The dynamics of sibling relationships with a down syndrome child

Siblings of special needs child are often seen as neglected children, especially when the special needs child needs more attention from their parents. This study aimed to find out the dynamics of sibling relationships with a down syndrome child. A phenomenological qualitative approach with data analysis of Interpretative Phenomenological Analysis (IPA) was chosen as the research method due to its suitability with the purpose of this study. The data were collected using in-depth semi-structured interviews on two biological older sisters (24 and 20 years old) of a boy with down syndrome (12 years old). The selection of subjects used a purposive sampling technique, which was based on the specified criteria. Three main themes were found in this study, namely (1) the functions of parents’ role, (2) acceptance towards a sibling with Down syndrome, and (3) sibling relationship. The results showed that the parents’ role in introducing the Down syndrome from the beginning helped the subjects accepted their sibling’s special needs. The subjects’ acceptance was expressed through their actions in supporting their younger sibling to become independent. Each subject also showed a sense of care in their own ways. Sibling relationships with a Down syndrome child were indicated by the existence of warmth, conflict, rivalry, role, engagement, stress, concern, and coping mechanisms.

GAMBARAN PROSES PENERIMAAN DIRI IBU DENGAN ANAK DOWN SINDROME

Parents put their hopes in their children who will be born. When a child is born with conditions that are not as expected, this causes an emotional reaction in parents, especially the mother as the main caregiver for children and people who give birth to children in the world. The existence of a diagnosis of Down syndrome in children, mothers feel lost hope and their role will change. According to Fidler, Down syndrome is known as a form of chromosomal abnormality that causes developmental delays, mild to severe mental retardation and physical abnormalities. Finally, the mother faces the terrible reality that her child has special needs. This is a situation that is difficult for mothers to accept and needs to go through a process to be able to achieve self-acceptance. If the mother accepts herself with the condition of having a Down syndrome child, it can help the child to grow and develop properly. Therefore, researchers want to know the process of self-acceptance of mothers with children with Down syndrome. This research uses a qualitative approach and data collection is carried out using the interview method. Participants in this study were 3 mothers who had children with Down syndrome at the age of 30-45 years. Through interviews, researchers explore the expectations of parents about children, events during pregnancy, childbirth and raising children. In addition, researchers also dig data about the process experienced by mothers to achieve self-acceptance. The analysis conducted on each participant was carried out with the thematic analysis method. The results showed that the three participants had a process of self-acceptance in accordance with the phase initiated by Duncan and Moses, but there were several different stages. It takes many years for mothers to be able to complete the emotional stages and feelings that emerge can overlap. When the mother has reached self-acceptance, it is still possible to experience a setback to the previous phase. Factors that influence, among others, hope, ignorance of Down syndrome, the economy and support from the surrounding environment.

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

Background: Down syndrome children have a high incidence of pes planus. Pain follows and does harm to their daily life. To well manage their foot pain, it’s necessary to know the mechanism of the pain from the aspect of biomechanics. The purpose of this study was to characterize the abnormal biomechanical conditions of foot in Down syndrome children during standing, comparing to the normal control children by finite element method. Methods: Two participants aged 5 were recruited in this study that are a Down syndrome child with pes planus and a normal control child. Two three-dimension finite element foot models were constructed from CT of the two participants, each of which include bones, ligaments, plantar fascia, cartilages, epiphyseal plates and an encapsulated soft tissue. The plantar pressure during standing and anthropometric data were collected from the same participants for model validation and simulation. Results: The abnormal alignment of the transverse tarsal joint showed in Down syndrome child. The contact pressure in Down syndrome child was higher in tibiotalar joint, compared with the normal control child. The tensile force of spring, plantar calcaneocuboid ligaments in Down syndrome child was approximately 9 folds and 58 folds greater than normal control child, respectively. In Down syndrome child contact force of the talonavicular joint was 0.05 times the body weight and calcaneocuboid joint was near zero, whereas the value in normal control child was 0.11 and 0.01 respectively. Conclusion: The Down syndrome child showed abnormal biomechanical conditions in foot in terms of joints contact pressure, tensile force of ligament around transverse tarsal joint and contact force transmission through transverse tarsal joint. These abnormal biomechanical conditions resulted from pes planus are the potential factors that may cause their foot pain. Conservative interventions should be considered at their early age to eliminate negative effect of these potential factors.

Gene Polymorphisms That Predispose Women for Down Syndrome Child Birth

Down syndrome caused by presence of extra chromosome 21 originates from nondisjunction during parental gametogenesis. For overwhelming cases, the error occurs in oocyte and all the nondisjunction events are not stochastic. With increasing number of research efforts, it has come to know that maternal genetic architecture may be considered as risk factors for chromosomal errors. Polymorphisms of the genes involved in chromosome segregation, recombination and folic acid metabolisms have been investigated for their association with Down syndrome child birth. But the results are conflicting owing to ethnic and sociocultural differences. Here, we have discussed and summarized the outcome of the studies conducted on different population sample from different parts of world and tried to figure out the common polymorphisms, which could be used as makers for preconceptional screening of Down syndrome child birth risk among the women.