|October 2002 Issue||
Our next meeting will be in February 2003, so please join us December 8th for the Down Syndrome Association of Greater St. Louis Christmas party. See Regional Events below for details. If you would like to volunteer to help organize this event, contact Marc and Peggy Mitchell at 346-5628.
The past July issue, this issue and the forthcoming December issue are in tribute to Holly Wrobbel.
Following is update our group's recent activities:
Peggy Mitchell and Sue Brown have been elected to the Board of Directors of the Down Syndrome Association of Greater St. Louis. Peggy's responsibility is to report the happening in Illinois, strengthen the bonds between both groups, increase paid memberships and ensure that the Illinois meetings have speakers and continue to support families. Sue is the Family Support co-chair, which is in the process of updating and adding to the information packets that are available. Sue graduated from Lewis and Clark College with a degree as an Occupational Therapy Assistant and works in the schools and in Early Intervention as a therapist.
Victor Bishop gave a presentation on Early Literacy and Down Syndrome on July 24, to Dr. Debra Hoge's SIUE summer class: Introduction to Early Childhood Special Education, with the assistance of Holly, 2 years old, who superbly sight-read her flash cards for her father, Dr. E. Duff Wrobbel.
Mary Trudell will speak on positive and negative aspects of dealing with public school personnel on October 17 in a Community School Psychology Program class. Mary is also a full scholarship recipient from the State of Illinois to obtain a Bachelor's in Special Education.
Sue Brown was part of the parents' panel on October 7, What will we tell the kids? A STARNet workshop promoting a more inclusive social-educational environment.
STARNet Region IV|
December 4, Friday, 9:00 a.m. - 3:00 p.m. The Proactive Paraprofession. This workshop is geared towards teaming and building relationships within the pre-kindergarten through third grade setting. Participants will benefit most if they come with their team. This workshop will provide participants with some ideas on how to deal with difficult behavior, work with other students in the room, prompt students, and identify roles and responsibilities. Presenter: Denise Henry, MA, worked first as a paraprofessional in primary special education and then as a teacher. She is former consultant with Project CHOICES, a grant funded ISBE initiative that provides technical assistance to schools families, and communities across the state as the work to include children with disabilities in general education. Denise is now a resource specialist with STARNet Region IV. Location: John A. Logan College (Dining Room Annex) 310 W. Plaza Drive. Carterville, IL. Driving directions: (618) 985-5975. For further information call STARNet at 397-8930, ext. 166.
Down Syndrome Articles
Nick Baltins ventured into new territory last year when he started college at National-Louis University outside of Chicago. It was the first time Nick left home for extended periods of time, roomed with someone his own age, and traveled to and from Minneapolis by himself. He learned new skills: balancing a checkbook, controlling his emotions, and making it to appointments on time.
Nick and Andy Baltins saw each other about once a month last school year, Nick's first at college near Chicago.|
Martial plan. Brandon Fullecido, born with Down syndrome, uses determination, courage and skill to earn a black belt by Cynthia Hubert - Bee Staff Writer, (916) 321-1082 or firstname.lastname@example.org, September 14, 2002. Copyright © The Sacramento Bee.
Brandon's mother, Flora Fullecido, congratulates her son after he successfully tested for his black belt. Sacramento Bee/Brian Baer.|
Brandon Fullecido, 16, set a goal eight years ago to get his black belt in karate. Sacramento Bee/Brian Baer.|
Brandon performs martial-arts moves during his black-belt test before a panel of master instructors. The 16-year-old has won many competitions in his age group. Sacramento Bee/Brian Baer.|
Brandon Fullecido is greeted by his father, Robert, after Brandon's successful black-belt test. Sacramento Bee/Brian Baer|
Commentary by Dr. Nicholas Lennox, M B B S, B Med Sc, Dip Obs, FRACGP, Head, Developmental Disability Unit, Department of Public Health and Community Medicine, The University of Melbourne, Melbourne, Vic. E-Mail: email@example.com.
Clinical Case Review is reprinted from Modern Medicine of Australia, June 1997 with the permission of Kate Murchison, Chief Assistant Editor, Medicine Today.
A 25-year-old man presents with a history of deteriorating function over the last five years. This has included a decrease in his vocabulary and use of words, and a loss of his ability to negotiate the geography of his community. Six months prior to presentation his mother had died. The man has Down syndrome, and apart from his recent deterioration he is otherwise well. Is this man demented, depressed or grieving? How should he be assessed and what investigations are appropriate?
Although there is thought to be an association between dementia and Down syndrome, the dementia usually occurs in the fourth and fifth decades and would be very unlikely in a man of this age. However, it would be worth simply excluding this as a possibility once other causes of his deterioration have been assessed.
With the patient's history of deteriorating function, I would also look for any evidence of depression in particular, the biological signs of depression (such as anorexia, weight loss, early morning waking, constipation) and also any signs of depressed mood. In people with intellectual disabilities it is not uncommon to find increasing levels of aggression and irritability associated with a major depressive disorder. As communication difficulties are common in such people, changes in behaviour are often a communication of their situation.
