Introduction
Nurses and medical practitioners working with special needs children have responsibilities requiring unwearied attention and dedication. However, adhering to practice standards and applying relevant theoretical concepts in assisting these students promises the best results as practitioners are better positioned to provide appropriate guidance. I had an opportunity to work with special needs educators, nurses, and students at the Little Light House School in Tulsa, where I completed my clinical. The institution is dedicated to improving the lives of children with disabilities by training them, providing personalized care, and enhancing their development in different areas. Although I observed several students from three and a half to five years and helped my friends complete their projects, a four-year-old girl with autism caught my attention as she was charismatic and ambitious. The following report details the information obtained from the Denver II test performed on this girl, a reflection of critical lessons, and an article review to further expound on the condition’s attributes.
Noticing
Mary, not her real name, is a four-year-old girl enrolled at the Little House School Tulsa due to her coping and learning disabilities. Mary is different from other students because her limitations are not easily noticeable. However, keenly observing her actions reveals that she has autism as she experiences difficulties in expressing herself, maintaining long conversations, and playing with others. Mary’s age is adjusted for prematurity to three years as she exhibits appropriate developmental milestones and can perform tasks as well as others in her age bracket but struggles with most initiatives. Autism Spectrum Disorder is a condition that interferes with an individual’s behavioral, social, and communication abilities (Lord et al., 2018). Nevertheless, children diagnosed with autism have unique issues and different strengths and weaknesses. Although Mary is charismatic and intelligent, she finds it hard to engage with others and concentrate on her work for extended periods. Additionally, she has problems imitating actions, and her parents suggest that she does not react well to situational or environmental changes.
The Denver Developmental Screening Test (Denver II) is a widely adopted instrument to evaluate child development and determine whether they appropriately reach their milestones. The results obtained from this test provide information about a child’s abilities and weaknesses and can guide decision-making on solutions to support their positive development (Rouvier et al., 2022). Denver II notes a child’s attributes based on four categories listed on the sheet, including social contact, fine motor skills, language, and gross motor skills. Thus, the test is reliable in determining issues educators should address when dealing with particular students.
The initial test involved observing Mary’s social development and abilities. The activities tested at Mary’s adjusted age include brushing her teeth with no assistance, playing board or card games, dressing, and putting on a T-shirt. The instrument evaluates preparing cereals at four years, and all skills are assessed at three years. Like three and four-year-old children, Mary cannot brush her teeth without help or play board and card games. Additionally, she cannot wholly dress but can put on a T-shirt. At her age, the Denver II test suggests that Mary should be able to dress. Thus, this is the only activity in this group where the child experiences limitations.
The fine motor and adaptive skills the child should exhibit at Mary’s adjusted age include picking a longer line, copying a circle, wiggling the thumb, building a tower using ice cubes, and imitating a vertical line. At four years, activities include drawing a person – 3 and 6 parts – and copying plus and square shapes. The child appropriately completed the tests by easily imitating a long line and building a tower of eight cubes. However, she experienced several issues copying all shapes, and it took some time for her to deliver as expected.
The Denver II test also indicates a child’s language development by assessing the ability to follow instructions. At her adjusted age, Mary should know three adjectives, name four colors, understand four prepositions, exhibit intelligible speech, know four actions, use three objects, count one block, one color, and use two objects. At four years, she should define seven words and two opposites, know five words, name four colors, and understand four prepositions. Unlike most children her age, Mary could not recollect and provide accurate responses when naming colors and explaining adjectives. However, she could perform other actions like students at her age.
The skills evaluated at Mary’s adjusted age for gross motor development include balancing each foot for 2 and 1 seconds, broad jumping, and throwing a ball overhand. At four years, the child should balance each foot for 4, 3, and 2 seconds and hop. According to the assessment, Mary could broad jump, throw a ball overhand, and balance each foot for 1 and 2 seconds. However, she could not balance her foot for four seconds, which is typical for four-year students. Thus, this section of the test reveals that Mary had surpassed the expected levels of gross motor development.
