Thursday, June 26, 2014

Care for your special child in Nigeria

Raising a child with special needs can be very challenging and one needs all the help one can get. Enter the therapy sessions. The good thing is that in Nigeria, one can get this help and more more. It is also good that parents are enlightened about what is going on and  understand the kind of help they are getting. 

In the U.S, U.K, and Canada, one approach is usually the norm in Therapy sessions. 
In Nigeria, the therapy sessions are a bit different, some adjustments have to be made hence the tasks are lifted out of a combination of 2 or more approaches in developing and implementing a individualized plan(IEP) for a child.

The belief is that the combination of Therapist led approaches (structured learning) and child led approaches through play, gives optimal learning effect.

For example, Dayo who is a shy 7 year old boy diagnosed with Cerebral palsy and dyslexia, has challenges in self care like belting his trousers, buttoning his shirt, identifying the back and the front of his shirt and academic skills which include memory,weak grip in handwriting and conversation skill development.

In drawing up program and implementation for Dayo, we combined drills and tasks from 
SONRISE (child led)
and NDT and massage therapy.

I know, I know, what nonsense is this? please speak english....
Now I would like to give a short overview of these common learning approaches used in Nigeria.

Sensory Integration Therapy: Sensory Integration is the neurological organization of sensations for use. These sensations include 
Auditory [hearing]
Gustatory [tasting]
Visual [seeing]
Olfactory [tasting]
Tactile (touch)
Vestibular (balance,gravity)
Proprioception(provides information about where body parts are and what they are doing).

Sensory integration Therapy is the assessment and use of purposely selected individualized multi-sensory experiences to treat a variety of developmental and learning difficulties including
Cerebral Palsy
Attention Deficit/or Hyperactive disorder and other developmental coordination and behavioural disorders.

Sensory integration postulates believe that deficits in sensory input result in concept (reasoning academic, and motor learning (posture,milestone developments).

Neurodevelopmental Therapy (NDT):  This intervention focuses on increasing function and the individual’s strengths through proper positioning and strengthening exercises.
The goals of this treatment include the acquisition of as much normal muscle as possible, facilitation of normal movement patterns, it could be of the head,arms,trunk,legs,or tongue.
It is a hands on, problem solving approach where the therapist uses his or her hands to provide guidance and optimize function.

Appropriate Behavioural Analysis(ABA): This type of therapy focuses on behavior. 
In teaching self-care play, language and conversation skills, It uses discrete trial training (breaking down complex skills into simpler graded components) and the use of reward systems, i.e increasing useful behaviours by positive rewards and reducing maladaptive behaviours such as aggression that may cause harm or interfere with learning.

It involves mostly one-on-one interaction. ABA is Therapist led (This means that the Therapist dictates the pace and skill to be learnt and other activities in therapy session. 
ABA is usually the Gold standard for all bevioural Therapy approaches because of its precise behavioural  data collation approach to monitoring progress and research oriented. Parents complain of it making the child too robotic and too structured.

TEACCH: An Acronym for the Treatment and Education of Autistic and communication handicapped children.
TEACCH draws up an IEP based on the uniqueness and the peculiarities of the individual with special needs.It was formerly developed for individuals with Autism but has been found useful in treatment of other developmental conditions in teaching functional skills.

TEACCH  makes the most of an individual’s strength within a structured familiar environment(structured teaching).

SONRISE is a child-led, one on one therapy for kids with Autism. It teaches how to bond well with the child, build trust and making the child know you accept the child the way he is by joining in the child’s unique stimming behavior then gradually encouraging the child to build more complex functional skills in a non forceful way.

Stimming: Self-stimulatory behavior and self-stimulation, is the repetition of physical movements, sounds, or repetitive movement of objects common in individuals with developmental disabilities, but most prevalent in people with autistic spectrum disorders] 

This style of therapy mostly follows the child’s interests. It's usually a very slow learning method of teaching but it has recently been backed by researches.

Relationship Development Intervention(RDI)
This method focuses on a child”s difficulties with flexibility of thought,emotional regulation and prospective taking.It uses everyday activities such as working,cooking,cleaning,football to build up simple conversational skills and complex skills.It uses lots of incidental learning opportunities to teach.its also a family oriented therapy approach.

Montessori Therapy approach
This is the best approach is  for kids with learning disability in a school based setting.

Where they develop cognitively at their own pace to learn age appropriate self care,school skills,group and social skills and also give kids opportunities to balance their sensory needs through sensory based activities and different age levels of kids in group setting encourages peer imitation i.e. the younger ones benefitting from watching the older ones and the older ones benefit by helping the younger children.

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