Development of children with Down syndrome: features and differences from a normal child. Methods of teaching a child with Down syndrome

Regardless of the form of Down syndrome, methods of teaching children with Down syndrome are based on taking into account the patterns of child development, developmental features in Down syndrome, as well as the specific characteristics and level of development of a particular baby. This approach allows the developed methods to be used for all children, individually adapting them for each child.

Children with Down syndrome certainly cannot be considered uneducable. Children with Down syndrome have a specific psychomotor development profile, which must be taken into account in the process of teaching and raising the child. Below are comparative data on the development of a child with Down syndrome and the average typically developing child.

Brief comparative table of development of children with Down syndrome and normative data (Siegfried M. Pueshel (Ed) “Down Syndrome Growing and Learning”, 1990, p. 93)

From the data presented in the table, it can be seen that a child with Down syndrome goes through all the same stages of development as a normal child, although the average time for the appearance of skills is, of course, delayed. In addition, it is obvious that the wide range of timing of the emergence of skills presents great opportunities for the work of teachers, parents and physicians. Children with Down syndrome have developmental strengths, such as: high ability to imitate, good level of visual perception, empathy, focus on social contact and interaction with adults. Specialists should rely on these areas in their work, paying no less attention to them than to the deficient areas of development of a child with Down syndrome.

All over the world and in our country, psychological and pedagogical methods have been developed to stimulate the development of a child, taking into account the characteristics of his development. There are also techniques developed specifically for children with Down syndrome.

The development of each child, like a child with Down syndrome, depends on the characteristics of the child himself, on what age, when and how classes with him are organized.

Like all children, babies with Down syndrome need the love and affection of their loved ones. A safe environment and care from the first days of life are the basis on which activities with your baby will be built. For an early age, the word “activities” is conditional. The child's development and formation of skills will occur during care, play, and through the creation of a safe developmental environment. All conditions for the development of the child are created by parents, with the advisory support of specialists. First of all, these are speech pathologists/correctional teachers who know how to work with young children. IN early age You will also need help from a motor development specialist. In this case, we do not mean massage, but active gymnastics, developed specifically for children with Down syndrome. You will also be helped by consultations with a speech therapist who knows how to work with young children with general speech underdevelopment.

IN preschool age specially organized activities occupy more and more space in a child’s life and the best option child development is visiting kindergarten. In preschool age, the role of specialists in a child’s education increases. These specialists are speech pathologists, speech therapists, motor development specialists, and child psychologists.

It is very important to begin actively promoting the development of a child with Down syndrome as early as possible and take into account the basic principles of its development.

There are no important and significant differences in the general course of development of a special child. The pace of development may be slower, but the order of steps is more or less the same.

Children with Down syndrome need more repetitions to master a particular skill.

The learning process should be gradual and regular, broken down into small steps.

The role of parents in the development of a child with Down syndrome is very important, since it is they who have to daily provide the necessary assistance in the child’s learning new skills and their development during Everyday life.

In order for a baby with Down syndrome to gradually prepare for an independent life as they grow up, a competency-based approach to child development is now used all over the world, according to which it is important for the child not only to acquire the necessary skills and abilities, but also to gradually learn to use them in a wide variety of social situations , which will help him become independent and successfully adapt to society, that is, acquire the competencies necessary for life.

Down is a genetic abnormality leading to serious abnormalities and changes in the body. Caused by the appearance of one extra chromosome in the twenty-first pair. It received its name in honor of the British doctor John L. Down, who first discovered this chromosomal pathology. The syndrome cannot be treated and cannot be cured.

Diagnosis of the disease

On early stages pregnancy it is not difficult to detect. Invasive and non-invasive diagnostic methods are used. To do this, an analysis of the fluid that is taken from the umbilical cord is performed. A biopsy or specific ultrasound examination is also used. Another method is intrauterine sequencing of the DNA of a pregnant child using fragments found in the mother’s blood. These methods are carried out in women who are at risk (have a predisposition to the disease) and under 30 years of age. They provide reliable information on identifying the disease.

For pregnant women over 35 years of age, such techniques are not advisable, as damage to the uterus and fetal rejection are possible. At the end of the first trimester, they undergo non-invasive studies, which, unfortunately, do not provide a 100% guarantee.

Thanks to timely diagnosis, the number of Down children born has now significantly decreased.

Causes of the disease

• Woman's age. In a woman giving birth over 35 years of age, the risk of gene mutation increases.
• Male age limit. After 45, a dad runs the risk of waiting for the birth of a baby with Down syndrome.
• Features of the genetic apparatus and heredity of parents.
• Closely related sexual relations. Incest leads to genome disruption.
• Scientists conducting research have determined that, to some extent, the development of the disease is influenced by increased solar activity.

However, no evidence has yet been found.

Distinctive features of a child

All Down children share common similarities in appearance.

External features:

• The face is particularly flat, especially the nose.
• The eye shape is oblique, a small fold is located near the inner corner of the eye.
• The head is short with a flat, sloping nape. Ears with various anomalies.
• The mouth is small, slightly open. The palate is too short, the tongue sticks out, does not fit in the oral cavity.
• Very weak muscle tone, and joints are overly mobile.
• There is a transverse fold on the palms.
• Crooked little finger.

Many patients with Down syndrome have abnormalities in the development of internal organs.

Among them are quite common:

• Congenital heart disease (more than 40%).
• Visual diseases – strabismus, glaucoma, cataracts.
• Decreased hearing.
• Disorders of the gastrointestinal tract, problems with digestion of food.
• The structure of the nasopharynx is abnormal, which often results in difficulty breathing at night.
• Endocrine.

Pathologies of the musculoskeletal system: absence of a rib, hip dysplasia, deformation of the chest, short stature.

Down children are similar to each other, but they also differ in the presence of certain facial features of their parents. These kids have bright sunny eyes, sincere smiles and good dispositions.

General development of a child with this syndrome

Families with Down children bear a huge responsibility for the happiness and health of the child. He needs constant supervision from specialists. After birth, it is important to undergo a medical examination in order to identify any concomitant pathologies and diseases. After which the doctor can prescribe medications that reduce the impact of the syndrome.

Babies develop much more slowly than ordinary children. The baby will learn to hold his head up only by three months, will sit up closer to a year, and will be able to walk independently by two years. But qualified assistance from specialists will help reduce these deadlines to earlier ones.

