CASE STUDY -1

GLOBAL
DEVELOPMENTAL
DELAYö
 CASE STUDY-1
GLOBAL DEVELOPMENTAL DELAY

DEMOGRAPHICDATA (CHILD)
NAME Sid
AGE /DOB 29 October, 2017
SEX male

EDUCATION Special Education

OCCUPATION Student
CAST/RELIGION Hindu
DATE 01/08/22
REGN. NO.
INFORMANT Mother
REF. BY Relative
LANGUAGE Hindi

DEMOGRAPHIC DATA (Parents/ Guardians)

FATHER'S NAME MR. P

FATHER'SEDUCATION Diploma in special education +

Graduation
FATHER'S OCCUPATION DelhiPolice
MOTHER'S NAME MRS. ABC

MOTHER'S EDUCATION M.A.

MOTHER'S OCCUPATION House maker

PRESENT ADDRESS Nangloi , Kavita colony
Mobile no. 98102XXXXX
PRESENTING COMPLAINTS /PRE ASSESSMENT CONCERN.

He finds difficulty in understanding things. He finds difficulty in following instruction

sometimes. He is less attentive. He needs help in basic daily life activities. He frequently
shakes his legs and hands and plays with his hands. He creates different voices while sitting
idle.

|as per mother]

PERSONAL HISTORY / CHILDHOOD HISTORY

PRENATAL HISTORY

His mother had a regular health check ups as per schedule during pregnancy. Her pregnancy
was wanted. Mother physical health was not good at all as she was having vomiting sensations,
less digestion of food and stress during 5-6 months of pregnancy.

NATAL HISTORY:

weight was
He was born at hospital with full term delivery. It was nomal delivery. His birth
prevention was
2.5 kgs. The mother of the child experienced normal labor duration. His body
color was pink at the
normal. Her birth cry was present and was normal on time. The infant's
time of birth.

POST NATAL HISTORY:

movement of
The infant kept on Breast Feeding after birth as per demand of infant. Bowel
as per
infant was sometimes normal and sometimes constipated. The child was immunized
schedule.

FAMILY HISTORY

The child is having a joint family headed by his grandmother their was no consanguineous

mariage in a family. He has a good interpersonal relationship with his mother and father. His
mother is sometimes authoritarian and his father is permissive. His family have a good
atmosphere at home. Attitude of all family member towards the child is good. He is more
attached with his grandmother and mother. All the personal needs of child like educational,
financial, play, emotional etc. are taken care by his parents & other family member. Child
 other fanily members. There is no
sometimes afraid of his uncle but has good relationship with
family history of any disability.

PEDIGREE CHART

grandmother age is 52 years. Child's

Subject maternal grandfather'sages 56 years and maternal
was cancer and paternal
mother has three siblings, child 's paternal grandfather cause of death
(his wife's age is 32
grand1mother age is 58 years, they have 2child, elder one is 36 years old
years and mother's age is 30
vears and they are having 2 children) child's father's age is 34
years. The subject is a 4 years 9 months old and he is a single child.
DEVELOPMENT HISTORY

a time and
His neck holding, sitting, walking etc. is normal. He is able to speak one word at
simple
tries to speak toward phrases sometimes, there is no toilet control. Child is able to avoid
hazards. Child finds difficulty in doing monetary transaction and has average scholastic
performance. There has no physical defomity &fits child has sensory impaiment.
SCHOOL HISTORY

Childwas admitted to special school named Ignited Minds Special School & Learning Centre
at the age of 4years. His attendance is regular. time duration at school is 8:30 AM to 12 Noon
He is less attentive in his classroom relation adjustment with peer groups and teacher are
nomal.
PLAY HISTORY

The child enjoys indoor games more and prefer to play alone, when he plays in agroup he took
part as a follower in a group plays. His muscular activity like running jumping is normal. He is
able to balance himself, play with clay , sand plastics etc. he becomes aggressiveand hyper
Child is able
sometimes as earlier , sometimes lhe makes things to destroy them knocking down.
to understand games governed by rules. In leisure time he likes to play with toys.
LIKING& DISLIKING

He likes toy car & does not like high voice/ pitch.
PERSONAL HISTORY

chicken and shrimp, milk and

His diet is vegetarian. He has allergy from non vegetarian that is
wheat.

