Pam and
Brian need more time to think about how they will cover their separate living expenses
as well as the medical costs for Michelle.
Brian has scraped by thus far working and sending money to the family,
but without Pam working at all, he is starting to consider quitting the family
altogether. He is not as attached to Michelle as her mother and does not
believe it is his fault for their daughter’s condition. Therefore, he should not
be expected to pay for them to get by. It has been almost about 10 months since
Pam and Brian’s divorce was finalized and he is ready to live the life of a college-aged
man and leave his struggling family behind.
Pam recently asked him if Brian would be willing to get his GED so that
he would not have such a poor choice in jobs.
This upset Brian and put him over his head in frustration and anger at
the family fate gave to him.
One night as Brian visited to drop off part of his
paycheck for the week at the apartment Michelle and Pam live in and he decides
to express his feelings to Pam. It is obvious that he has been drinking when he
arrives. It is not his fault for Michelle’s condition and it is not fair to him
to support all three of them even though they are no longer married. Pam is
furious and it leads to an extended argument. Over the next few weeks, all
contact between the two of them is full of arguments and disagreements. Brian
is becoming less interested in taking care of his daughter and Pam is furious
at him for attempting and threatening to leave the two of them unsupported. Brian’s
visits become shorter and farther between.
Pam is finding it harder to get by each day, especially
while living in a rural part of North Carolina where the nearest grocery store
is nearly 25-30 miles away. The
arguments Pam has with Brian have temporarily halted his checks from coming
into the household. The landlord is not
a very lenient man and after 2 months of being unable to pay rent, she and
Michelle are forced to move in with her mother, Margaret Denby on the condition
that she has to pay $150 a month in rent as well as buy their own food. Margaret Denby lives on the opposite side of
their small town.
Pam’s mother looks after Michelle during the days while
Pam is at work. Pam found a part time job as a waitress at a diner a few miles
from her mom’s house. Margaret does not have any knowledge about children with
Down syndrome and does not know much about the individualized plan that was
setup for Michelle. Also, her late husband, Charles, beat Margaret for almost
35 years until he passed away from a heart attack. During those dreadful years, Margaret fell
into a deep depression and made her a recluse to the society she had once been
so tight knit with.
The
little town diner Pam works in has its regulars and those passing through, but
often Pam does not exceed $60 a day in tips at the diner, not to mention the
$2.25 minimum wage before taxes are taken out.
Pam is debating about getting her GED so that she can have more options
for work; however, she does not know how or when would be able to accomplish
this goal with a toddler who requires so much care with a mother unwilling to
accept how her daughter is.
At 26
months, Michelle can stand on her own with support from a nearby object but
still does not speak. Pam bought her
some toys with different fabrics, noises, and motions for Michelle to play with
in hopes for her to get some stimulation.
Atypically developing children at this age are able to walk or run and use
two word commands or statements. Typical 26-month-old children are able to feed
themselves and play alone creatively. Michelle does none of these things. Even
an average child with DS at this age should be able to understand words and
begin speaking and walking freely (Layton, n.d.).
Margaret
is not well educated and believes her granddaughter is trying to get away with
doing these things because of a lack of IQ.
When Margaret was growing up children with disabilities were known as
“mongoloids” and were hopelessly sad creatures that needed to be hidden from
the world (Solomon, 2012). Because of this negative view of her precious granddaughter,
Grandma Margaret chose to have little interaction with Michelle throughout the
day and hardly ever took Michelle outdoors.
This abuse showed in Michelle’s cognitive, social, and physical
development greatly because she was not advancing in any way. Michelle also continues to have many ear and
throat infections because of her poor immune system. Grandmother Margaret gives
Michelle expired over the counter medicine to help with the infections but
nothing more.
