Captivated by our existence's plenitude or precariousness, overwhelmed by passing joys or despairs, full of dreams and hopes so often destroyed, we tend to forget about our fellows that bear a huge pain for us to live a normal life. Let's turn to them heart-opened, let's give them hope that life can be formed of beautiful moments too, let's restore their trust in themselves, let's not leave them in pain and crying. Let's help them to live among us and feel useful. Let's not be indifferent!
We can do all these if we know at least some things about the problems making them be like that, about their causes, about the possibility of solving them, even in part.
GENERALITIES
As a state of infirmity, a congenital absence of an aptitude or its loss - caused by the chronic evolution of some diseases - DEFICIENCY makes the individual somehow different from his fellows, giving him a special psychological, biological, medical and social condition.
Deficiency affects one's integrity (complete somatic-psychological organization) and functionality (capacity of being psychologically and biologically righteous), the two aspects being in great interdependence.
Deficiencies: sensorial (concerning the analyzers' activity - especially the visual and auditory ones), psychic (concerning the Central Nervous System's development and maturation, with consequences on the intellectual and instrumental faculties' evolution) or neurological (problems in the CNS's development, with consequences on functionality, especially the motor one), determines difficulties in adapting, small communicating capability (or even this capability's loss) and, thus, behavior modifications.
Deficiencies are congenital or appear very early, in the first months of living.
Deficiencies appearing later are sequels of some diseases or therapy accidents. If they affect persons being until that moment structurally and functionally righteous, they will form a category named infirmity conditions (aphasias, paraplegias, amputations etc).
The separate approach of development deficiencies, ignoring the compensatory elements that make the recuperation and integration possible - even in part -, will result in offering an incomplete image on the different types of disabilities and make it impossible for us to efficiently intervene in ameliorating the social and psychic lack of balance caused by them.
The complexity of problems arises from the individualized biological, psychological and social evolution of disabled persons, although they belong to a general type of deviation from normality. The psychological and emotional fragility, the socio-cultural conditions in which the child with special needs grows up, all these are factors that essentially influence the recuperation-rehabilitation-integration rate.
During recuperation, strategies and methods administered and anticipated results individually apply to every major deficiency category: mental deficiencies, sensorial deficiencies, physical deficiencies, language disorders, communication and relation disorders. The diversity of the causes producing organic and functional disorders - endogenous factors (genetic) and exogenous ones: antenatal, during birth, postnatal (intoxication with different substances, radiations, traumas, virosis, childhood diseases) - determines the variety of deficiencies and of their extent. In the infantile pathology, the following symptom charts appear:
1) Mental deficiency
The reducing of psychic capacity, determining disorders in reactions and in environment adaptation mechanisms; it has different degrees of manifesting, depending in the IQ: limit intellect (IQ from 70 to79), slight mental deficiency (IQ from 50 to 69), severe mental deficiency - imbecility - (IQ from 20 to 49), profound mental deficiency - idiocy - (IQ from 0 to 19).
2) Sensorial deficiencies
Disorders in the visual and auditory analyzers, having different extents.
3) Physical deficiencies
Disorders affecting mostly the motor system of the individual (neuro and psychomotor); they refer to: malformations of the locomotor apparatus, developmental diseases, post-traumatic sequels, articular, osseous and muscular system deficiencies, deficiencies especially neurological (diseases affecting the central and peripheral motor neuron), psychomotricity disorders.
4) Language disorders
Disorders in the reception, understanding, elaborating and realizing communication; determining: pronunciation disorders, speaking rhythm and fluency disorders, voice disorders, language writing-reading disorders, polymorphous disorders (aphasia, alalia), language development disorders, language disorders in mental diseases.
Therapy practicing indicates individuals manifesting symptoms of what we call associate disability, in the case of which we find associations from the categories presented above. Here are some examples:
CEREBRAL PALSY, generally considered as being a consequence of a cerebral lesion, can also represent - in case of minor problems of the cerebral function - the result of some emotional agitation.
Cerebral palsy affects motor development, also producing physical distortions. Despite the "literal" meaning of the word, palsy is not a lack of movement or muscle insufficiency, but rather a movement distortion caused by muscular over-activity and incapacity to control muscle contractions. The different types of cerebral palsy stimulate body parts in different ways, generating various forms of incapacity:
# Tetraplegia - palsy of the arms and also of the legs, one of them probably being more severely affected
# Paraplegia - palsy of both arms or both legs (not always in the same extent)
# Hemiplegia - palsy of only one side of the body - left or right - probably being affected the arm and also the leg from that side.