Individually designed programs can help your baby’s development:

Special gymnastics aimed at developing fine motor skills. A set of exercises is done daily, which changes and becomes more complex with age.

• Massage is considered an effective method in the rehabilitation process, promoting overall health.
• Educational finger active games.
• Teaching the alphabet and the ability to count, read, learn songs and poems by heart.
• The most important thing is to instill in children with Down syndrome the skills of independence, accustom them to life in society and fully communicate with peers.

Differences in physical development

Physical condition is determined by the influence of genetic material. Such children are characterized by poor physical development and light weight, they don't look their age.

The skin is very light in color; skin rashes appear in infancy. It is dry and rough to the touch, and in winter it can crack.

Deviations in the structure of internal organs are quite common. Thus, in children born with a heart defect, high-frequency heart murmurs are heard. A malfunctioning valve or narrowing of large blood vessels causes a hole to form through which blood flows. In this case, a serious heart defect develops.

The lungs are formed according to the norms, only in some they show slight underdevelopment. Down children with the birth defect have high blood pressure in the lungs and are prone to pneumonia.

The abdominal muscles are poorly developed, causing the stomach to protrude slightly. Most people experience an umbilical hernia that does not require surgical intervention. As the child grows gradually, the hernia heals on its own.

The spleen, kidneys, and liver develop normally, without pathologies. The genitals may be slightly smaller than those of normal children.

The limbs are characterized by short, wide feet and hands. The little fingers on the hands are bent forward. The lines on the palms have a characteristic, pronounced pattern caused by the disease. On the feet, the distance between the first and second toes is increased, and there is an unusual fold on the sole. Flaccid tendons cause the development of flat feet. Therefore, orthopedists advise wearing special shoes with orthopedic insoles.

There is abruptness, uncoordination and inconsistency in the movements. The swings of the arms are abrupt, and varied movements are observed at the legs. Weakness of muscle tone and bone tissue contributes to dislocations, bruises, and fractures.

Not all children with Down syndrome have the disorders listed above. Some may have more pronounced these features, while others may have them to a lesser extent.

Mental development

Modern research studies refute the mental retardation of Down children. The mental retardation of such children is mild or moderate. Only a small percentage of Downs experience profound intellectual delay.

Unlike an ordinary baby, who at the age of three months develops a reaction to the mother’s voice, he begins to smile, turn and hold his head, such a child does not have the so-called “revival” complex. He doesn't react at all to sounds. tactile sensations who takes him in his arms - a stranger or a relative.

Intellectual development slows down and stops at approximately the seven-year level. The vocabulary is minimal, memory is greatly weakened, attention is scattered, reflex relationships instantly fade away. He can cry for a long time without any reason, while being fed, dry, and warmly wrapped.

It is difficult to communicate with Down children due to poor concentration; they hear, but do not want to answer just like that. They are interested in watching bouncing sports balls for a long time, without practicing with hoops or jump ropes.

For society, a child with the syndrome, unfortunately, cannot become a full-fledged and equal member, but after appropriate correctional work, he can be taught to comply with basic sanitary standards and self-hygienic care. In addition, among them there are excellent scientists in mathematics, since these people are able to concentrate on one specific task and remember all its sequential actions.

This syndrome is no longer characterized by difficulty in developing intellectual abilities, but rather by the upbringing of a normal personality.

An appropriate environment should be created for these children in which they will feel comfortable and communicate with others without inhibitions. Qualified specialists with medical education will help you adapt to society and find childhood happiness.

Preschool development

Staying in a child with Down plays a huge role in kindergarten. The activities of the kindergarten are aimed at the comprehensive development of children. They acquire certain skills, abilities, and knowledge.

Every child has to adhere to standards of behavior, maintain discipline, learn to play and communicate with other children. At this age, the leading position is occupied by outdoor play, during which acquired knowledge is consolidated, direct contact with peers occurs, and coordination of movement is formed.

At such moments, the caring attitude of educators and their assistance in normal adaptation in the group is important.

During joint play processes, kids imitate and copy movements, learn to think, draw conclusions, manage events, and share toys and things with others. Games allow you to form a common model of behavior for everyone and solve assigned problems.

Therapeutic physical education and music lessons develop hearing, organicity and accuracy of motor reflexes. Classes with speech therapists help to get rid of speech disorders, create unpronounceable sounds, and learn to pronounce words clearly.

Oligophrenopedagogues are involved in the training, integration and social adaptation of Downs.

Being in a preschool institution, the individual approach of teachers and parents is an ideal way for specific children to be involved in an interesting children's life, in communication, develop speech functions and gain the necessary experience.

School years of development

After kindergarten, it is much easier for first-graders with Down syndrome to join the class team and get used to the lessons. Those who have not attended kindergarten may have difficulties. Teachers bear a special responsibility here, who must help children tune in to school and adapt to a new life.

The school stimulates the discovery of character traits and continues to develop the abilities of students, arouses interest and curiosity in understanding the world around them. Children with the syndrome learn self-expression and self-respect, and discover their individuality.

Practical classes and academic disciplines are difficult for such children. They lack perseverance, reaction speed, and basic skills. Along with others, they do not have quick thinking, absent-minded attention, and weakened memory.

What makes the learning process difficult?

Poorly developed fine and gross motor skills.

Visual impairment. Most have reduced vision or eye diseases. But visual methods of explaining new material are well accepted by the Downs.

Hearing problems. Sensorineural hearing loss, caused by complicated development of the nerves and ear, makes it difficult to hear information.

General speech underdevelopment (GSD) of varying degrees. Inability to correctly compose sentences, poor pronunciation of sounds, stuttering, small vocabulary, fast or sluggish speech - do not make it possible to express thoughts orally and in writing.

Difficulty in thinking. Simple tasks (counting, writing down) are performed at the level of typically developed children. Drawing a conclusion, generalizing, building a logical chain, coming from simple to complex, and vice versa, is not possible for children with Down syndrome. They lack abstract thinking and do not know how to adapt to situations.

Memory is short-term. The amount of memory is not significant, it is required long time to remember and learn new things.

Unstable attention, inability to focus, concentrate, fatigue and distraction from the desired object of study.

There is no perception of a holistic image: they cannot create a whole picture from individual details.

