Author: Zvezdelina Atanasova, director of the Karin Dom Center for Vocational Training, methodologist of the Karin Dom Center for Social Rehabilitation and Integration. Zvezdi is one of the emblematic specialists of Karin Dom – an experienced trainer, presenter, consultant, and supervisor. For more than 20 years, she shares her knowledge and experience with colleagues, specialists, parents and works to improve the quality of life of children with special needs. As a methodologist at Karin Dom, she selects therapeutic methods and approaches for working with children. She is the author and co-author of specialized guides and manuals for working with children with special needs. She develops the training programs conducted by Karin Dom. She trains specialists from the country and abroad, parents, students, etc.
Do you have colorful socks?
March 21 is approaching – the Down Syndrome Awareness Day. The choice of this date came from the fact that the spelling coincides with the other name of the Syndrome – trisomy 21. And it is time, as a sign of empathy and understanding, to put on our colorful socks. Colorful, like the chromosomes, when they stain them with fluorescent molecules to detect the extra third copy to chromosome 21 using a fluorescence microscope.
In fact, this extra chromosome changes the normal course of growth and development of children. But this is not an obstacle for them to smile, communicate, play, learn, create, develop their potential, and be as independent as possible.
With children with Down Syndrome, the world is more colorful, different, and sunny!
Support for families can begin even before birth, and work with children with Down Syndrome – from birth.
Early childhood intervention services are already available in many places in the country. The family-oriented approach and work in the natural environment of families are fundamental principles in the provision of the social service Early Intervention Center of “Karin Dom” Foundation for children aged 0-3 and their families. Empowering families, increasing their competence, awareness, and confidence is an advantage and a guarantee of success in the development of their children. The main services of the Early Intervention Center are provided in the child’s home, and some of the complementary ones, such as play groups, toy library, etc. are offered in the “Karin Dom” building.
Early intervention is most effective if it takes place in the home environment, on the playground, in a nursery, or kindergarten. The involvement of parents, siblings, grandparents, all adults, and children who are important to the child facilitates the process of achieving developmental progress, results are more sustainable, and children are included from an early age in the social life of the community.
According to the child’s needs, various specialists collaborate with them – a rehabilitator, a speech therapist, a psychologist, and the goals and tasks in the individual family service plan are discussed and implemented together with the parents.
The consultants from the Karin Dom services, together with the parents, discuss the daily care of the baby, its nutrition, hygiene, sleep, physical activity, determining the regime, building routines, and following the development of the child from early childhood. They show parents how to provoke movement in children, how to support them to have stable sitting or standing, how to teach them to stand, how to crawl, how and when to teach their children to walk, what toys to play with, how to engage with their children at home so that learning is fun.
Since they were babies, children with Down Syndrome are attracted to people’s faces, both real and in photos or pictures. They look into each other’s eyes and smile. For this reason, every communication with the child must be accompanied by a search for eye contact, a smile, warm, and gentle words. The child learns to copy these behaviors, thus supporting their overall development and laying the foundation for the development of language and cognitive skills. It is important to provide as many such opportunities as possible.
To encourage copying in children with Down Syndrome, while playing with them we can imitate simple actions and sounds, such as blowing balloons, making funny faces, making “ooooo” with the mouth and sticking out and retracting the tongue, games such as “ku- ku”, let’s repeat these games in front of the mirror as well. Rhymes and finger games are fun for children when the child performs the actions with other children or with an adult.
When performing joint actions with the child, we can use the “hand on hand” method, and name the action being performed. Guiding the child’s hand to build a tower of cubes by saying “get the cube” followed by “put it on top” helps with spatial orientation and gives him confidence that he will succeed. Assistance is gradually limited, guiding the hand only from the elbow or gently pushing from the shoulder until complete independence is achieved.
Suitable for this game can be, for example, cubes, of such a size that the child can grasp them with his fingers. Due to impaired motor skills, the process is slower and children with Down Syndrome need more time. They can easily give up, so support at this stage is very important.
Children with Down Syndrome, like all children, learn about objects by manipulating and experimenting with them, by pawing and touching them to their faces, by dropping, knocking, throwing, touching, and kicking on different materials and surfaces. Thus, they gain a lot of sensory experience, a prerequisite for learning categories such as thick-thin, rough-smooth, hard-soft, and discover what objects can and cannot do. This experience is fundamental to future learning, and for this it is important to provide access to a wide range of different subjects, especially those that are stimulating, motivating, and interesting for children, provoking them to explore the environment. While in the beginning, the toys should be large and easy to grasp, gradually as the child grows, their size is reduced. It is good to provide children with a wide range of toys and other objects with different properties, different textures, shapes, colors, and those that make different sounds. Kitchen utensils, dishes – empty or filled with various liquids, raw vegetables / but always under the supervision of an adult so that they do not get into the nose, ears or be swallowed /, corn semolina, flour, mashed potatoes, etc. can be used. , which the child touches, digs with his hands and pours with a spoon from one container to another. Handmade musical instruments from bottles filled to a quarter with rice, lentils, beans, salt, sugar, balls, coins, sequins, and well-sealed, drums from pots, pans, and wooden spoons can evoke many positive emotions in children.
