Madrid 1997 World Down Syndrome Conference Life Stages Workshops
NORMAL AND ABNORMAL DEVELOPMENT OF THE CHILDREN WITH DOWN SYNDROME
Pfanner, P., Marcheschi, M., Bargagna, S.
IRCCS Stella Maris. INPE University of Pisa. Via dei Giacinti, 2 56018 Calambrone, Pisa (Italia) Phone: 050-886111 Fax: 050-886247
The development of children with Down Syndrome (DS) is similar to that of non handicapped children, but, at the same time, it shows different and peculiar aspects. In particular it presents both psychometric and structural mental retardation (RM), with diminished ability and consequently a limitation in learning. These children are passive, lacking in determination and show little capacity of developing autonomous thoughts. In this study we describe an experience of intervention that we consider useful and interesting to increase metacognitive and strategic structures and support more complex thought structures. Preliminary results come from the application of MS 4-8 training (Mental structures 4-8) to a group of children with Down syndrome. The method is Vianello's MS 48 test (Vianello'91) and in material for the training (Vianello'93). Our study group was comprised by 10 children (3F/7M) age range 6-15 years who were trained for 8 months at least. These children were compared to other children of the same chronological and mental age who had not in been be trained. The analysis of our results showed that scores in the test were higher than those of the non trained group. From the analysis of different areas (classification, series, numeration, conservation) we noticed an amelioration in seriation, an easier passage from an intuitive first preoperational thought to the more complex preoperational period. Moreover, positive change could be noticed in the individual approach to the task, with an increase in interest, better capacity to organize the strategies for solving problems. These data indicate out that this type of therapy may be carried out with success in the rehabilitation of DS children. We can conclude that this training is efficient in moving mental structures, that it has a greater effect over a long period, that children maintain their learning also during a rest period, that this training method seems to produce a sudden improvement in learning and in autonomous thought organization and we suppose that being better able to solve conflictual problems may help to increase their adaptation to social life.
LA MENARCA Y SU IMPACTO EN JOVENES CON SINDROME DE DOWN Y SUS FAMILIAS
Savaglio, R.*, Goddard, P., Siemaszko, K., Rodriguez, L.
Programa de Adolescencia Htal. De Clínicas de J. De San Martín. U.B.A., Córdoba 2351 C.P. 1120 (Argentina)
Introducción: En niñas con Síndrome de Down el avance en la atención médica ha mejorado la calidad y expectativa de vida. La pubertad enfrenta a las jóvenes y sus familias a nuevos desafíos generando interrogantes que deben ser atendidos.
Objetivos:
Determinar:
Características de la menarca.
Vivencias en torno a la misma.
Factores facilitadores de la autonomía. Material y métodos: Se distribuyó, en escuelas especiales, un cuestionario especialmente diseñado. Fue respondido por 84 padres de jóvenes integrados en sus familias con una edad promedio de 15.9 años.
Resultados: Habían presentado su menarca un 80%: la edad promedio fue a los 12.2 años; un 70% tenía ciclos regulares de 20 a 30 días; un 42% refirió menstruacciones abundantes; un 43% algiomenorrea expresándolo verbalmente el 79% y con cambios de carácter un 21%. Recibieron información el 85%, el 72% antes de la menarca. Informaron a la madre el 86.4%, a docentes el 15.1%, a médicos 6.2% y a hermanos u otros el 26.4%. Ante la menarca tanto los padres como los jóvenes refirieron preocupación, temor, sorpresa y alegría, un 30% no consultó con un médico.Los padres mostraron preocupación por la higiene menstrual, inicio de relaciones sexuales, embarazo y abuso. El 45.6% era autónoma en su higiene y el 44.6% requería alguna ayuda. La información, el recibirla antes de la menarca, la edad y el NES se correlacionaron positivamente con la independencia en la higiene. La presencia de hermanos parece favorecerla.
Conclusiones: La menarca y los ciclos menstruales son similares a los de la población general. Se destacan menstruaciones abundantes por su asociación con el hipotiroidismo y obesidad y la algiomenorrea por su repercusión en el rendimiento escolar. La menarca genera sentimientos contradictorios y preocupación sin una contención y orientación adecuadas. El equipo de salud, la familia y la escuela deben trabajar juntos para facilitar el procesamiento de esta etapa y así favorecer el desarrollo de su identidad como mujer, acrecentar la autonomía y promover el desarrollo de sus potencialidades.
ADOLESCENCE IN DS AND PSYCHOLOGICAL DISEASE. WHICH INTERRELATION BETWEEN INTRAPSYCHIC AND SOCIAL PROBLEMS?
Tabarini, P., Biondi, G.
Psychosocial Centre, Pediatric Bambino Gesu, Piazza S. Onofrio, 4 00165 Roma (Italy) Fax: 39-6-68592228
Introduction: The present study arises from psychological development evaluations of children/adolescents with Down Syndrome (DS) and from psychotherapy attended by some of them.Some symptoms of discomfort are identified in patients in developmental stages such as childhood, latency, adolescence; in the present study we have specifically examined the adolescent period.
Method: Each adolescent underwent a psychologial screening, by using: projective tests, personality questionnaires, evaluation of frustration, clinical interviews with DS adolescents and their parents, play-observations. Some of the subjects attended psychotherapy.Results: From our clinical experience, we have identified some of the most important defensive strategies used by DS children in order to react to frustrations caused by environment. The lasting use of these strategies might be a potential activator of psychopathology. Furthermore, it has underlined the necessity to inform properly adolescents about their condition, respecting everyone's elaboration process. We also consider it necessary to give parents psychological support after diagnosis communication.Discussion: We have analysed the importance of diagnosis communication and its emotional impact on parents; we have also examined how family attitude may influence a child's psychological development and, later on, how enviromental refusal may increase the employment of defensive mechanisms by adolescents.
Summary: As professionals, we should consider that rehabilitation staff may reinforce parents' defensive mechanism such as: escape from real problems, denial, acting out tendency, etc. The possibility to follow for parents through a psychological therapeutic program should permit an elaboration of the emotive background related to the birth of an handicapped child.