Emotional behavior. They are obedient, obey instructions, affectionate, friendly, and readily carry out orders. They are happy to make contact with teachers and classmates, showing positive emotions. Failure from an incorrectly completed task does not upset them at all, which is not acceptable for studying.

Success and praise from a job well done serves as an incentive in the educational process and gives dynamics in development. A teacher's positive approach to a special child makes his learning effective.

Social society and family influence

A great incentive for the development of children with Down syndrome is their presence in society and their environment. loving people. In addition to school, the child spends a lot of time in the family, on the street, communicating with friends and neighbors. Understanding and perceiving them as they are reveals a child’s character, his inclinations and abilities.

Parents can instill in them a sense of responsibility for themselves, their actions, and teach them to always look beautiful and neat. Brushing teeth, washing, bathing, changing clothes, helping to clean the room, washing dishes - these everyday tasks have a beneficial effect on emotional state child. Such moments will be reflected in the future on the formation of one’s attitude towards oneself, one’s self-esteem and independence.

It is important to give the child the opportunity to be alone so that he can show independence, learn to occupy himself with other things, play games, draw, take a break from current affairs, listen to music, dance.

Accepted by society, the baby develops better, gets acquainted with new useful information, gains confidence in his abilities and feels needed.

In the attached video you can find out more about Down syndrome.

The successful and harmonious personality of a child with Down syndrome depends on the touching and caring attitude of parents and the pedagogical abilities of teachers.

In order for a child with Down syndrome to successfully study, you need to understand two things - society needs him just like any other person, so he needs to be taught everything that an ordinary child can do. Secondly, these children not only can, but also love to learn; maximum results can be obtained only with maximum attention. If the result is insufficient, then insufficient effort has been made. Teaching children with Down syndrome is not an easy, but very rewarding task; the achievements of this child bring a lot of joy to both him and his parents. Society should promote the formation of personality despite the peculiarities of development, both intellectual and physical.

Peculiarities

Before teaching, you should determine what the child can do. As a rule, skills and development are assessed based on the following criteria:

1. How the child communicates and how well his social skills are developed (mutual understanding, mutual assistance, behavior in a team).
2. How he takes care of himself - eats, dresses and undresses, washes himself.
3. Development of gross motor skills - how a child walks, runs, crawls, jumps, bends, rolls over from back to stomach.
4. Development of fine motor skills is the ability to control small objects, transfer them from hand to hand, perform tasks that require coordination of vision and hand movements. Fine motor skills include, for example, grasping an object with the thumb and forefinger “pincer grip,” as well as drawing and fastening buttons.
5. Speech development - not only vocabulary is taken into account, but also the ability to express one’s thoughts, clarity of pronunciation, smoothness of conversation, emotional intonations.
6. Understanding of language - attentiveness to what is said, the ability to follow instructions, speed of reaction to a request, reaction to loud, quiet, simple and complex phrases both in the number of words and in the complexity of the sentence structure (for example, understanding a complex and simple sentence, using synonyms, antonyms , expressions in a figurative sense). Understanding the emotionality of the address - jokes, stern conversation.

Children with the syndrome are quite ordinary, but, of course, there are features that make it more difficult for them to master educational material:

• Down syndrome causes thin and gross motor skills may be difficult, these physical characteristics need to be developed through exercise;
• since the main part of information is perceived through hearing and vision, problems with these senses that are observed in children are also a factor that slows down learning, in case of problems, you need to undergo appropriate treatment and during treatment procedures you need to take these features into account in the curriculum;
• speech may be equipped with insufficient vocabulary, pronunciation is not clear enough, there may be problems with the logical expression of one’s thoughts, but this can be solved simply by intensifying learning, in which the speech areas of the brain develop faster, this problem requires close attention, but it has a psychological orientation, not physiological (speech muscles are strengthened during work);
• the child often needs to be repeated several times, and in short phrases, since short-term auditory memory is poorly developed, mental retardation is possible, which, however, can be caught up with the help of targeted work;
• despite the fact that children are diligent, it is difficult for them to concentrate on one thing for a long time;
• new skills and concepts need to be repeated many times, especially if they are not interesting, so it is advisable to do the training in a playful, but clear form, so that the essence of the concept that needs to be learned is not lost behind the game process; or simply to interest the child, because learning can be carried out in a dull or interesting form, as with ordinary children, the result very much depends on the creativity and efforts of the teacher, there is no need to manipulate mental retardation, you need to work creatively with the child;
• need to work on figurative and logical thinking, since generalizations, substantiation of statements, and the ability to find evidence of a particular fact are usually difficult for children;
• pay attention to such seemingly details as the arrangement of objects or actions in a certain sequence, in accordance with rules or patterns;
• Despite the fact that children are well versed in visual aids, non-verbal tasks (which need to be shown without verbal accompaniment) related to counting and classifying things are quite difficult at an early age for all children, but especially for children who have the syndrome Down;
• Due to the great efforts that children must make even for seemingly simple tasks, they quickly get tired and their attention is scattered.

Fine motor skills

With the help of fine motor skills, a child can fasten buttons, draw, and do actions that help take care of himself in everyday life. Therefore, it is very important to develop it.

Children with Down syndrome often have reduced muscle tone, so hand movements are compensated by movements of the shoulder and forearm, the muscles in which are stronger. But the wrist gradually strengthens, and the child learns to use the palm. The fingers gradually develop, they can be trained using the technique - the hand is placed on the table, with the edge of the palm down. The work is carried out with the thumb, index and middle fingers. Strengthening the wrist is done using circular, up-down and sideways movements.

You need to learn to grab with your palm, with a pinch, with your thumb and forefinger at the same time (tweezers), and also do similar exercises, for example, touching the thumb of the same hand with your fingers one at a time. Problems are possible - a palm grip can be obtained without the participation of the thumb, the grip may be insufficiently strong, a tweezer grip can be carried out with the thumb and middle, and not the index finger. In these cases, it is necessary to carry out correction, trying to interest the child in the learning process as follows:

• play finger games;
• sculpt from plasticine, clay, flour, plastic;
• draw with a pencil, paints, chalk, you can make pictures by drawing with your finger in the sand or dipping it in paint, it is important to change the drawing methods, since each of them better develops the brush in a certain way;
• in between classes, you can massage your fingers, which will increase the mobility of your hands, improve blood circulation, and maintain muscle tone.

If fine motor skills are developed, the child will be able to develop better, and mental retardation will gradually disappear.