A useful skill for children is to learn to stick and peel Velcro strips attached to various objects or laminated pictures. This skill can later be transferred to self-care in shoeing and dressing, as in educational picture games, in the use of visual timetables, and in the use of picture dictionaries for alternative or supplementary communication.
In early childhood, children think that people and objects exist only when they can see them, and when they disappear from their sight, they cease to exist and easily give up looking for them. Realizing that objects continue to exist even when we cannot see them is a developmental milestone and an indication of a child’s ability to construct concepts. This process is slowed down in children with Down Syndrome, and purposeful games in this direction support the awareness of the immutability of objects. To teach this concept, it is appropriate to offer children games with partially hidden toys and objects that are gradually revealed in full. For covering, a transparent veil or a vessel can be used initially, and then a denser material, opaque vessels. The game can be made more fun by encouraging the child to hide objects and the adults to find them. Gradually increasing the complexity of the task can go through rolling carts and balls through tunnels or pipes, gradually the games can include acceleration of movement using inclines. The games of crawling under the table or through tunnels made of transparent materials with the possibility of adjusting the length to avoid the fear of closed spaces give quite a sensory experience. At a later stage, children are offered games with searching for objects in the room, placed out of their field of vision. As children play with toys and objects, they begin to understand that their actions lead to some consequence, an effect. They learn that when an object is dropped, a certain sound is heard and that different objects make different sounds. They try again and again until they learn cause-and-effect. For children with Down Syndrome, this process should be further stimulated, and they should be taught that they can influence objects and their environment and use them in relation to others. Such games are placing objects in a box or filling empty containers, building simple towers by starting with the larger cubes and continuing with the smaller ones – “Chimney” or arranging the cubes in a row like “Train”. In the next stage, we help children learn to combine identical objects, to generalize by combining objects by categories and by more than one attribute. Following this, they learn to choose one subject from a group. Thus, they learn to make an association between a spoken word and an object and to respond by pointing or picking up. Children with Down Syndrome take longer to begin to generalize and understand that things can be the same in one way but different in another. They need more time to explore and combine many objects of different shapes, sizes, and colors. Everyday objects, household items, clothes, and shoes can be used. For example, they can group apples by color – two red and two yellow, or by shape – determine a group of bananas and a group of lemons, a pair of patterned socks and a pair of plain ones, distribution of cutlery by type, etc. Two bowls can be used for the child to place the pairs of identical objects for better visualization and understanding. If successful, you can continue with matching pairs of photos of close people, geometric figures, elements of puzzles, and other matching objects familiar to the child. Finally, children begin to name or sign for the objects. For some children, pointing may be the most appropriate response method.
Through play, children learn concepts that are the basis for numbers and mathematics, mastering concepts such as same and different, big, and small, long and short, heavy and light. The specialists at Karin Dom give their ideas and guidance to parents to continue working with children at home. They discuss with them what possibilities there are for this in the home environment, and how therapy can become an easy part of everyday life, without everyone feeling extra burdened.
Children with Down Syndrome take longer to learn number concepts because of a general developmental delay, but they also learn to count by heart without error and understand that one means one thing and two means two things. Children with Down Syndrome need lots of practice with real objects in real situations and with a real purpose. And success comes with practice!
Eye contact is fundamental for language development and communication. Children develop an understanding of communication by observing the movements of the lips and other parts of the face. Children with Down Syndrome are particularly good at using gestures and reading body language and develop a good understanding of the non-verbal aspects of language. They learn to wait their turn in a conversation and pick up emotions from facial expressions, especially the eyes. During the development of early speech and language skills in children with Down Syndrome, the timely introduction of alternative or complementary communication is important. Every child needs functional communication. These can be simple gestures that reduce anxiety due to the delay in speech development. Children copy and learn them easily. Through gestures, they communicate, understand, and learn new words. Some of the children can be introduced to the PECS picture communication system, which we have been successfully implementing for many years at Karin Dom. It gives the children the opportunity to initiate communication, the symbolic pictures are good visual support, and the children feel confident that they will be understood. Gestures and symbols are always accompanied by words, which also supports language development.