Characteristic to these deficiency categories are: spasticity (palsy of a limb or articulation and muscle contraction), atetosis (movements are involuntary, spinning or spiral, exaggerated, being unable to achieve their goal), ataxia or "the movement going beyond its target" (consequence of an insufficient compensation from antagonistic muscles), the rigid palsy type (with very low amplitude movements).
Implying perception as well as spatial integration, representing a motor incapacity and also a sensorial deficiency (visual, auditory and emotional hypersensitivity, lack of self-consciousness and of corporal identity), cerebral palsy is accompanied by a great psychic and emotional fragility, an acute feeling of insecurity and an almost exacerbated desire to be protected, needing a very careful assistance and selection of the therapy methods applied, all the more as there are children with cerebral palsy, even with severe forms of infirmity, having special intelligence, sensitiveness, spiritual and moral integrity - and their potential must be properly capitalized.
LANGDON-DOWN SYNDROME, also known as trisomy 21 or mongolism, is a chromosomal anomaly which can take the form of a trisomy (the existence of an additional chromosome attached to the 21 pair) or a translocation (chromosomal structure anomalies).
Children with Langdon-Down have a series of visible features: microcephaly, facial anomalies (flat nose, macroglosy, Mongolian eyes, facial prominence), ears with structure or position malformations, extremely thin abdomen walls, limbs too short comparing to the body and finger malformations; and also organic idiosyncrasies or diseases (cardiac and gastro-intestinal problems, high infection risk, visual and auditory malfunctions).
Psychically speaking, children suffering from Langdon-Down are characterized by low intellectual development, varying from mental debility to idiocy, imbecility in most of the cases.
Beyond these aspects particularizing him, the Down child is extremely low natively endowed for self-protection, therefore permanently exposed to the vicissitudes of life - because of the lack of fear (incapacity to discern evil), a dominating feeling of shame which may inhibit him, unhandness and especially his great innocent affective availability towards all people around.
Nevertheless, that affective availability is in many cases the power the Langdon-Down child has to take to the autistic child, getting the latter out of his characteristic isolation and making him feel wanted, as part of an unique social experience.
INFANTILE AUTISM, still having unknown causes, but surely based on an extremely severe affective deficiency, is characterized by: lack of communication; lack of language or language oddities; inadequate use of the personal pronoun; anxiety produced by obsessions or caprices (parallelism in arranging objects, maintaining spatial relations between objects and also their order); avoiding visual contact with other individuals; movements which, although seeming co-ordinated, dexterous, even graceful, are in fact odd and unusual, often associated with parasite gestures; refuse to do certain things because of an insufficient motivation.
The autistic child doesn't seem to integrate in a social structure or to have self-consciousness.
From the age it appears at (2-3 years), autism determines a series of regressive changes, the affected ones loosing on the way acquisitions and habituations obtained by normal development until that moment (including speaking).
No matter how discouraging is the image of the autistic child's development, any therapeutic program has to take into account also a series of inclinations that this child manifests towards certain fields of activity, his eternal curiosity, his interest in mechanisms and his extraordinary ability to manipulate them; and especially what surprises us most - the devotion that this isolated introverted child has in taking to the fragile needy child with cerebral palsy, in order to assist and help the latter.
In a positive, motivated and harmoniously organized environment, meetings between children with different disabilities are benefic, compensatory and curative.
Development infantile pathology raises many approach problems, the final objective of all efforts made being that of erasing barriers between Them and the world, learning on the fly how to make this possible, them - helping us to explore their complex universe, us - helping them to win the battle, all - building a better world.
BIBLIOGRAPHY
C. Enachescu, Mental hygiene (1996)
P. Arcan & D. Ciumageanu, The child with mental deficiency (1980)
T. J. Weihs, Children in need of special care (1987)
Deficiency, incapacity, disability, coord. C. Rusu (1997).
C. Paunescu, The child with special needs - knowing and educating (1983)
C. Paunescu, Mental deficiency and the learning process (1976)
C. Neamtu & A. Ghergut, Special psycho pedagogy (2000).