Games and activities

With Down syndrome, the characteristics of physical development should be taken into account in learning and play. The following games and activities will help improve fine motor skills:

1. The game darlings is for the little ones. When playing with a child, mom (or dad) communicates with the child, which helps not only physical, but also early psychological development.
2. Tearing newspapers and harder paper, cardboard, when your hands get stronger. This exercise can be given from half a year, but you need to make sure that the baby does not eat paper. You also need to teach your child to distinguish which objects can be torn and which cannot. For example, books cannot be torn, they must be leafed through.
3. Flipping book pages. It is better to master this exercise from one year old. It is advisable to have large, colorful pictures. You can begin to teach the child - in addition to pictures, you can give publications with capital letters, and later - encyclopedias in which pictures illustrate educational information; with the help of visual perception of not only beautiful, but also useful information, mental retardation is eliminated. By flipping through the pages, the child learns to grasp small and thin objects.
4. The use of beads and buttons in teaching - sorting by color, size, stringing on a thread; at an older age, more complex creativity is possible, for example, handicrafts in the form of making jewelry, bead embroidery.
5. Cubes, geometric figures, towers made of rings, figures that can be nested into each other.
6. Pouring cereals from container to container, sorting two or three types of cereals that need to be pre-mixed. There is no need to overdo it with the amount of cereal; the activity should not be tiring.
7. You can draw on sand poured onto a tray. Simple Shapes can be complicated up to complex drawings. In addition, you can make paintings in relief, use colorful sand. You can make various shapes from wet sand and apply designs on them using your finger or stick.
8. To develop fine motor skills, you can screw the caps on jars and bottles. You can play with the girls in the kitchen, where real or toy products will be stored in jars. With boys (and girls too) you can play construction sets with large parts where you need to tighten screws and nuts.
9. It is important to teach your child how to button and unfasten his clothes and shoes himself. He must independently handle zippers, buttons, and lacing. You also need to dress and undress toy dolls; it is advisable to have one doll with several sets of clothes that can be cut, sewn and decorated with the help of a child.
10. Modeling with the help of static efforts develops the muscles of the fingers well. And it is not necessary to sculpt figures from plasticine, you can stick dumplings, and the baby will help, to the best of his ability, by kneading the dough, and then rolling it out, even making the dumplings themselves. Not only girls, but also boys like this activity, because the result is edible and the efforts are compensated not only by praise, but also by a completely material meal.
11. Drawing can take place in different planes - on a flat table, an inclined easel or a vertical wall. You can give your child a brush and paint the fence, or make another useful work, the volumes of which are significant. After all, if the result should be serious, then the work will last longer, and in the case of Down syndrome, the amount of effort applied is directly proportional to the progress of physical and psychological development. Long-term work will also contribute to the possibility of relaxed communication with the baby, and useful work will develop responsibility. There is no need to be afraid to give your child adult work - the main thing is that the activity is safe and takes place under the supervision of adults.
12. Mosaics and puzzles are important for development, but it is important that they are so accessible that a child can put them together without the help of an adult. After all, the presence of complex drawings can lead to the child watching indifferently as mom or dad put together the drawing; parents may simply get tired of fiddling around with monotonous and useless work for half a day. If the activity is complex, it can be extended over several days; as a result, a beautifully folded picture from puzzles can be put in a frame and the child will be able to look at the result of his efforts.
13. Using scissors, cut out shapes and snowflakes from which you can make appliqués. You can also cut out patterns from which you can sew clothes for dolls or even for the child himself.

Techniques

Down Syndrome Among different methods upbringing and education, the following can be distinguished:

1. The method of Maria Montessori, who proposed learning through games. According to this technique, the child must be given freedom of choice between different types activities, and each of these types should have equal value for learning. main idea- creating an environment in which the child will independently want to do what adults require of him. The duration of the lesson and educational material are adjusted based on the child’s wishes. Collective games should prepare the child for independence, that is, they should have a practical orientation. Mental retardation cannot be a reason for isolation, but is a reason for persistent learning, which comes through understanding the child’s characteristics.
2. Glen Doman method. Characteristics of the method: classes should take place as early as possible, that is, from the moment of birth. Active teaching of mathematics, language and reading - from one year, when the child is psychologically ready for classes of a higher level of complexity.
3. Method Cecile Lupan. The main idea is to interest the child; activities should bring joy. It is necessary to help the child master new activities that he himself strives to learn. Foster curiosity with new things interesting information. The child himself must learn to expand the horizons of his activities, this will help eliminate mental retardation.
4. The Nikitins' method is freedom of creativity, light clothing, comfortable environment in the classroom or apartment. Improving health should contribute to improving educational results, so sports training and hardening of the body are needed. Toys should have an educational background - for example, the image of cubes and numbers should be there even if the child has not yet started studying them. Parents should take part in games, be friends and support outside of the educational process.
5. Zaitsev's technique is the use of materials made by the author of the technique - cubes, tables, musical recordings, to which you can sing along to the words from the table. The basis of the methodology and its most popular part is teaching early reading; training should influence further literacy in writing. With the help of intellectual activities and teaching reading skills, mental retardation is eliminated.

The methods of teaching children with Down syndrome and rehabilitating children with disabilities are similar - these are special exercises, communication with animals, which can be combined with the skills of caring for them. These methods are unconventional, but quite effective, since their main task is to make the child’s significant efforts aimed at his development invisible through interest. This is hippotherapy - riding, communicating and caring for horses; canistherapy - living in a house with a child of a well-bred, friendly and playful dog; dolphin therapy - swimming with dolphins. Collective activities are important so that stronger children psychologically pull behind them those who are slower in learning.

Children with Down syndrome undoubtedly differ in their level of intellectual development from their healthy peers. The article will tell you how children with Down syndrome develop and learn, what features this process has.

The birth of a baby is a long-awaited and desired event. But is this always the case? What if a child is born with an incurable serious illness, in which he will be significantly different in appearance from his peers and lag behind them in mental development? For many parents, the diagnosis of Down syndrome found in a tiny child sounds like a terrible death sentence.

Previously, it was generally accepted that all children with Down syndrome were not amenable to learning, since they were characterized by a severe degree of mental retardation. As modern research shows, indeed, almost all patients with this disease have delays in intellectual development. However, the intellectual level of patients within this group varies significantly and can range from slight retardation to severe retardation.