symptoms of rashes and itching all over

He was diagnosedon 14" February 2022. As there was
discontinued it.
the body. He had medicines for 1-2 months after that he

OBSERVATION(MSE)
appearance is neat and
APPEARANCE: Child entered the room, he was well dressed. his
weather. His sandals were clean his hair was
clean, he was wearing t-shirt and shorts as per hot
properly trimmed and allover he was well maintained.
looking here and
MOVEMENT AND BEHAVIOR: When he entered the room he started
when we called his name. He roamed in
there. He does not imake eye contact with anyone even
seated on his mother's lap and
the room touching and playing with nearby objects then he
front of him. He was
started playing with the pen stand that was placed on the table in
pen 2-3 times then he
followingthe instructions only if it is focused (like we told him to hold a
held it).

AFFECT: While sitting there he was making unusual sounds repeatedly and counting 1to 6
again and again. There was no facial expression and there was no eye contact at all.
MOOD: Subject was seemed to be in neutral mood while entering the room. He was not
seating in a stable manner on his mother's lap as he was shaking his legs and playing with his
hands. He was looking upwards and noticing andenjoying themovement of fan.
SPEECH: Speech was not clear. He was making sounds again and again but finds difficulty in
speed but finds difiiculty in speak clear words or full sentences. It seemned like he is
communicating with himself.
THOUGHT CONTENT:

Subject was not answering the questions as well as not giving even a little attention towards
question asked. He was finds difficulty in comprehend what is going around him.
PURPOSEOF TESTING

To assess the level of currentdevelopment and social maturity of asubject using VINELAND
SOCIAL MATURITY SCALE. This assessment may support the subject to understand future
course of action and guidance for proper intervention.
DIAGNOSED:

Social maturity
TEST ADMINISTERED:

Vineland Social Maturity Scale

In addition toproviding measures of social age (SA) and social quotient (SQ), this scale also
identifiesa child's social deficits as well as social assets. The scale is intended for children
between the ages of 0and 15. This measurement is also an excellent tool for identifying mental
retardation as well as superior intelligence. Rights of Person with Disability Acts(RPWD)
2016 made this tool compulsory for testing Intellectual Ability of aSubject. There are 89 items
on the test, measuring 8 different aspects of social maturity:
Communication skills (COM)
General self-help ability (SHG)
Locomotion skills (LOC)
Occupation skills (0CC)
Self-direction (SD)

Self-help eating (SHE)

Self-help dressing (SHD)

Socialization skills (SOC)

BEHAVIOR OBSERVATION DURING ASSESSMENT:

Child aged 4.9 years neatly dressed. His gross and fine motor skills were appropriate. Roaming
in a room noticing different objects and enjoying movement of fan while sitting on mother's
lap. He was continuously making sounds, shaking his legs and playing with his hands. He was
talking to himself and not responding to question that was asked to him.
TEST RESULTS

On VSMS his score of total SQis54.3 which indicates that child is having mild delayed
development and lack of maturity. In different age domains of VSMS his SQ is given below
Chart Title
80

60

40

20

Category 1 Category 2 Category 3 Category 4 Category 5 Category 6 Category 7 Category 8

E Series 1 t Column2 Column1

SELF-HELPGENERAL
Subject is able to avoid simple hazard, subject is not having toilet control. Subject is finds
difficulty in differentiate between AM and PM. In this domain subject is having a SQ of 56.1.

SELF-HELP EATING

Subject is finds diffculty in care and help himself at meals, can't able to mix rice properly
unassisted but can drink water unassisted. In this domain his SQ score is 56.1.
SELF-HELP DRESSING

Subject is finds difficulty inwash his hands, face unassisted. Subject is finds difficulty input on
shirt or butons shirts unassisted but he can be able to dries on hands unaided. In this domain
subject is having a SQ of 56.1.
SELF DIRECTION

Subject finds difficulty in doing any of the task mentioned in self direction category.
CCUPATION

Subject is finds difficulty infly kites, uses knife, uses pencils, crayons, or chalk for drawing and
canfinds difficulty indo paper folding. Subject can initiate on play activities. In this domain
subject is having a SQ of 56.1.
COMMUNICATION