Pam herself has not been following Michelle’s family
support plan completely. Since she has started working, she is exhausted when
she gets home from the diner. Michelle is not her first priority. While she can
get buy paying her rent and food costs, Pam does not have the time or the money
to take Michelle to the doctor any longer. She cannot afford insurance and she
is working on mending her relationship with Brian so he will begin supporting
them again. Pam decides to ignore the
fact that her daughter needs a doctor and interventions for just a couple more
months so that she can figure out how to take care of them. It is not until
this carries on for another few months that Pam has her suspicions about
Michelle’s hearing. She knows she must
bring it up to the doctor, but she cannot afford to pay for yet another visit. Pam is also ashamed to talk to Brian about the
hearing issue and too stubborn to admit that she needs help again and cannot
raise their child on her own. Pam is
also concerned about Michelle’s heart because the surgery was almost two years
ago and knows she is not getting it checked on like it should.
Michelle no longer seems to notice her family as she
moves around her grandma’s house. She ignores any mention of her name or any
commands given to her. The lack of
medical attention for her throat and ear infections has led to severe damage to
her hearing. Margaret and Pam do not
talk much about Michelle or how she acts throughout the days. Margaret still
assumes that Michelle is not learning due to the fact that she is hopeless because
of her DS.
Questions
1) What are the effects of stress on a child’s development?
See "Childhood poverty, chronic stress, and adult working
memory." By Gary W. Evans and Michelle A. Schamberg. Proceedings of
the National Academy of Sciences, Vol. 106 No. 13, March 30, 2009.
2) Describe how Down syndrome
affects parent/child attachment. Consult the literature.
3) If Grandma Margaret were so
inclined (which we know she is not!), what possible community-based services
might exist to aid Michelle, Michelle and Pam, or the whole family?
DECISION POINT: Does Pam return
to get her GED? Why or why not?
Citations:
Layton, Dr. T. L. (n.d.). Developmental Scale for Children
with Down syndrome. Retrieved June 20, 2014, from http://www.dsacc.org/downloads/parents/downsyndromedevelopmentalscale.pdf
Solomon, A.
(2012). Down Syndrome. Far from the Tree: Parents, Children, and the Search
for Identity (ed.,). New York: Scribner.
What Conditions or
Disorders Are Commonly Associated with Down Syndrome? (2014, January 17). Retrieved
June 20, 2014, from http://www.nichd.nih.gov/health/topics/down/ conditioninfo/Pages/associated.aspx.
1) What are the effects of stress on a child’s development? See "Childhood poverty, chronic stress, and adult working memory." By Gary W. Evans and Michelle A. Schamberg. Proceedings of the National Academy of Sciences, Vol. 106 No. 13, March 30, 2009.
ReplyDeleteResearch shows that childhood poverty as well as chronic stress can damage children's executive functioning (EF) capacities, including working memory. However, this does not mean that all children suffer the same degree of adverse consequences from risk exposure. Elevated levels of chronic physiological stress during early childhood largely accounted for the potential link between childhood poverty and deficits in adult working memory. AL is an index of cumulative wear and tear on the body caused by repeated physiological mobilizations in response to environmental demands. AL has increasingly become the measure of choice for chronic stress because it predicts morbidity and mortality better than singular markers of stress (Evans, 2009)
Low- relative to middle-income children (such as Michelle) confront a wider array of psychosocial (e.g. family turmoil) and physical (e.g. substandard housing) stressors. If the children are better equipped to deal with these stressors, then they may suffer less damage to working memory as well as other cognitive processes linked to stress. However, this requires better self-regulatory skills to enable children to cope more effectively with the stressful conditions of poverty making them more resilient to stress. Having a child with a disability adds another dynamic. Such as in Michelle’s case, because of the developmental delays, it may be difficult for her to learn how to cope with the stresses of poverty and family when she is already stressing with how to function day to day given her disability (Evans 2009).
2) Describe how Down syndrome affects parent/child attachment. Consult the literature.
ReplyDeleteIn families where parents have found it difficult to bond with the baby with Down syndrome, there are usually more stressors and more behavior difficulties reported. Many parents have a hard time coping with that fact that their child has a disability, and therefore it is hard for them to love their child unconditionally. When parents have negative feelings about their child, they tend to not see a positive future for their child because they are focused on all the things they aren’t capable of instead of focusing on what their child is capable as. This may lead them to dwell on the problems instead of focusing on achievements even though compared to other children they may be delayed, they are still successes. Children can sense adult attitudes and having parents that always has negative feelings towards you can start to wear on the child, making them emotionally insecure. This could lead to an increase in behavior issues or lead to the child withdrawing because they don’t feel loved.