It is of particular importance for the development of speech and communication skills in children with Down Syndrome that anyone dealing with them improves the methods and extent of communication in daily activities.
From an early age, children with Down Syndrome are trained in good visual discrimination skills, and this is an area where they do very well. Their good visual skills suggest training in reading from an early age. For them, learning by watching is easier than learning by listening.
Typed words are easier to remember than spoken words. They can be looked at as often as necessary to explain the meaning of the words. This makes the language visual and overcomes the difficulties associated with learning by listening. This helps memory and difficulties related to short-term auditory memory deficits.
The earlier a child with Down Syndrome starts reading, the faster his language and communication skills develop. To facilitate and speed up this process, children can be given simple picture books with bright and clear illustrations of familiar objects, animals, and people with well-defined faces. While looking at pictures, children can be stimulated to imitate animals, sounds, and actions, such as kissing a baby for example. It is important to develop their visual skills and for this, you can also use object picture puzzles, “Lotto” or “Spot the difference” type games, etc.
Children love handmade albums with family photos, and pictures on various topics, which they can deal with with their loved ones.
It is good to follow the three steps when working with pictures – “This is….., Where is ……, What is this?”. It is important to teach children function words and to explain the meaning of new words, encouraging repetition, imitation, or pointing when asked a question. By adding materials to the albums, they become a favorite book that has collected all the information from the child’s accumulated experience, to which they always have access.
When children begin to draw and later to write, they need a lot of sensory experience and physical control.
To facilitate the movements, we can include songs. While singing with the child, we can perform imitation movements to the lyrics of the song, initially in the air. Then, we can transfer the hand movements on a large sheet, resembling scribbles, horizontal and vertical lines, dots, and circles, and only then, start drawing and writing tools.
Painting with shaving foam or finger paints on large surfaces is suitable to enhance the sensory experience and get children to pay attention to their hands. This is a prerequisite for strengthening hand-eye control, and for children to enjoy drawing with their hands. In these attempts to draw, children will always be successful, and this will motivate them to try again and again and use drawing tools. As children’s skills improve, the size of the drawing sheet can be gradually reduced. Sometimes, children with Down Syndrome do not manage to control the pressure on the paper at first, they have difficulty grasping the means of drawing or writing. To improve their skills, we can use adapters for drawing and writing, help them “hand on hand”. Praises are important, even for the smallest success!
Gradually, children realize that these signs they draw have more than one purpose and learn that they can be used to draw pictures – “grass, rain, sun, flowers, people, animals, trees, houses, etc.” Later, children learn that these characters can be used to write letters. For children with Down Syndrome, it is important to write letters with tools that easily leave marks on the paper and to use “writing windows” until they feel confident to do it independently. Varying writing materials and surfaces, paper sizes, and highlighting lines with raised markers make activities more enjoyable for children.
When they are in a group, children learn to recognize each other and to name each other, to follow the rules of the group. They learn to interact and cooperate during the common activity, to express impressions, feelings, and observations, to make a choice which of the finished activities to present to their parents, and to judge how their finished product looks. Combining drawing with appliqué, cutting, and modeling develops creative thinking and skills in children. Art therapy techniques at “Karin Dom” give children the opportunity to express themselves, show their emotions, and be successful!
Children with Down Syndrome gain experience every day, develop their skills to communicate, play, interact with their peers, create, and learn!
They are successfully included in general education kindergartens and schools, and as they grow up, they become more independent and independent. They have the potential to realize themselves in the labor market. They can! And we can support them with lots of love, knowledge, and skills and offer suitable activities and games to stimulate their individual development!
Let’s wear colorful socks on March 21 as a sign of empathy and acceptance of the difference and specific capabilities of each person!
About the Karin Dom Foundation
Karin Dom was established in 1996 by the famous Bulgarian diplomat and philanthropist Ivan Stancioff. It is a dream come true, both for its creator and for parents, children, and specialists who over the years have united their efforts in a common goal for the sake of children. Our team is constantly developing and training, providing not only therapy to children, but also an environment for development, training, and emotional growth, both for the child and their family.
The services of Karin Dom are aimed both at children with special needs and their families (we work with children from 0 to 7 years old) and at all specialists in the field who need to upgrade their knowledge and skills for their work with children with special needs. In recent years, we have directed a serious resource in conducting training for primary teachers, medical specialists, students, etc., so that they can feel more confident and effective in their work, in this way we actively support the process of inclusive education in our country.
Строим новия терапевтичен и образователен комплекс във Варна