:

Self-care skills (such as eating, dressing, caring, General appearance, personal hygiene and etc).

Gross and fine motor skills.

Cognitive skills (including pre-writing skills).

Play skills that are appropriate with the child's developmental age.

The golden period of learning which is the first five-years of the child’s life is considered really crucial, therefore starting occupational therapy from this age is valuable tomaximize the benefits for the child. The intervention process begins with assessing the child's skills, abilities and identify the strengths and weaknesses, so then the occupational therapist candevelop a treatment plan to treat the child and reduce weaknesses in order to help the child reaches the highest levels ofIndependence.

At this point the occupational therapist may participate in:

  1. Dealing with feeding problems related to the movement of the mouth muscles, such as laxity and weakness in cheeks, tongue and lips muscles, consequently, itcomplicates the breastfeeding process in children with Down syndrome. Hence, the occupational therapist suggests better bodily positions and methods of feeding.
  2. Help to facilitate the development of basic features of the child's physical movement specially, fine motor skills.
  3. The occupational therapist also works closely with the physiotherapist to help the child with his developmental milestones for the gross motor skills (such as sitting, crawling, standing, and walking). Also, the occupational therapist elevates the child’s fine motor skills by strengthening the arm and hands movements.
  1. Some people with Down syndrome have problems in processing different sensory inputs such as (Tactile, Vestibular, proprioception, vocal, visual, olfactory) which might lead to problems in theiroccupational skills and might hinder their performance of daily activities.

 

  • Preschool

When the child reaches his pre-school age, the child is trained to move independently and explore his environment, and this could be a result from providing him/her with opportunities that enhance the learning process andhelp develop the autonomous skills in preforming the daily activities such as eating, wearing clothes,playing, interacting appropriately with other children and improving his overallmotorskills.

In this stage, the occupational therapist may interfere:

  1. to Facilitate the development of fine motor skills-

In this stage achild with Down syndrome might begin to develop his fine motor skills.By improving his hands and arm movement, but in many cases, thechild needs occupational therapy to support his motor developmental skills. Children with Down syndrome can improve their fine motor skills by playing(coloring, opening and closing objects, picking and unlocking games of all shapes, sizes, pilingand buildingmanipulating and Pressing the game button, and many more). A child with Down syndrome may face some additional challenges when learningfine motor skills as a result of muscular dystrophy and lack of flexibility in joint ligaments orbecause of the small size of hands.

  1. Promote the beginnings of self-care skills

A therapist can help parents see progress and meet their expectationsby simplifying skillsand teaching them how to train their child. The occupational therapist can also suggestSuitable positions for the child and provide suitable equipment for the child, such as using a specific dish or spoon when eating. These recommendations and suggestions might help the child to adapt to his condition better and enable him to be self-sufficient as much as possible.

  • Entering the school stage:

When a child enters school, we helpthe child to adapt to the new habits, attend school meetings and plan educational programs for the child, and focus on discussing and communicating.

Help the child practice fine motor skills (such as writing).

Believe in the child’s ability to have futuredevelopment and independence in activities.

Find extracurricular activities that would expose the child to avariety of social, educational and material experiences.

In this stage occupational therapy has many purposes such as:

- Facilitating the development of fine motor skills in the classroomby providing typing and writing courses and classes

- Environmental assessment(Such as table height, etc)to help the child adapt better to the school environment

- Create an educational programbased on the child's different abilities.

  • Work Stage:

Study and evaluate the capabilities of the individual with Down syndrome and find their preferences in work and search for the suitable and appropriate careers and work environments.

 

SLPs specialize in the evaluation, diagnosis and treatment of communication difficulties such asspeech and language delay, voice disorders, and swallowing disorders related to Down Syndrome or any other disorder.

SLPs also play an important role in the diagnosis and treatment of autism spectrum disorder, hearing impairment, stuttering and dyslexia.

There are any Devices used in Speech and Language Therapy?

