Doctoral Degrees (Occupational Therapy)

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    The impact of the "Developmental Resource Stimulation Programme" on children with Down syndrome
    (University of the Free State, 2013-06) Russell, Dorothy Charmaine; Van Heerden, S. M.; Van Vuuren, S.; Venter, A.; Joubert, G.
    The effect of stimulation programmes on children with Down syndrome is necessary especially with a South African impetus. This study was an attempt to investigate the impact of an intensive early-intervention programme, the Developmental Resource Stimulation Programme (DRSP), on Down syndrome children younger than 42 months in the South African context. The DRSP would assist any occupational therapist using one stimulation programme to enable parents to assist their child to develop to their full potential at an earlier age. Down syndrome is a multisystem chromosomal disorder, which has been recognised to be the single most common cause of intellectual disability occurring in approximately one in 650–700 births. Down syndrome is associated with cognitive limitations and speech as well as motor-developmental problems. Documented studies focused on motor and speech development in older children, with very few studies on babies younger than three years. Adequate early-intervention programmes for babies with Down syndrome with parent involvement do not exist in the South African context. Contrary to the literature, this study may show the benefits of the role of the occupational therapist in early intervention. The World Health Organization has adopted the International Classification of Functioning, Disability and Health (ICF-CY), a bio psychosocial model that emphasises components of health and reflects participation, activities and function. A holistic approach is essential to the developmental problems of children with Down syndrome to create a long-term difference in their functioning in totality. The researcher developed the Developmental Resource Stimulation Programme (DRSP) to assist in the management of early intervention of the child with Down syndrome over a period of 20 years. The DRSP is a unique, child-parent specific, one-on-one, integrated developmental programme for children with Down syndrome from birth to 42 months. Each activity of the DRSP is designed to accomplish specific activity performances in developmental domains, appropriate to the child’s ability for different age band groups younger than 42 months. The activities comprise cognitive, motor, sensory and language skills, as well as activities found in everyday living. The Developmental Resource Stimulation Programme was compared to Occupational Therapy Practice Framework. The aim of this study was to investigate the impact of the DRSP on Down syndrome children younger than 42 months in the South African context. There were four objectives in order to achieve the aim of the study. A quantitative approach with an experimental and descriptive study design was followed, to confirm results and enhance the reliability and validity of the study. The measurable attributes of the DRSP, including the participation of the parents were the focus. The Bayley Scales of Infant and Toddler Development (3rd edition) and DRSP checklists were used in a pre-test and post-test to measure the effect of the DRSP. There were two groups namely the intervention group, consisting of 32 participants (children and parents) and the control group, consisting of 28 (children and parents) over a period of six months. Evaluation and intervention sessions were video-recorded and moderated. Informed consent was obtained prior to the study, supported by an information document in the language of choice, namely Afrikaans, English and Sesotho. A self-administered questionnaire, developed by the researcher, focused on the attainment of information regarding the overall presentation of the area, service and treatment of the participants. The results were analysed, presented in tables and graphs, and discussed. The results of this study showed that a specifically designed programme with participation of a parent has a positive impact on the development of the child with Down syndrome. Contrary to the literature, there were positive changes in the language, fine-motor and >9- month gross-motor development of children with Down syndrome. The DRSP with specific goals indicated to be an attribute in the early-intervention process. The results emphasised the holistic approach, rendered by an occupational therapist in Down syndrome early intervention.