Kathryn Semones CHD 265 Child Case Study I chose to do a child case study on a child whose family I have

worked for as a nanny for about six months. However, during this observation period for this project, I did not work for the family, and instead I chose to come and observe him twice a week for a couple of hours with the parents consent. When I first met the family as their nanny, it was clear to me that there were some red flags with the childs speech, but I did not press for information about it, and I simply did my job and took care of the child and played with him and tried to encourage a little bit of verbal communication with the child, but did not get very much response. When I chose to do this case study, I knew exactly which family I wanted to work with. I attempted to get a written and signed document allowing me to take photos of the child doing the activities, but the parents were not comfortable with me taking any pictures, even if the childs face is not shown. When I sat down to talk to the childs mother about her son, we discussed the background of the child, as well as the prenatal development and birth process that she encountered. She told me that her sons brain did not develop as fast as the rest of his body did during gestation. When playing with him, his mother has often said that he cannot play rough like he wants to for too long, because it shakes up his brain too much, which can cause brain damage. When I asked her about the birth process, she told me that the child was born at 35 weeks gestation, and the doctors were concerned about whether or not he would be able to survive outside the womb. His mother recalls a difficult labor for

twenty-two hours, and the doctor had to use forceps to deliver the baby. He was born at five pounds, two ounces, and he was sent directly to the NICU because they were concerned with how small he was. We discussed the childs significant developmental milestones and experiences, and the mother told me that the child does not talk, but instead he moans and makes noises, along with pointing to indicate what he wants. The interview was conducted before the child started school for special needs children, and he also started speech therapy around the same time as school. The three areas of development that I chose to focus on are emotional and social development, cognitive development, and speech development. I decided to focus on these areas of development, because I was told during the parent interview that the child not only has a speech delay, but he also is on the lower spectrum of Autism. When learning about the childs emotional and social development, I learned that he is on the lower spectrum of autism. When he knows a person well enough, or feels comfortable around them after a short period of time, he latches onto that person for the entire time you are around him and his family. He becomes fixated on doing one thing, such as playing chase or playing with a certain toy. I chose to use a frequency count to observe this area of development. I decided to observe how many times he wanted to play the game of chase in one hour, since that is the one game he plays with everyone he meets, and even with people he has seen multiple times.

Time frame 0-15 minutes 15-30 minutes 30-45 minutes 45-60 minutes

Frequency

The way I observed and recorded this observation, was whenever he would want to play chase, we would play chase for about fifteen minutes, and then I would sit down somewhere and say, Okay, I am going to take a break. The next time he would come asking to play chase was when I would mark the frequency chart. It occurred eight times within an hour. This shows that the child was not only comfortable with playing with me, but it shows his obsession with that particular game, which shows the signs of Autism. While he is very social, his fixation on one game for a long period of time is what I have seen each time I visit with him. I have learned that chasing him around the house is his way of socializing with everyone. His mother and father both play this game with him when they want to spend quality time with him, because that is the one game that the child likes to play. He also likes monsters, so when he is being chased, he will turn around and roar at the person chasing him. When focusing on the childs cognitive development, I learned through the parent interview that he has been professionally tested to see how his cognitive skills have developed. He has the cognitive development of a three-year-old, and maybe even more advanced than his age. He knows colors, how to write letters and

numbers, and he has the intellectual capacity of a typically functioning three-yearold. I used an anecdotal record to document my observation of the child as he did a couple of activities, such as writing letters and naming colors. After observing the child, it has come to my attention that, although he knows his colors, he is having a much harder time actually saying the colors correctly, which coincides with the speech delay. It is clear that he knows the color, because for the color blue, he says, boo, and for red he says ed. The pronunciation is the only thing that is incorrect. When I had the child sit with me and write the letters of the alphabet, he did not want to sit and do it, but I was able to have him write the letters A, B, and C for me before he got out of his seat and wanted to play again. His writing skills were pretty good, and it was clear that he had written his letters a few times before this activity. The only visually documented activity I was able to get was the paper with the three letters he wrote for me before getting bored and running off.

Before I even sat down to speak with the parents, I had known that the child had an obvious and severe speech delay. When I started to work for this family, that is the first thing I learned about this child. Before he started attending school and speech therapy, his speech was at the level of a one-year-old. He would only point and grunt and yell when he wanted something. The childs parents and I all tried working with him for a while, trying to help him with his speech development by annunciating words to him and talking to him about anything and everything to promote speaking. When he wanted something, we would try to not give him what he asked for unless he could say it to us. I decided to look up the checklist for the speech development of a three-yearold on the CDC website, and used that checklist to observe the childs speech development. Through completing the checklist with the child, I learned that he is very good at following simple instructions, and that he can understand words such as in, on, and under when I would tell him to go find a toy behind or on top of something in the room. His challenges came with the speech portions of the checklist, such as being able to carry on a two to three sentence conversation, or even naming familiar things.

Skill Follows instructions with two or three steps Can name most familiar

Can Do It

Cannot Do It

things Understands words like in, on, and under Says first name, age, and sex Names a friend Says words like I, me, we, and you and some plurals (cars, dogs, cats) Talks well enough for strangers to understand most of the time Carries on a conversation using two to three sentences Says his name, but not age or sex Says me, but not the others

I have learned that, even though it makes people unable to understand him, the childs speech delay and Autism does not mean that the child is incapable of learning. He is a very smart child, who is simply limited in his ability to communicate verbally with people at this time. He has made significant improvement in his speech development in the few months that I have been working with him and observing him specifically for this project. I have learned that observation can give you more information about why a child may be acting in a certain way that can raise suspicions. There are multiple observation techniques, and each of them can allow the observer to look back and analyze the information, and come to some sort of conclusion about a childs behavior. From the activities performed with the child, the language activity and the social and emotional activity produced the best results. The language activity was simply asking the child to say or do something specific, and the results were marked off as can do it or cannot do it. The social and emotional activity was simple as well, because the objective was to see how many times the child would ask to play a game of chase in an hour. The child asked me to play chase eight times within an hour, and I marked off each time within fifteen-minute increments. The hardest activity to complete was the cognitive development activity, because the child was not interested in sitting and showing me if he could write his letters and talk about colors. I luckily got one work sample of the three letters I asked him to write for me, but after he completed that, he wanted to go play chase around the house. That was the most frustrating one, because I was hoping to get

more work samples and information, but I was not going to force him to do something he did not want to do. I learned through completing this project that I need to be more patient and open to the idea that not everything is going to get done. When making a lesson plan, there needs to be room for deviations, especially when working with young children who do not understand that there is a set plan. I need to learn to go with the flow of things and not get caught up in the idea that everything I start with the children has to be completed. Sometimes children get bored and do not want to do the activity, and it would not be beneficial to anyone to force the children to complete something that they have no interest in doing. This project has made me feel like much more of a professional, because I have taken what I already know about children and the typical development of a three-year-old, and I used that to come up with the activities, and learn where this particular child is in his development. I have used the skills I have learned about observation, and put those skills to the test throughout this entire project experience. I learned which observation techniques are my favorite, and which ones are not. I have definitely grown as a professional, and this project opened my eyes about speech development as well as Autism, and taught me that, just because a child has these special needs, does not mean that he cannot cognitively function like a typical three-year-old with a lot of support, and some professional assistance. I was very pleased with the outcome of this project.