A group of Augmentative and assistive communication devices and others to enhance the communication process for Children with Down syndrome. They face many challenges in the speech processes and it is necessary that a Speech and Language Pathologist can help young children to start the communication process and improve the eligibility of speech. Most children with Down Syndrome learn to speak and use the spoken language as the primary way of communication but before they are able to learn to speak,they will have the ability to understand and communicate like physical andverbal imitation, non-verbal and verbal communication.

When should you start with a Speech and Language Pathologist? What is meant by early language intervention?

A Speech and Language Pathologist can be visited for an early intervention from infancy. The term Early Language Intervention is called for the services provided to the child from birth until the age of two years. The treatment provided may include vocal and linguistic stimulation accompanied by playing and feeding, oral motor exercises and other training techniques. Families must be present in the sessions as parents are the main teachers of speech and language for their kids. Speech and Language Pathology services are based on an integrated treatment plan for the same age group and maybe at home or center and it can be a part of teamwork includingPhysical and Occupational Therapists. There are Early Language Intervention Programs offered by the center and also provides different treatment services for eligible children under the age of two according to an individual treatment plan and depending on the evaluation. Most children with Down Syndrome are eligible for Speech and Language Therapy services and these services continue after the age of three years through individual sessions and follow-up with parents and support whether for school programs or external activities.

What other skills that help to improve the Speech and Language?

There are other skills that are important to achieve before Speech:
  • The ability to imitate and echo sounds
  • Role-exchange skills (can be learned from games such as hide and seek)
  • Visual skills (looking at and distinguishing people and things)
  • Hearing skills (listening to music, pronouncing and practicing phoneme for long periods of time)
  • Touch skills (learn to touch and explore things in the mouth)
  • Oral Motor parts moving skills (using the tongue and moving the lips)
  • Cognitive skills (understanding the permanence of things and the causal relationship).
Parents can stimulate these skills at home and they can also seek help from specialists in treating speech and language disorders to learn the skills necessary to help their children.

How can parents help their child to learn to speak and communicate?

Parents are the main persons that a child interacts with from birth and they have a great impact in helping the child learn how to communicate. The home is the best environment in which the child acquires the skills of pre-pronunciation and communication previously mentioned.

Parents must do the following to develop their child's skills:

  • Remember that the language goes beyond the spoken words to teach the child a word or concept, the focus must be on communicating the meaning to the child through play or feeling (hearing, touching, seeing).
  • Provide many models, the child needs to repeat words and events repeatedly to learn only one word, you must repeat what the child says and provide a model to help him establish the word in his mind.
  • Providing models and real situations, so that communication is part of the child’s life, one of the parents uses realistic activities and situations and exploits them to learn their child a concept for example; when the child is eating food the parents can teach the child the food labels or the names of body parts when showering or even simple concepts (under, In, on) when playing with him.
  • Reading to the child, parents help their son to teach him new concepts by reading to him about it, taking neighborhood tours and explaining the daily situations.
  • Track what the child wants, if the child shows his interest in something, person or an event, the parents must inform the child the appropriate word for that concept.
  • There are many positive turning points that parents will notice on their child's pronunciation. Upon hearing the child, he would respond with a familiar voice, distinguish people, interact with different sounds, make several of them, and launch special sounds to indicate his mother and father (Papa - Mama).
  • Most children enjoy looking at the mirror by making sounds and bubbling. Parents can develop these skills and apply them effectively at home by attending intervention sessions, books, workshops, or with speech and language disorders treatment specialists.

When will the child be able to pronounce his first word?

It is not possible to determine the age at which a child with Down syndrome can pronounce the first word, but it usually begins with the use of individual words between the second and three years of age and the first word may take a form of sign language, not pronounced words because the majority of children with Down syndrome communicate from the age of Birth by crying and looking or using sign language. They show a desire to communicate because they know that crying or making sounds may affect the environment around them and bring them either help, play or draw attention.

