EFFECTIVENESS OF USING TIMETABLE TO INCREASE THE MEMORY OF A CHILD

WITH DOWN SYNDROME: A CASE STUDY

Introduction

I. Background of the Study

Down syndrome is a congenital disorder arising from a chromosome defect, causing

intellectual impairment and physical abnormalities including short stature and a broad facial
profile. It arises from a defecting involving chromosome 21, usually an extra copy (trisomy-21)
Origin 1960s:named after John L. H. Down (1828-96), the English physician who first described
it.

By definition, Down syndrome is a genetic condition whereby an individual has a surplus

of a DNA material, says Mary Pipan, MD, a behavioural Pediatrician and director of the Trisomy
Program at Children’s Hospital of Philadelphia. Every cell in a person body contains their genetic
code or DNA, which typically consist of 23 pairs of chromosomes- with one chromosome in each
pair coming from the child’s mother and the other chromosome in each pair coming from the
child’s father. (2) Those 46 chromosomes are a person’s genetic blueprint- the stuff that makes
them who they are, determining things like eye colour, personality traits, and inherited risk of
different diseases. When someone has Down syndrome, they have all 23 pairs of their
chromosomes, but they are also born with an extra full or partial copy of the 21st chromosome,
Dr. Pipan explains. Every chromosome carries dozens, hundreds, or even thousands of specific
genes. And Pipan points out that many disorders stem from a single gene abnormality or
mutation. (Cystic fibrosis and muscular dystrophy are two examples of these single-gene
disorder) (3) “But the 21st chromosome has 350 genes, and probably all of them contribute to
Down syndrome,” Pipan says. “So it’s a pretty complicated disorder.” The extra genetic material
is present from the moment of conception, so Down syndrome is not something a person can
develop after birth or later in life: You’re either born with it or you’re not. Also, because every
gene in the extra 21st chromosome is affected, children with Down syndrome “may have
medical condition that affect every part of the body,” Pipan adds.

As an employee of Emirates British Nursery which provides inclusive education that

caters quality education to all learners regardless of the cultural orientation, economic status,
social and gender role, abilities and talents, the institution has been teaching children with
Down syndrome for couple of years to the present. Hence, with the desire to help teachers with
students of the same case in order to provide more meaningful and essential learning and
improvement on the child’s thinking and memorizing skills and procedures, this case study has
been conceptualized to be conducted to one of the learners in the institution.
 II. Statement of the Problem

This study is sought to answer the following question/s:

1. Does visual timetable help increase the memory of a child with Down Syndrome?

III. Method and Research Plan:

1. Observation

a. At Home
b. AT the nursery
The respondent has been observed in the places where she spends her time often. The
factors which has been observed are:
 Gross motor movements and social communication
2. Interview with the family members

ANALYSIS AND SYNTHESIS

My case study patient is one of the students in the nursery
where I work with. Her name is Salama, (the name was exposed
with the parents consent) she’s 3 years and 4 months now. But
when she started in my class, she’s only 2years and 7 months.
She’s the youngest among her 7 siblings. Salama was diagnosed
as a down syndrome baby since she was born, aside from that it
trigger her situation because she was born with IMPERFORATE
ANUS (it means she was born without hole in her anus). For
that her
parents urge to do surgery called COLOSTOMY SURGERY(is an
operation that creates an opening for the colon, or large
intestine, through the abdomen. A colostomy may be
temporary or permanent. It is usually done after bowel surgery
or injury. The edges of the colon are then stitched to the skin of
the abdominal wall to form an opening called a stoma).
According to her mum, except of this anus abnormality,
salama’s health condition was great not to mention that she is
a Down syndrome child. When I asked the mum how did they
accept about salama’s being a Down Syndrome child, how her
siblings treat her? She said they feel lucky having her, because
in their belief having a children with disabilities is a big help to
enter the kingdom of heaven. I went to salama’s house to
observed how her siblings and family treat her.
They treat her as a normal child. They give her food and let her
eat alone. At home she have her own playroom area and have
lots of activities to enhance her physical development. And
based on my observation her behaviour at home is different
during her time in the nursery. At the nursery she’s not paying
attention well not like at home she’s always happy playing or
doing something on her own. She started in the nursery at the
age of 2 and 7 months during that time she can’t walk alone.
She can’t utter any words, and no reaction at all. But she have
the obsessive behaviour of one thing and cause her harder to
control her feeling when she get frustrated. She was delayed in
walking and also having a speech problem that’s why she’s
attending Physiotherapy and Speech therapy joint session at
home for 45 minutes everyday and she have her Occupational
Therapy centre that last for 45 minutes per week .Currently
Salama attended the nursery again and received Special
Education in Early Years Foundation Stage (EYFS) 5 times per
week 4 hours a day.