Subject is finds difficulty inuse pencils, or chalk for writing and finds difficulty inwrites simple
words. Subject is able to relate experiences. In this domain subject is having a SQ of 70.1.
LOCOMOTION

walk down stairs, one

Subject cannot goto school and neighborhood unintendedly but able to
step, at a time. In this domain subject is having a SQ of 70.1.
SOCIALIZATION

inperfom for
Subject is finds difficulty inplay simple or competitive games. Finds difficulty
is having a SQ
others. Subject plays cooperatively at kindergarten level. In this domain subject
of 70.1.
PROVISIONAL DIAGNOSIS

The subject was having mild daily development due to this he faces difficulty in his daily
tentative
routine activities and academic performance. Tentative assessment was done and
score / His social quotient was 54.3 score that falls under mild social quotient category.
 INTERVIEW - 1I

COUNSELLOR :- Hello Sid !

CLIENT :- (Didn't respond )

COUNSELLOR:- Hello Sid ! High Five

CLIENT:- (Again he didn't respond)

(Taken session from CLIENT's mother as CLIENT was not responding)
COUNSELLOR :- Hello Mrs ABC !

CLIENT'SMOTHER :- Hello Ma' am

COUNSELLOR:- How are you ?

CLIENT'S MOTHER:- I am good ma'am . What about you ?

cOUNSELLOR :-I am also good dear. Can you tellCOUNSELLOR what do you do ?
CLIENT'S MOTHER:- I am house maker.

COUNSELLOR:-What's youeducation qualification ?

CLIENT'SMOTHER:- M.A.

COUNSELLOR:- What is your husband's name ?

CLIENTSMOTHER:- His name is Mr P
COUNSELLOR:-What's his education qualification?

CLIENT'S MOTHER:- He has done Graduation+ Diploma in special education.

COUNSELLOR:-What's his Occupation ?

CLIENT'S MOTHER:- He is in Delhi Police right now ?

COUNSELLOR:- Can you tellCOUNSELLOR your contact no ?

CLIENT'S MOTHER:- 98745XXXXX

COUNSELLOR:- Where are you living ?

CLIENT'SMOTHER:- ilive in Nangloi , Kavitacolony.
COUNSELLOR :- OK! Can you tell me. What is your child's age or his date of birth.
CLIENT'S MOTHER :- He was born on 29ih October ,2017 and now he is 4.5 years old
COUNSELLOR:- Is he persuing his education.
CLIENTSMOTHER:- Yes , he is a student in Ignite Minds, Special school.
COUNSELLOR :- By religious , you are ?
CLIENT'S MOTHER:- By religious we are hindu.
COUNSELLOR:- Ok ma'am ! you can go now.I will call you again tomorrow. Take Care

CLIENT'S MOTHER:- Ok ma'am. ( Left the room with smile)

INTERVIEW -2

COUNSELLOR :- Hello Mrs ABC ! How are you ?

CLIENT'SMOTHER:- Hello ma'am ! Iam fine.

COUNSELLOR:-Okay dear
tell COUNSELLOR,did you have regular checkup during the time of pregnancy ?

CLIENT'S MOTHER:-yes. Ihad regular checkups as per schedule.

COUNSELLOR :- Was your pregnancy wanted '?

CLIENT'SMOTHER:- yes, it was.
COUNSELLOR:- What was your age at the age at the time of conception.

CLIENT'S MOTHER:-My age was 24.

COUNSELLOR:-And what was child's father age at the that time.

CLIENT'S MOTHER:- He was 28 around.

COUNSELLOR :- Is your health was good during pregnancy.

CLIENT's MOTHER:- No na'am . Ihad vomiting sensation , food digestion problem and
stress during last month of pregnancy.
COUNSELLOR:-Can you tell COUNSELLOR, what was the cause of stress.
 CLIENT'SMOTHER:- Because my father in law was suflering from cancer and that's why
family / home environment was not that good.

COUNSELLOR :- delivery of child was normal ?

CLIENT'S MOTHER:- Yes , it was.

COUNSELLOR:- His bowl movement was normal ?