  • Many children with Down syndrome understand the relationship between the word and the concept when they reach ten months and a year but, at that age, the child does not have sufficient neurological and motor skills that are qualified to help him speak, so it is very important to provide another system that helps the child to communicate and learn the language before he can speak.

There have been many strategies established by the association to enhance the learning experience, for example;building an attractivelearning environment, reinforce and increasing good behaviors,offering AssistiveTechnology and extra curriculum activities for the students and finally dividing the class into sections to serve different purposes such as individual sessions, group learning, and games.  All of these strategies work together to upgrade peopleofdetermination skills and abilities,

Approved curricula

  • HELP (Hawaii Early Learning Profile)

The assessment includes evaluating all the developmental areas such as: sensory skills, cognitive skills, fine and gross motor skills, personal care abilities, social and emotional skills, and it also includes a booklet for the manual and extra activities.

  • Bavariancurricula

This curriculum was designed by a German instructor from an area called Bavaria, the curricula was under intensive testing for five years, then it was modified and extra ideas and recommendations from parents, instructors and psychologists were added, currently the curriculum is divided into three sections which are:

  • Developmental Learning
  • Basic Subjects Skills
  • Secondary Subjects Skills

The curriculum aims to motivate instructors into thinking creatively about the ways of teaching that suit each learner’s abilities and way of learning, this forces instructors to think out of the box and figure out as many learning goals as possible that could aid the learning process. The teaching process is very diverse, it includes direct verbal guidance, discussionand conversation, stimulation and modeling, playing, physical education, role play and act, as well as individual and group sessions. Moreover, extra curriculum activities are very crucial to help enhance the learning experience by allowing the learners to use all their senses such as visual and hearing in the process of learning, anexample of extra curriculum activities are trips, conventions, and modern technology.

Special Education and Behavior Modification Sessions:

The association accepts all students with Down syndrome that are part of the educational inclusion plan, and it offers services to them; individual sessions andbehavior modification Sessions.Moreover,the association helps find and explain a better educational plan with the school that student is involved in. Finally,the association providessupport for the student’s family.

Assessment :

All beneficiaries that are in the Educational Rehabilitation Classes go through comprehensive assessment that evaluate their developmental levels. Along with the assessment the associationin collaboration with the family build an Educational Individual Plan (EIP) andtherapeutic plan that will determines the student needsand strengths, the association makes sure to follow up with the family and make sure the family is working on these needs or making progress.Furthermore,the working crew ofexperts individually work on making a plan that is suitable for the beneficiary to help him/her train and learn to improve him/her abilities.

The current used Tests and Assessments:

  1. Stanford- Binet- intelligence quotient (IQ test)
  2. Childhood Autism Rating Scale (CARS)
  3. The Social Maturity Scale (Vineland)
  4. Children's Attention and Compatibility Scale (ADHD)
Early intervention
يلعب التدخل المبكر دوراً هاماً في تطوير أطفال ذوي متلازمة داون، ويبدأ منذ الأسابيع الأولى بعد الولادة. ويتمتع الأشخاص أصحاب الهمم من ذوي متلازمة داون بحقوق متساوية في الصحة والتعليم والتوظيف والدمج الذي كفله لهم القانون الاتحادي رقم 26 لعام 2006 في حقوق أصحاب الهمم والسياسات الوطنية والاتفاقيات الدولية ذات الصلة.

تكمن أهمية التدخل المبكر في تقديم الدعم المتخصص والخبرات اللازمة للأهل والمهتمين بالطفل والعمل على استثمار المرحلة العمرية الذهبية المبكرة في حياة الأطفال والتي تشكل الأساس في اكتساب وتطوير المهارات في المجالات النمائية وتشمل المهارات الإداركية والمهارات اللغوية والتواصل والمهارات الحركية الكبرى والدقيقة والمهارات الاستقلالية والاعتماد على النفس والتهيئة للدمج التعليمي. ويؤدي التدخل المبكر إلى تخفيف العبء المادي على الأسرة والدولة.