Interpreting/Responding
The general classroom objectives for the day involved assisting educators and students in carrying out initiatives and operating comfortably. The administration expected all volunteers to lend a hand, follow instructions and guidelines, assist students by not completing tasks for them, interact, play with them, and encourage them to perform to their best. These initiatives were implemented in the four developmental stages as the teachers provided a curriculum and specific task initiatives to facilitate language, fine motor, social, and gross motor skills. Children with autism experience developmental challenges with high-level skills (Lord et al., 2018). As a result, Mary’s therapy objectives included respecting her boundaries and space, assisting her in controlling behaviors such as rocking and hand flapping, and training her on how to express emotions. In addition, her management plan involves instructing her on how to convey her frustration in productive ways and encouraging her to make and maintain eye contact when communicating with others. These initiatives aimed at assisting her in coping with her environment and managing issues due to her disabilities.
The disciplinary measures adopted at the Little Light House School included a system of rewards and punishment, clearly defined expectations, simple language, establishing a routine, and praising students for reaching milestones. However, encouragement was practical as it allowed students to focus on their weaknesses and continuous advancement. The teaching adaptations for special needs children like Mary include embracing differences, advocating, being patient, keeping instructions simple, creating improvement opportunities, fostering a supportive environment, and observing high organization levels. The role of the nurse practitioner at Little Light House was to assist students with tube feeding and wound care. However, nurses in special needs institutions are also responsible for outlining a plan of care, evaluating health needs, and providing appropriate accommodation. Thus, the nurses on duty attended to all their responsibilities as required.
Reflection
My clinical project at the Little Light House School exposed me to unmatched experiences as I enjoyed spending time with the children and striking valuable bonds with the institution’s teachers and other volunteers. The most critical lesson I learned from the program was the essence of being prepared and the need for resilience. For example, dealing with special needs children and overseeing developmental improvement takes time and patience. Thus it is necessary to embark on recommended solutions without giving up. Additionally, service providers should be prepared to tackle complex challenges because they work in high-pressure environments. A child I was working with fell, hit his head and sustained an injury. However, the nurse on duty quickly attended to him and calmed him down. Sitting down and dealing with students at a personalized level while addressing all their needs are some new concepts I learned. In addition, the program reinforced the importance of teamwork and collaboration in delivering on tasks. Hence, it is best to always be prepared to counter critical issues as they can arise at any time.
Technological solutions effectively address issues that limit autistic students from performing and living normally. The article by Wood-Downie et al. (2021) investigated the implication of digital stories in transition planning and assessment of children with autism. The researchers suggest that preschool children with autism experience hurdles transitioning from one activity to another. However, digital stories that target particular developmental skills can enable educators to prepare these children for changes and facilitate better outcomes (Wood-Downie et al., 2021). The article supports the growth and development of autistic children by providing a solution to allow them to accommodate change and new situations. Thus, parents can learn to use digital stories to train their children on initiatives depending on their ages and milestones.
Conclusion
Children living with disabilities experience significant challenges because of negligence and insufficient resources to cater to their issues. However, institutions such as the Little Light House School have made obtaining high-quality care services easier and created opportunities for these children. During my clinical, I interacted with special needs children and assisted teachers and other volunteers in the facility to deliver on their objectives. Nevertheless, I performed a Denver II test on a female student with autism. The results revealed that the child had unique abilities but could not deliver on basic activities. Additionally, she lacks appropriate language and social skills, thus interfering with her ability to socialize with others. Regardless, the institution is staffed with professional nurses, educators, and volunteers who assist the students and oversee initiatives.
References
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum Disorder. The Lancet, 392(10146), 508-520. Web.
Rouvier, M. E., Granana, N., Ruiz, F. R., Zeltman, A., & Gil, S. R. (2022). Screening for Autism
Spectrum disorders in underserved populations: Global versus specific surveillance instruments. Advances in Neurology and Neuroscience. 5 (3), 155, 160, 2. Web.
Wood-Downie, H., Ward, V. C. S., Ivil, K., Kovshoff, H., & Parsons, S. (2021). Using Digital Stories for assessments and transition planning for autistic preschool children. Educational and Child Psychology, 38(3), 62-74. Web.