For this assignment I try to focus on the importance of lifespan development theory when appreciating the effects of hearing impairment on a person. I aim to focus on the lifespan development of a kid in its infancy stage (0-2 years).
Human development or also known as the developmental psychology is the study of systematic emotional changes, psychological changes and social changes that occur throughout an individual's life span. The study analyses the individual's physical development, cognitive development which involves learning, interaction and problem solving and emotional and intellectual development. By evaluating human development it is effortless to understand the changing or arrangement of beliefs, worry, desires and skills that occur at different periods of the life cycle (Mussen et al. , 1974).
Hearing is now clearly identified as being essential to early communication, speech and language development and active learning. Children with hearing impairment may therefore lag behind in communication skills, intellectual achievement and social performance. Therefore as a healthcare professional it is valuable to understand the different stages of lifespan development when trying to understand the individual's awareness and behaviour. The sooner the hearing impairment is recognized and treated the smaller the severity of the impact on the introduction of the kid (ASHA, 2012).
In order to respect patient confidentiality I will use the name Ellie for my case scenario. Ellie is a 1 and a half year old girl who attended the appointment for a hearing test with her mum and her four siblings. Ellie is part of a huge category of seven and Ellie's mother is an extremely heavy smoker and smoked during her pregnancy with Ellie. Her mother reports that Ellie is quite an aggressive girl and doesn't try to socialise with her siblings and other children her age. In addition, she reports that Ellie doesn't focus on her when given requests or instructions. Ellie passed her new-born hearing screening, however after great encouragement from us Audiologist VRA (visual reinforcement audiometry) and tympanometry was performed revealing that Ellie has a moderate flat conductive hearing loss. Because of concerns of Ellie's lack of speech and language development and behaviour problems, valuable information about grommets or a hearing aid was supplied to the mother. However, Ellie's mother was at disagreement about any of these options. Therefore Ellie was given a follow-up appointment to observe how she actually is getting on.
I have chosen this case I am able to truly observe how hearing impairment affects the physical, social and cognitive development of a child.
In order to evaluate an infant's condition immediately after birth it has now become essential to perform an instant test such as an APGAR test devised by Virginia Apgar in 1953 (MedlinePlus, 2009). This assessment is occurred instantly on the new-born to detect how well the heart is beating, their colour, respiratory rate, general reaction to stimulation and their muscle tone. The new-borns are then given an Apgar score which is rated out of 10, with a score above 7 meaning the new-born is at no danger, and a score of 4-6 meaning the new-born has some difficulty breathing and could have possible long-term risks. However with an Apgar score of less than 3 the new-born is said to be in a critical condition and requires immediate special support or treatment (Bee and Boyd, 2007). Through the gathered history extracted from Ellie's mother, Ellie underwent a normal birth without significant abnormalities occurring therefore Ellie will need to have been given an Apgar score of above seven.
According to Arnold Gesell children develop at different rates, however their patterns of development are all continuous (Mussen et al. , 1974). The development of a child can be analysed in three different ways- their physical development, social and cognitive development. Physical development is at its greatest between your ages of 0-2 years and is essential for children providing them with the skills to seek the entire world around them. For the first year of any child's life the main apparent physical development is the immense growth changes that eventually your body. By the age of one your body length would have increased over the third of the original length (20 inches) and the weight could have gained approximately triple the original weight (7. 5pounds). These physical developmental changes arises from the head downwards (Cephalocaudal) to the trunk outwards (Proximodistal) (Fitxgerald et al. , 1977). Therefore insurance firms these normative values we can tell if the child's physical development is lacking. Ellie was created as a minimal birth weight baby possibly because of this of the mother smoking throughout the pregnancy. Low birth weight babies like Ellie generally progress slower through the developmental stages but generally catch up in the first two years (Vasta et al. , 1999). However Ellie is now one and a half and does not have any apparent physical developmental abnormalities.