Infants and young children with Down syndrome have been found to reach the same developmental milestones, including the development of an attachment relationship, as healthy children, but at a slower rate. In young children with Down syndrome, development of attachment relationships usually occurs between 12 and 24 months of age. Toddlers with Down syndrome use attachment figures as a secure base in order to explore the environment and use it as a haven of safety when frightened or distressed. Children with Down syndrome differ from normally developing children with respect to affective and behavioral responses to separation (e.g., less intense distress, briefer recoveries from distress, and diminished range of expressed emotion) but not behavioral issues related to the caregiver (Carlson, 2003).
3) If Grandma Margaret were so inclined (which we know she is not!), what possible community-based services might exist to aid Michelle, Michelle and Pam, or the whole family?
ReplyDeleteIf Pam thought that living at her Mom’s house was a bad influence on Michelle, then she could look into getting her own place with assistance. One service that may be offered in her community that she could take advantage of is she could get rental assistance from the Salvation Army and/or other charity organizations such as Catholic Charities. Various centers offer rent and housing help and self-sufficiency programs that may have a focus on single mothers and their children (Rental Insurance, 2014).
Also, to help with child care since staying with Grandma Margaret may not be very beneficial, Pam could apply for SSI (Supplemental security income) which makes monthly payments to people with low income and limited resources who are 65 or older, blind or disabled. Any child younger than age 18 can qualify if they meet Social Security’s definition of disability for children, and if their income and resources fall within the eligibility limits. The amount of the SSI payment is different from one state to another because some states add to the SSI payment. Pam could use this money to pay for someone to take care of Michelle while she is at work (HHS, 2014). Pam could also look into the Federation for children with specials needs which is a program that works to inform, educate and empower families. They offer resources such as family support centers, advocacy centers, and a community engagement center. This would strengthen Pam’s knowledge about Michelle and hopefully help her come to acceptance with her child’s disability by talking with other Moms in similar situations and by increasing her knowledge of how to raise her child (FCSN, 2014).
DECISION POINT: Does Pam return to get her GED? Why or why not?
Yes, Pam would have more job opportunities, hopefully those that would be of increased income. And if not, she would still have more education that may help her to better assist herself and her daughter. 96 percent of employers accept the GED credential as equal to a traditional high school diploma. Also, passing the GED Tests provides an opportunity for adults to continue their education. The GED is only about 7 hours and costs around $100 (GED, 2004). Pam would have to save up money in order to take the test. She may also benefit by finding free online classes that may better prepare her for the test. She would also need to find a way to take off work to be able to take the exam and she would need to have someone take care of Michelle, but taking this test has many advantages that far outweigh the disadvantages. Taking the GED would be a positive step for Pam because it shows that she cares and is trying to make positive changes in her life. Reports from adult educators indicating that passing the GED may increase and build self0 confidence. This confidences the to them working to improve their economic status by pursing better jobs while considering even higher education (Benefits, 2014).
References
ReplyDeleteBenefits of Getting a GED. (2014). Global Post- International News. Retrieved from http://everydaylife.globalpost.com/benefits-getting-ged-3876.html
Carlson, E., Sampson, M., Sroufe, L. (2003). Implications of Attachment Thoery and Research for Developmental-Beharioval Pediatrics.Journal of Developmental & Behavioral Pediatrics, 24, 364.
Evans, G., Fuller-Rowell, T. (2009). Childhood poverty, chronic stress, and young adult working memory: the protective role of self-regulatory capacity. Developmental Science 106, 13.
Families.(2014). United States Department of Health and Human Services. Retrieved from http://www.hhs.gov/children
Federation for Children with Special Needs. (2014). FCSN. Retrieved from http://fcsn.org/programs/
General Education Development. (2004). Center for Execptional Educatoin. Retrieved , from http://www.cee.ac.ae/programs/ged.php
Issues for families with children with Down syndrome. (2014). Down Syndrome Education International. Retrieved from http://www.down-syndrome.org/information/family/overview/?page=3
Rental assistance for single mothers and parents. (2014). http://www.needhelppayingbills.com/html/rental_assistance_for_single_m.html