Features of development

But still, many children with Down syndrome are able to learn to walk, talk, write, read and do almost everything that their healthy peers can. But in order to achieve this, parents need to provide their sick children with appropriate educational programs and an adequate living environment.

When diagnosed with Down syndrome, the child's development has its own characteristics. Thus, speech appears late and remains underdeveloped throughout life, understanding speech is difficult, the vocabulary is very modest, and sound pronunciations in the form of dyslania or dysarthria are often observed.

Such difficulties in mastering speech are caused by decreased hearing acuity, small oral cavity, decreased muscle tone. Also, sick children have narrow and small ear canals, which negatively affects their listening ability. Great importance in the development of speech is given to tactile sensations inside the oral cavity. Patients can hardly recognize their sensations, having little idea where to place their tongue to pronounce sounds.

Visual perception in children with this diagnosis is also underdeveloped. Young patients prefer to avoid complex pictorial configurations and fix their attention, as a rule, only on single visual images. Children are not able to search and find details, or carefully examine specific objects.

Despite such a severe intellectual defect, the emotional sphere remains preserved. Down children can be friendly, obedient, and affectionate. They are capable of loving, being offended, and being embarrassed, but at the same time they can also be stubborn, angry and irritable. Many kids are curious and have a good ability to imitate, which is of great importance for instilling work processes and self-service skills. The level of skills that children with this diagnosis are able to achieve may vary and depend on genetic factors and the child’s social environment.

The 21st additional chromosome, which is the cause of the development of downism, causes the occurrence of some physiological characteristics, due to which the child’s development occurs much slower than in healthy children.

Features of training

Many have been developed various techniques, allowing for the development and effective training of down children. But parents should prepare themselves for the fact that teaching children with Down syndrome is a rather complex process that takes a lot of time. The earlier classes with your baby were started, the higher the chances of achieving success. The main didactic principle of teaching such patients is the use of various channels of perception (sense organs). The process of learning should go quite slowly, and the activities themselves should be pleasant and interesting for the child.

Early help. It should be provided from the moment the appropriate diagnosis is made until the little patient is admitted to educational institution. Its main goal is to ensure maximum realization of the child’s capabilities, prevent the development of secondary disorders, and include the child in the general educational stream.

Preschool education. Down kids can become students at a compensatory preschool institution created for children with intellectual disabilities. The training program includes the following main areas: “ Social development", "Health", "Formation of activities", " Physical development and physical education", " Aesthetic development" And " Cognitive development" All classes are conducted by qualified teachers, based on generally accepted methods of teaching and developing children with intellectual disabilities.

In modern times, integrated education in educational institutions (both school and preschool) is becoming increasingly popular, which provides for the joint education of healthy children and children with disabilities, providing the latter with social adaptation and special conditions. When a down child attends integrated groups in kindergartens, individual educational plans are developed in accordance with his capabilities, which undoubtedly gives positive results training.

Schooling. Education for patients diagnosed with Down syndrome can take place in special correctional schools, where classes are organized according to a special program for children with intellectual disabilities. Schoolchildren can also study in integrated classes, where, just like in kindergarten, a separate curriculum is developed for each student, in accordance with his level of development.

Down syndrome is a common genetic disorder. For every 600 - 800 newborns, there is 1 child suffering from this disease. The disease was first described by John Langdoun Down in 1866 and took its name from the name of this famous professor. Only almost a century later (in 1959) the French scientist Jerome Lejeune managed to identify the cause of the syndrome, which was the presence of an extra chromosome.

Rehabilitation of children with Down syndrome is undoubtedly a difficult and lengthy process. The task of parents is to help their child as much as possible and create conditions for him in which he would feel like everyone else - a full-fledged member of society. And then, undoubtedly, the baby will be able to achieve great success.

Currently, a new category of children is coming to school I and II - children with Down syndrome. This material is devoted to the causes of this disorder, the personality characteristics of these children and the tasks of the school in their education and development.

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Children with Down syndrome

Personality characteristics, development prospects

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Tkacheva A.A.

What is Down Syndrome

The word "syndrome" refers to a combination of many signs or characteristics.“Down syndrome” is the most common form known today chromosomal pathology. First described in 1866John Langdon Down called "Mongolism". In 1959, French professor Lejeune proved that Down syndrome is associated with genetic changes. Each cell contains a certain number of chromosomes. Typically, each cell contains 46 chromosomes, half of which we get from our mother and half from our father. A person with Down syndrome has a third extra chromosome on the 21st pair of chromosomes, making a total of 47 chromosomes.

The most common form of Down syndrome is standard trisomy (complete tripling of chromosome 21 in all cells of the body). This form accounts for 94% of all cases of the disease.

Less common (approximately 4% of cases) is a translocation (displacement) of the 21st pair of chromosomes to other chromosomes.

The mosaic form (approximately 2% of cases) is the rarest form of Down syndrome, in which only some cells of the patient’s body contain the tripled 21st chromosome, and the patients themselves have normal appearance and intelligence, but are at high risk of having a child with Down syndrome.

Down syndrome occurs in one in 600-1000 newborns. The reason why this happens is still not clear. Children with Down syndrome are born to parents from all social classes and ethnic groups, with very different levels of education. Down syndrome cannot be prevented and cannot be cured. But thanks to recent genetic research, much more is now known about the functioning of chromosomes, especially the 21st.

The study revealed four factors that influence the likelihood of Down syndrome in a child:

• middle-aged parents: mother over 35 years old, father over 45 years old
• mother's age is too young (under 18 years old)

For women under 25 years of age, the likelihood of giving birth to a sick personchild is 1/1400, up to 30 - 1/1000, at 35 years old the risk increases to 1/350, at 42 years old - to 1/60, and at 49 years old - to 1/12. However, because young women in general give birth to many more children, the majority (80%) of all Down syndrome patients are actually born to young women under the age of 30.

• consanguineous marriages
• and also, oddly enough, the age of the maternal grandmother.

Moreover, the last of the four factors turned out to be the most significant. The older the grandmother was when she gave birth to her daughter, the higher the likelihood that she would give birth to a grandson or granddaughter with Down syndrome. This probability increases by 30% with each year “lost” by the future grandmother.