III. DIAGNOSIS:
 Delayed in speech

 Less muscles tone and less interaction with the other kids.

 Uncommon Behaviour

IV. Intervention:

My intervention targeted are 2 areas:

 Gross motor area and social communication area.

 She’s lazy to move from one area to another area .In the nursery
we have the jungle gym at the play area. At first Salama cannot
climb alone. She rolls by turning segmental from stomach to back
and from back to stomach to climb up on the bridge. She was
scared to slide alone without someone holding her hand.
  I help her to hold the handle of the bridge so that she can climb,
stand and walk over the bridge going down the slide, now she can
do it alone.

 She can slide down alone with smile in her face.

 Social-communication Area

 Salama can’t utter any words when she started nursery.

 She’s playing alone.

 She got frustrated for a small thing.

 She wasn’t listening during circle time (reading books, singing)

 Jolly phonics in circle time helps Salama a lot.

 Reading the same book everyday it help her to recognise and say
some words from the books.

 Using visual timetable help her to remember the places where

we going.

 Now she can say some words like pee if she need toilet, am if she
want to eat, and etc.

Present level of performance:

Salama’s improvement during her therapy and attending the
nursery.

1. Salama turns head, move arms, and kicks legs independently

of each other

2. From any position (e.g., standing, creeping, lying down).

Salama moves to a sitting position on a flat surface without
support.

3. She manage her self to sit down in and get out of child-size
chair.

4. Salama climbs up and down, moves up and down, moves

under, over and through obstacle ( e.g., she climb on slide,
jungle gym at the playground).

5. She can express her affection towards familiar adult.

6. She can vocalize and do gestures to express her excitement.

7. Salama can initiate and maintains interaction with familiar

adult and she respond well.
V. Conclusion
Dealing with down syndrome patient is a lot of courage and
understanding and at the same time u need to have the passion
to deal with your patient. In this way u
you will be able to cater the needs of the patient and give more
understanding with your patients feelings without uttering any
single words.

Based on the conducted procedures and results, using

timetable is a very effective way to increase the memory of
Salama. There were noticeable changes in the child’s behaviour
especially in dealing with other people and executing daily
routines in school.

However, the range of time in the utilization of the timetable

was by term. Other time frames were not yet experimented on.

VI. Recommendation

In Salama’s case she needs to continue all her therapies. To

enhance more her self esteem
At this moment Salama continued all her therapies at home
based and school based to sustain and help her more
physically, socially, and developed her fine and gross motor
skills continuously.
Reference:
www.everydayhealth.com

About the Author

My name is Alicia D. Requizo, I’m currently working as a

teacher assistant and bus coordinator at Emirates British
Nursery. For 9 years at the nursery, I handled children with
Down Syndrome cases in 2 consecutive years. This is why I
pursue my studies in Shadow Teaching . I want to enhance
more my knowledge about these different kind of learning
disabilities specially children with Down syndrome. I’ve been
working under the curriculum of UK Early Years Foundation
Stage. I was trained and
equipped in different responsibilities as:
 Assisting and helping the teacher in taking good care of
the student.

 Helping on preparing teaching materials.

 Assisting the children all the time.

 Ensuring children safety first.

 Preparing decoration for the beautification of the nursery.

 Attending training and seminars.