The death of the man's mother is a major event in his life. The symptoms he presents with may be his way of communicating his distress. The consequences of this major loss may not be just interpersonal, but may result in changes in his accommodation, a change in his primary caregiver, and major dislocation of the usual patterns and rhythms of his life. Adjusting to such changes can be a major challenge for anyone, including the person with an intellectual disability. Indeed, for people who have high dependency needs, a very limited social network and a limited ability to adjust to change, the consequences of the loss of a parent or sibling can be devastating.
It is important to attend to such a patient's need to undergo a healthy grieving process. This should include providing him or her with the opportunity to attend the funeral and associated gatherings, to visit the grave and to share feelings about the loss. If verbal communication is a problem, visual aids which graphically represent feelings, events and objects, such as COMPIC, can be used to facilitate the process of grieving.
Physical assessment should particularly include assessment for possible hypothyroidism (which is quite commonly seen in people with Down syndrome), screening for dementia and exclusion of any sensory deficits.
Referral for hearing and vision testing is essential, as neurosensory and conductive hearing losses are very common in people with Down syndrome, as are a whole range of ophthalmic disorders, including cataracts, myopia and keratoconus. Adult-onset epilepsy should be excluded as this is a common presentation of epilepsy in people with Down syndrome.
If the physical investigations are essentially normal and there is some indication of a depressive disorder, especially irritability with other features of depression, I would commence the patient on an SSRI rather than a tricyclic antidepressant. Tricyclic antidepressants can cause hypotension and anticholinergic side effects. These side effects may exacerbate the tendency of people with Down syndrome to have hypotension and dry skin.
Kids with Down syndrome learn language beyond adolescence by Emily Carlson (608) 262-9772, firstname.lastname@example.org. Contact: Robin Chapman, (608) 263-5820, email@example.com.
MADISON, WI, October 16, 2002 Children with Down syndrome can face many challenges - health problems, hearing impairments and learning disabilities, including those affecting language development. While modern advances in medicine have improved the health of children with this disability, a concern remains about the development of communications skills among these children.
Countering the claim among researchers that language learning in children with Down syndrome ends during the teen-age years, a new study from the University of Wisconsin-Madison suggests that individuals with Down syndrome can benefit from language intervention programs during adolescence.
Down syndrome is a developmental disability resulting from an extra copy of chromosome 21, and it affects about 5,000 newborns in the United States every year. A century ago, most children with this disability reached the age of only 9; today, they live well beyond their 50s.
Most children begin learning language skills, such as grammar and speaking, at rapid rates early in their lives. Children with Down syndrome, however, typically experience delays in language development, learning more slowly and at varying rates.
"There's a fanning out of skills in individuals that isn't seen in normally developing children," explains Robin Chapman, the study's primary investigator and a professor emeritus of communicative disorders at UW-Madison's Waisman Center, a facility dedicated to advancing the understanding of developmental disabilities. For example, vocabulary learning may progress much more rapidly than the learning of sentence structure, she says.
Though all these skills continue to improve throughout childhood, Chapman says that some researchers have claimed that the skills begin to plateau as a child with Down syndrome reaches adolescence. As a result of this claim, she notes, educational opportunities for teen-agers with this disability generally shift away from language learning.
Chapman's study, on other hand, shows that certain language skills continue to improve well beyond the teen-age years, suggesting that adolescents with Down syndrome should continue programs for language learning.
For the last six years, Chapman and her colleagues have charted the trajectory of learning skills and memory abilities in 31 individuals with Down syndrome who were ages 5-20 at the study's start. Through comprehension tests and storytelling tasks, they measured each person's ability to understand complex grammar (language comprehension) and his or her ability to speak it (language expression).
While Chapman found that some language skills may stop developing as these children reach late adolescence, she also found that language expression skills continue to improve well into young adulthood - and that their development depends on the development of language comprehension skills, which do tend to plateau.
The longitudinal pattern of language learning in individuals with Down syndrome, says Chapman, shows that language comprehension skills quickly develop during childhood, but that development slows down as the child reaches the teen-age years.
Language expression skills run a different course. "The biggest gap in language learning occurs between language comprehension and expression," she says. But, unlike the other set, expression skills continue to improve throughout adolescence.
Chapman found, however, that the continued development of language expression depends on at least maintaining comprehension skills.
"The rate of change in expressive learning skills," she says, "is predicted by the rate of change in language comprehension skills." For example, if an adolescent acquires the ability to understand complex grammar more slowly, he will also acquire the ability to speak that grammar more slowly.
These findings, says Chapman, point to the importance of continuing language intervention during the teen-age years: "The study's findings suggest that there should continue to be language work in both comprehension and expression throughout teen-age and young adult years."
Furthermore, Chapman suggests that, because of the gap in the development of the two skill sets, language instruction should alternate its emphasis between them.