The mechanism of this connection is not entirely clear, but it is unlikely that anything supernatural should be seen in it. After all, oocytes (future eggs) undergo the first meiotic division while the female embryo is in the womb. It is during this division that the divergence of homologous chromosomes occurs - either correct or not. Girls are born with a complete set of oocytes that have already undergone the first meiotic division. Among these oocytes, some already carry an extra 21st chromosome: if these cells are destined to be fertilized, they will produce children with Down syndrome. And the number of such defective cells in the ovaries of a newborn girl appears to depend on the age of her mother.

Clinical picture

The most characteristic external signs of Down syndrome, which can be used to make a presumptive diagnosis immediately after the birth of a child, are:

• “flat” face - 90%
• thickened cervical skin fold
• brachycephaly (short head) - 81%
• slanted eyes
• semilunar skin fold at the inner corner of the eye (epicanthus).

Further examination of the child reveals:

• muscle hypotonia (decreased muscle tone)
• increased joint mobility
• short and wide hands, small arched palate, flat nape
• deformed ears, large folded nose.
• transverse palmar fold, as a universal sign of Down syndrome, can occur only in 45% of children born with this disease
• chest deformity, keeled or funnel-shaped
• pigment spots along the edge of the iris (Brushfield spots).

Also, children with Downham syndrome may experience certain changes in internal organs

• combined, multiple, congenital heart defects, such as ventricular septal defect, atrial septal defect, anomalies of large vessels, patent atrioventricular canal
• from the respiratory system - respiratory arrest during sleep due to a large tongue and structural features of the oropharynx;
• vision problems(congenital cataract, glaucoma, strabismus- strabismus)
• hearing impairment
• thyroid disease (congenitalhypothyroidism)
• pathology of the gastrointestinal tract (intestinal stenosis, megacolon, atresia of the rectum and anus)
• abnormalities of the musculoskeletal system (hip dysplasia, unilateral or bilateral absence of one rib, clinodactyly (curvature of fingers), short stature, chest deformity)
• hypoplasia (underdevelopment) of the kidneys, hydroureter, hydronephrosis

The final diagnosis of Down syndrome can be made only after examining the karyotype (chromosome set) of the child.

The structure of mental underdevelopment of children with Down syndrome peculiar:

• speech appears late and remains underdeveloped throughout life, speech understanding is insufficient, vocabulary is poor, sound pronunciation in the form of dysarthria or dyslania is often encountered
• Difficulties in learning speech in children with Down syndrome are associated with frequent infectious diseases of the middle ear, decreased hearing acuity, decreased muscle tone, small oral cavity, and delayed intellectual development.
• Children with Down syndrome have small and narrow ear canals, which negatively affects auditory perception and listening ability, that is, hearing consistent, consistent sounds in the environment, concentrating on them and recognizing them
• During the development of speech, tactile sensations inside the oral cavity are of significant importance; children often experience difficulties in recognizing their sensations: they have little idea where the tongue is and where it should be placed in order to pronounce this or that sound
• Children with Down syndrome often speak quickly or in separate sequences of words, without pauses between them, so that the words run into each other; in addition, at the age of 11-13 years, these children begin to stutter
• Children with Down syndrome experience significant difficulties in developing the ability to reason and build evidence. Children have a harder time transferring skills and knowledge from one situation to another. Abstract concepts, in academic disciplines incomprehensible. It may also be difficult to solve practical problems that arise. Limited ideas and insufficient inferences underlying mental activity make it impossible for many children with Down syndrome to learn specific school subjects.
• the profound underdevelopment of the speech of these children often masks the true state of their thinking and creates the impression of lower cognitive abilities. However, when performing nonverbal tasks (classifying objects, counting operations, etc.), some children with Down syndrome may show the same results as other children
• Features of visual perception: children with Down syndrome fix their attention on single features of the visual image, prefer simple stimuli and avoid complex pictorial configurations. This preference persists throughout life; children do not see details and do not know how to look for and find them. They cannot carefully examine part of the world and are distracted by brighter images. However, as a result of numerous experiments, it was found that it is better to operate with materials perceived visually than auditorily.
• children with Down syndrome do not and cannot integrate their sensations - simultaneously concentrate attention, listen, watch and react and, therefore, do not have the opportunity to process signals from more than one stimulus at a given time
• but, despite the severity of the intellectual defect, the emotional sphere remains practically preserved. “Downists” can be affectionate, obedient, and friendly. They can be loving, embarrassed, and offended, although they are sometimes irritable, angry, and stubborn
• most of them are curious and have a good ability to imitate, which helps to develop self-service skills and work processes.

The level of skills and abilities that children with Down syndrome can achieve varies greatly. This is due to genetic and environmental factors.

Thus, profound limitations in capabilities are naturally accompanied by a significant reduction in quality of life. A child’s serious illness also affects communication with peers, learning, labor activity, self-care abilities. The child, unfortunately, is excluded from public life. All of the above determines the significance of the problem social adaptation and correction of the corresponding contingents of children.

In the medical literature, Down syndrome is considered as a differentiated form of mental retardation and, therefore, is also divided into degrees of mental retardation.

1. Profound degree of mental retardation.

2. Severe mental retardation.

3. Average or moderate degree of mental retardation.

4. Weak or mild mental retardation.

Main directions of work on adaptation of children with Down syndrome

The goal of correctional work with children with Down syndrome is their social adaptation, adaptation to life and possible integration into society. It is necessary, using all the cognitive abilities of children, and, taking into account the specifics of the development of mental processes, to develop vital skills in them so that, as adults, they can take care of themselves, perform simple work in everyday life, and improve the quality of their lives and the lives of their parents.

Achieving the set goals is ensured by solving the following main tasks:

1. Development of children’s mental functions in the process of work and the earliest possible correction of their deficiencies.

2. Raising children with Down syndrome, developing correct behavior in them. The main focus of this section of work is on developing habits. Children need to develop skills of cultural behavior in communicating with people and teach them communication skills. They must be able to express a request, be able to defend themselves or avoid danger. Much attention must be paid to external forms of behavior.

3. Labor training, development of self-service skills and preparation for feasible types of household labor. It is necessary to develop self-care skills.

Corrective education for severely retarded children can lead to significant positive changes in the child’s development, which should affect his future fate.

Sensory education is one of the areas of work on the social adaptation of children with Down syndrome.