The bones of an infant are more supple than adult's bones as a result of higher water content. These bones then harden through the developmental stages of an individual up to adolescence in an activity called ossification. A new-born baby's skull has the capacity to compress without damage during birth as it is separated by spaces named fontanels. By Ellie's age the fontanels would have been replete with bone developing into one combined skull bone (Bee and Boyd, 2004). Within the first few years of the infant's life there can be an accelerated growth in the mind with the greatest development occurring in the midbrain. The cerebral cortex and the cerebrum enclose the midbrain and control the construction of language, consciousness, problem solving, thinking and learning. Thus an infant's life commences with a set of beneficial natural responses called reflexes. A reflex is an involuntary movement in response to any stimuli. Based on the psychologist Jean Piaget the beginning of an infant's life is all regarding movement and so almost all of the infants actions are reflexive (Davenport, 1994). Many of these reflexes may be adaptive reflexes or also known as survival reflexes in which assists the infant to swallow, breath, grasp or suck involuntary. Whilst the primitive reflexes are not needed for their survival, it only gives a good suggestion of the status of the infant's neurological system. Examples may be of the Babisnki reflex (as the sole of the infant's foot is stroked the top toe enhances with the other toes spreading outwards) ; and the Moro reflex (startle reflex - extending arms and legs after loud noises). With Ellie's case these reflexes have disappeared which is normal on her behalf age and demonstrates that there surely is no damage to her nervous system (Mussen et al. , 1974).
Infants are born with surprisingly good set of perceptual skills and so are fully equipped to check out objects that are 12 inches away, distinguish pitch and level of sound and recognize parent's faces from others. By a month old the infants posture and large movements should be fully developed. The infant's arms would be more active than the legs, the newborn will turn head away as you rub its ear, their head will descent loosely unless supported nevertheless the neck muscles will start to develop at this time (Sheridan, 1975). Through the VRA testing it is apparent that Ellie's small and large motor skills such as handling of small objects, hand-eye coordination, grasping, sitting upright and walking seem to be to be fully developed. However her language development was lacking which might be due to her hearing loss. Ellie's mother raised a slight concern on Ellie's ability to talk. During the appointment Ellie's speech was very difficult to comprehend and her sentence structures were concerning be likely from a kid with a hearing loss. Infant's with a hearing loss often cannot hear speech sounds and for that reason misinterpret and misuse their vocabulary. Developmental problems such as speech and language could also contribute to a lower life expectancy academic achievement and social isolation from the kids which may be remarkably distressing for the parents (ASHA, 2012).
Erik Erikson was the first psychologist to build up the 'psychosocial style of personality', which is the foremost known style of development and personality. He believed that development is frequent throughout one's life. Erikson's model expresses how a child's social experiences influence a person's value of self and their personality (Mcleod, 2008). Like Erik, John Bowlby (1907-1990) was another theorist worried about child development which created the attachment theory. Bowlby suggested an infant's personality is influenced by their childhood relationships. According to Bowlby: 'children enter into the globe biologically pre-programmed to create attachments with others, because this can help these to survive' (Cited from Mcleod, 2007). Children who neglect to form this real attachment by around 6 months of age tend to be less sociable, less emotionally mature and more aggressive. Therefore for an optimistic and healthy development of a child like Ellie it is essential for a strong attachment between your infant and the primary caregiver (usually the mother). However Ellie's positive behaviour and social skills appeared to be lacking. A child comparable to Ellie with a significant hearing loss may often feel isolated as they can not communicate therefore it is vital at this stage for the mother to understand this and meet their child's needs (Shaffer, 1993). From informally assessing Ellie behaviour and her mother it is clear that this initial bonding may be absent between your two.
Vygotsky the theorist believed that a child's development associates mostly to mental development, being language, interpretation processes and thought (Cattan and Tilford, 2006). However Jean Piaget (1896-1980) figured a child's cognitive development is formed from a distinct group of stages. He believed a child's cognitive development skills take place due to advancement of the brain and the child's capabilities to connect to their surroundings. Piaget characterizes the development of children into four set stages with each stage symbolizing the child's appreciation of the reality and its own surroundings at that stage. The first two years of the infant's development is regarded to as the sensorimotor stage. In this stage the kid learns and activities the earth around them through their senses and movement. The child accomplishes an activity and by repeating this activity they are able to advance on their new knowledge and awareness (Bee and Boyd, 2004). Piaget termed the cognitive structures as schemes (set of activity, anticipations and memories that allow the child to comprehend their surroundings). Therefore for Ellie to maintain with her cognitive development she must have good coordination between her sensory (hearing) and motor actions (movement). Ellie's cognitive development might be underdeveloped as she receives less sensory information due to her hearing loss and therefore has less motor actions. The effect of any hearing loss on the cognitive development of a child like Ellie is rather intricate due to different ways cultures, families and human kind respond to children whom attempts or fails to talk and communicate due to their hearing loss (Mayberry, 2002).