Sensory education is the initial stage of the learning process and is aimed at developing full-fledged perception in a child with developmental anomalies; this is the basis for knowledge of the world around him. The basis of sensory perception is the development of sensory sensation. Perception affects the child’s sense analyzers. The accumulation of sensory sensations about the world around us contributes to the activity of the child’s sense organs. The child begins to feel and positively perceive the surrounding reality through his practical activities,

Sensory perception develops the child’s orienting activity in the surrounding world, since the child becomes familiar with the signs, and it is this activity that is disrupted in children with Down syndrome.

In order for a child to assimilate the transmitted information, it is necessary to develop mental processes, including comparison, analysis, synthesis, generalization, classification.

The state’s attitude to the problem of “special” children

For many years, in Russian medical, pedagogical and psychological science, the position has been asserted that this diagnosis is hopeless for the further development of the individual. It was believed that a person with Down syndrome was not educable, and attempts to treat this “genetic disease” were doomed to failure. State policies that recognize the value of a person based on his ability to work for the good of society contributed to the fact that people in this category were classified as an “inferior minority,” outcasts, outcasts. Therefore, the main concern of the state was to isolate them from society, placing them in a system of closed institutions, where only basic care and treatment were provided as needed. Programs for psychological, pedagogical and social rehabilitation of people with Down syndrome have not been developed. It was generally accepted that neonatologists had to convince parents in the maternity hospital to abandon the child, citing the futility of any type of help for such children. As a result, most children with Down syndrome, as soon as they were born, became orphans with living parents. The number of social orphans with developmental disabilities, increasing year by year, has increased so much that a significant number of special closed-type institutions for isolating these children from society were overcrowded.

Such a government approach to solving the problems of “special” children with non-compliance with the rights of the child, the absence in the country of laws on the civil rights of people with disabilities and on special education, led to a crisis situation both at the level of preschool and school education of children, vocational training and social and labor rehabilitation of adults with disabilities. Down syndrome, so at the level of training personnel to work with this category of the Russian population.

Attempts to change the current situation on the part of state and government structures in recent years of socio-political transformations in Russian Federation expressed in the adoption of a number of laws and regulations. These regulatory documents consider persons with problems in the intellectual, physical, and psychological spheres as an object of special public care and assistance. And the attitude of society towards such people becomes a criterion for assessing the level of its civilization and development.

Carrying out plastic surgery for children with diabetes

Over the past ten years, both in the press and in the medical literature, the problem of performing plastic surgery for people with Down syndrome has been discussed. In particular, in Germany, Israel, Australia and occasionally in Canada and the USA, attempts have been made to correct the facial features of these people using such operations. Although the surgical procedure itself may vary depending on the individual needs of the child and the approach preferred by the surgeon himself, as a rule, the operation still involves removing the folds between the nose and eyes, straightening slightly oblique palpebral fissures, and cartilage implantation in the area of ​​the bridge of the nose, cheeks and chin and removal of part of the tip of the tongue.

Proponents of plastic surgery believe that some shortening of the tongue will improve the child’s speech abilities. In addition, in their opinion, after such an operation, children with Down syndrome will be better accepted in society, since, as a result, they will drool less and it will be easier for them to chew food and drink; they will be less likely to be exposed infectious diseases. Although some subjective observations from parents indicate that people with Down syndrome benefit from such operations, more recent studies have not demonstrated big difference in pronunciation before and after tongue shortening surgery (the number of incorrect sounds did not decrease). An analysis of pronunciation ratings made by parents of children who underwent and did not undergo surgery also did not reveal any difference between these groups of children. Many questions regarding facial plastic surgery still remain unclear and continue to be discussed in scientific circles. It is not entirely clear for whom such an operation is actually being performed: for the child, for the parents or for society. Should the child be involved in deciding whether surgery is necessary? What should be the indications for plastic surgery? What effect will the injury have on the child, without which no operation can be done? Is it possible to avoid prejudice towards a child with Down syndrome by correcting facial features? What will the results of the operation mean for the child’s self-identification and self-image? Should the degree of delay mental development be a criterion when deciding whether to undergo plastic surgery?

Other difficulties relate to incorrect expectations that the child will be “normal” after surgery. This in some cases can lead to denial of the impairments he has. Currently to plastic surgery in the case of Down syndrome, the relationship is contradictory.

Early help system

The establishment of an early intervention system in our country is today one of the priorities for the development of the special education system.

Research by foreign scientists has shown that systematic early pedagogical assistance to children with Down syndrome in a family setting with the involvement of parents in the process of correctional work allows not only the process of child development itself to be brought to a new qualitative level, but also largely determines the process of integration into society. At all stages of life, children with Down syndrome should, according to scientists, be under the patronage of specialists who organize the process of accompanying these people in the educational and social space.

Education programs for children with diabetes

1. Early pedagogical assistance program for children with developmental disabilities"Little steps", developed at Macquarie University (Sydney, Australia, 1975), tested in training center of this university into the category of children with Down syndrome and other developmental disorders. This program encourages children to interact more fully with the world around them.Developed at the Australian Macquarie University, it is successfully used in many countries and is recommended for use by the Ministry of Education of the Russian Federation.
   The methodology is presented in 8 books, which discuss the basic principles and techniques of teaching. The program's curricula cover specific areas of development: general motor skills, speech, motor activity, fine motor skills, self-care, and social skills of the child. The method of teaching a child in each section of the program allows you to gradually develop any skill, ability, or knowledge. The latest book contains a list of skills that determine the development of a child, and a series of test tables that allow children to be tested. Many children trained using these methods were subsequently able to attend integrated and inclusive classes in regular schools.The conceptual provisions of the “Little Steps” program represent an innovative approach to the education of children with developmental disabilities:

• “All children can learn. A child with developmental disabilities learns more slowly, but he can learn!
• Children with mental and physical disabilities need to master all the skills they need to play, communicate with others, and achieve the greatest possible independence to integrate into society.
• Parents, like teachers, play the most important role.
• The effectiveness of learning largely depends on the age of the child. Classes should begin from the moment the diagnosis is made.
• A child’s individual program must satisfy both the needs of the child himself and the capabilities of his family.

1. Methodology for the formation of basic motor skills (BMS)

   Developed by Peter Lauteslager, a Dutch physiotherapist specializing in motor development and specialized care for children with Down syndrome. Suitable for children from 3 months to 3-4 years. Includes testing the child’s levels of development of basic motor skills and drawing up a program of activities with him. The technique implements a functional approach to stimulating the development of children, allows you to assess the dynamics of development and optimally plan classes. It is aimed at habilitation of the child, prevents and corrects deviations in the baby’s motor development. It does not involve influencing the child, but interacting with him with the active participation of parents. The level of motor development is directly related to the primary research activities child and his inclusion in ordinary life- socialization. Testing gives a clear idea of ​​the successive stages of formation of each motor skill, which allows specialists to competently draw up a program for the child’s motor development and develop recommendations for parents. Mastering motor skills provides the child with a certain level of independent existence, allowing him to consistently learn everything that ordinary children can do. The successful development of a child in the motor area moves him forward in the area of ​​communication.

   3. “Step by step”

   First of all, a child with Down syndrome should be taught self-care skills and behavior in everyday life, which not only ensure his independence and independence, but also serve the development of personality, promote confidence and increase self-esteem. In Europe and America, the step-by-step methodology has been used for many years to teach children with special needs. It is very effective for children with Down syndrome. The difficulties of social adaptation of such children are largely determined by their insufficient development of basic everyday skills. The basic skills that ensure a child’s independence in any situation include self-care skills and home care skills. And it is important to learn them in a timely manner. Any activity is based on basic motor and mental functions: concentration, gross and fine motor skills. These are preparatory skills. You can teach one or another self-service skill only when the child has mastered the preparatory skills included in it. The process of learning to master skills must be purposeful, taking into account the characteristics of psychophysical development and life experience, and be carried out against a positive emotional background with the widespread use of incentives. The child needs dedicated time to practice skills, learn and repeat. You need to teach your child independence and everyday skills simple material and in the simplest conditions.
   

   4. Socio-psychological model Portage
   The technique was developed in the USA in the 70s of the last century and is successfully used in many countries around the world. Portage's goal is to work with families with a disabled child, help reduce barriers to disability, and socialize children. The family is visited by a home visiting specialist. The process of child rehabilitation involves a team consisting of project managers, specialists familiar with the methodology and specially trained volunteers from among students, future doctors, psychologists and teachers. During visits, parents are taught structured teaching techniques to use in their daily interactions with their child. Parents are taught to monitor the child, plan achievable goals, and reward desired behavior. Portage sections include infant stimulation, socialization, cognitive activity, development of motor activity, speech, and self-care skills. The Portage method consistently describes all the skills, abilities and knowledge that a child should master as a result of targeted training. It clearly defines: what to teach, when to teach and how to teach.
   5. Methods of speech development and teaching reading by Romena Augustova
   This is the only method of its kind for developing the speech of children with Down syndrome. The author, who has been involved in speech pedagogy all his life, explains in simple and accessible language in his book “Speak! You can do this”, how to teach a child with complex developmental disorders to talk, how to communicate with such children, help them discover their abilities and creative inclinations. Children who study according to the Augustova method not only master well orally, but also learn to read with enthusiasm.
   6. Hippotherapy
   Corrective horse riding - hippotherapy, is very effective and multifunctional for solving the problems of rehabilitation of children with Down syndrome. It develops children's motor, sensory, emotional and psychological abilities. Communication with horses, care and concern for them increases the feeling of trust, patience, and reduces anxiety. Hippotherapy develops the intellectual abilities of children, promotes their social adaptation and better adjustment to life. Specially trained teachers are familiar with the methods of conducting hippotherapy classes.
   7. Numicon system
   A child with Down syndrome has a very difficult time learning mathematics, even the basic skills needed in everyday life. “Numikon” is a set of educational material and a specially developed methodology for working with it when teaching the basics of mathematics. Numbers in a set visual material are presented in template forms, painted in different colors, which makes them accessible to visual and tactile perception. The set includes colored pins, a panel and task cards. The child’s manipulations with details lead to the fact that actions with numbers become visual and tangible. This makes it possible to successfully teach children with Down syndrome the basics of mathematical knowledge.
   8. Lekoteka
   The word “lekoteka” literally translates as “toy storage.” This new technique, developed by Swedish scientists, is being successfully used in Russia. psychological support and special pedagogical assistance to parents raising children with severe disabilities and developmental problems. The lekoteka service creates in children the prerequisites for educational activities, supports the development of each child's personality through play-based learning. Forms of work of the lekotek: consultations for parents, diagnostic play sessions, therapeutic play sessions, group parent trainings. The library's arsenal includes many toys and games for children's development, special equipment, video libraries, and music libraries. Children with Down syndrome can attend classes at the lekotek from 2 months to 7 years.
   

Schooling

The school should

• teach basic disciplines: reading, writing, mathematics
• teach the ability to complete a job
• teach the ability to get along with people and know where to turn to find the answer to a question
• build independence and self-confidence
• develop the ability to occupy oneself

Although social relationships are an important aspect of life, children should be able to spend part of the day alone. They should learn to keep themselves busy. Time spent alone is also good for development. It is during such hours that a child can assimilate the ideas he has encountered and try to do something new on his own. He must have suitable toys and materials so that he does not get bored when alone.

• ensure the musical development of children with diabetes

The movements help develop gross motor skills and teach balance. They are a means of self-expression. Rhythmic dancing improves coordination of movements and makes the movements themselves more graceful. Such activities bring pleasure to the child and give self-confidence for many years.

• sports development

Sports will contribute to the diversified development of the child, and using his physical capabilities, he will be able to increase the overall level of his adaptability to life, endurance, develop muscles, improve coordination of movements and the quality of general motor skills

Being full-fledged members of society, people with Down syndrome can, just like their healthy peers, lead active image life: study, work.

The main didactic principle in teaching such children is

• the involvement of different channels of perception, that is, different senses. First of all, it is necessary to ensure the clarity of learning, and to improve the result, connect the senses of touch, hearing and kinesthetic sensations.
• the process of assimilation of new knowledge should proceed in small steps; it is more advisable to break one task into several parts.
• classes need to be made as interesting and enjoyable as possible for the child, noting his slightest achievements and successes

Modern research has shown a deep connection between the psychological situation in the family, the level of interaction between parents and children, the effectiveness of early intervention programs, preschool and school assistance.

A favorable combination of the body’s compensatory capabilities with correctly selected programs at each stage of education and effective forms of its organization can largely and sometimes completely neutralize the effect of the primary defect on the course of the child’s psychophysical development.

The future of children with Down syndrome is now more promising than ever, and many parents have already dealt with the challenges they face.