There are also learning theories involved with cognitive development. Ivan Pavlov devised the classically conditioned model, which is described as a learning process that occurs when an unfamiliar stimulus is presented into the system. As the new-born is repeatedly conditioned to the same stimuli (brush cheek before feeding), this stimuli can be a conditioned stimuli in the course of time. Operant conditioning is also classed as a learning process as the new-born learns and interacts through the use of reinforcement - like a toy, smile, attention or food (Bee and Boyd, 2007). Through the VRA testing, Ellie was conditioned to go her eyes in the direction of the sound source and rewarded visually with a lighted up toy ('BATOD', 2012). After great encouragement Ellie performed an optimistic VRA test and therefore show no signs of abnormal learning process.
Starting at the age of 1 and increasing before age of 5, repetitive and exploratory play is very common in children. At around Ellie's age it is expected of children to have the ability to push and pull large toys, carry a toy, grasp crayon, enjoy coloured books and perform VRA testing. Yet, in Ellie's case and for any child with a hearing loss these normal behaviours might be deficient or absent as hearing and speech are the vital implements to learning process, play and development of social skills (Sheridan, 1975). Hearing is essential to a child's development, 'yet children with hearing problems continue being an under recognized and undeserved population' (Cited from 'ASHA', 2012). Not only does a child's hearing loss affect the child's development it also affects the parents/primary caregivers involved inflicting feelings of anxiety on their new responsibilities for their child. It is therefore essential to provide the parents or the principal caregivers the essential information and advice on their child's hearing loss for the child's positive development. Ellie's mum needed great encouragement upon this in order to improve Ellie's self-esteem and help her to positively develop ('ASHA', 2012).
Hearing impairment has a great influence on the child's social life, cognitive and learning development. Ellie has proven to have normal physical development; however her cognitive and social development and speech and language features are evidently hindered by her hearing impairment. It is therefore essential to supply the family of the child with any valuable information that will benefit the child's development and stress the importance of early intervention. The sooner the hearing impairment is recognized and intervened the higher the developmental outcome.
Without knowing the normative of a child's developmental process it is hard to analyse the exact reason behind the child's behaviour. Ellie's hearing loss has evidently delayed her revealing and acceptant communication skills (speech and language) leading to her social seclusion and low self-esteem. Her aggressive behaviour and her lack of fascination with others can be explained by her lack of auditory input and for that reason lack of her ability to effectively communicate. It is important for Ellie's mum to appreciate the challenges that Ellie is faced before managing them properly herself. Nonetheless it is also crucial to support the entire family through Ellie's developmental progress and early family concentrated intervention is advised to advance Ellie's language and cognitive development ('ASHA', 2012).
An additional appointment was made for Ellie to see if indeed they have changed their mind regarding to trying a hearing aid, however Ellie will continue to receive advice and care from us Audiologist, a specialised paediatrician and speech and language therapist throughout. From this case study I am able to fully appreciate the result a hearing impairment is wearing the developmental process of a kid. However I am also very aware for the future of the value to support the entire family when wanting to provide the best look after a child very much like Ellie.
Why is ellie aggressive and do not socialise. . can categorize them into being naughty straight away. Important that ellie gets enough attention she needs to help her develop, but important that this doesn't overurule the development of other kids. Vital to give all info need to parents and stress on the importance of early implementation - better outcome.
http://www. asha. org/About/news/Press-Releases/2011/Do-You-Understand-The-Effects-Of-Hearing-Loss-On-Your-Child-s-Development. htm
http://unitron. com/unitron/global/en/consumer/children-c/supporting. html
http://asha. org/public/hearing/disorders/effects. htm
http://entcentre. com/FAQs/impact_of_hearing_loss_in_childr. htm
http://unitron. com/unitron/global/en/consumer/children-c/supporting. html
http://www. asha. org/About/news/Press-Releases/2011/Do-You-Understand-The-Effects-Of-Hearing-Loss-On-Your-Child-s-Development. htm - conclusion?
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