CLIENT'S MOTHER:- yes, but only sometimes constipated.

coUNSELLOR:- Is there any specific allegeries does child have ?
CLIENT'S MOTHER:- Yes , he is having allergies from non vegetarian food, milk products ,
wheat and shrimp.
COUNSELLOR:- When you got to know about these allergies.

CLIENT'S MOTHER:- It was diagnosed on February 2022.

COUNSELLOR :- Was there any symptoms of allergies like itching.

CLIENT'S MOTHER:- Yes ! there was symptoms itching , rashes on almost every body part.

COUNSELLOR:- Did he take any medicine for it ?

CLIENT'S MOTHER:- Yes he had taken medicine for 1-2 months.

COUNSELLOR:- Now, Is he taking any medicines or not ?

CLIENT'S MOTHER:- No ma'am , we just take precautions that are needed regarding these
allergies.
COUNSELLOR :- Is his attendance regular at school.

CLIENT'SMOTHER:- Yes ma,am.

COUNSELLOR :- Does he follow your instructions ?
CLIENT'S MOTHER:- Sometimes he follows.

COUNSELLOR :- Does he help you with small household chores like placing glass from one
place to another.
CLIENT'S MOTHER:-Yes , sometimes he follows my command. But it totally depends on
his mood.

COUNSELLOR :- Your family is nuclear or joint ?

CLIENT'S MOTHER:-Joint family.
COUNSELLOR :- To which family member he is most comfatable or attached ?
CLIENT'S MOTHER:- With his grandmother and COUNSELLOR ?
COUNSELLOR:- OK ! for now you can leave dear, we will meet again.
CLIENT'S MOTHER:- ok ma'am

INTERVIEW 3(with his mother and father)

COUNSELLOR ;- Hellodear ! How are you ?
CLIENTSMOTHER:- Hello ma'am. Iam good. how are you ?
COUNSELLOR:- Iam also good dear. Can you tell COUNSELLOR , Is his sitting and
walking normal ?
CLIENT'S MOTHER:- Yes ma'am.

COUNSELLOR:- Does he able to speak clear words?

CLIENT'S MOTHER:- No ma'am. He is only able to speak one word at a time, and started

speaking very late.

COUNSELLOR :- Did you visited any doctor regarding this?

CLIENT'SFATHER:- Yes, we have visited to dr. Vijender Aggarwal

COUNSELLOR :- What did he told you ?

CLIENT'S FATHER:- He told us that he is having speech related problem then after this we
get to knowabout this special school.
COUNSELLOR:- OK! Is there toilet control or he tells you about it ?
CLIENT:SMOTHER:- No ma'am.He doesn't have toilet corntrol.
COUNSELLOR:- Does he know about monetary transactions ?
 CLIENT'SMOTHER:- No. he doesn't
COUNSELLOR:- Does he able to avoid simple hazards, like he wants togo in another room
ishe open the door himselfand leave to the next room ?
CLIENT'SMOTHER:- Yes.

COUNSELLOR:- Is he able tounderstand thigs that are going around him in his daily lite.
CLIENT'S MOTHER:- Yes , sometimes he understands.

COUNSELLOR:- Does he follow your instructions like when you tell him to getyoua tea
cup.

CLIENT'S MOTHER:- Yes, sometimes , but sometimes not, it is totally depends on his
mood.

COUNSELLOR:- He pays attention when you call his name or anything youdo to him ?
CLIENT"S MOTHER:- Sometimes mostly he is less attentive.
cOUNSELLOR:- Can you tell COUNSELLOR , have you ever taking any religious help
regarding his symptoms.

CLIENT's MOTHER:- Nowe haven't taken any religous help yet.

cOUNSELLOR:- Does he able to pullof his clothes independently.
CLIENT'S MOTHER:- Yes,but if it is unbuttoned.

COUNSELLOR:;- Does he fetches or carries familiar objects.

CLIENT'S MOTHER:- Yes, moreoften.

COUNSELLOR:- Does he drinks from cup or glass unassisted '?
CLIENT'S MOTHER:- Yes he is able to drink

COUNSELLOR:- Does he plays with another children?

CLIENT'S MOTHER:- Yes he likes to play with his cousins.

COUNSELLOR:- Does he able to unwraps sweets , chocolates ?

CLIENT'S MOTHER:- No.

COUNSELLOR:- Is there any other information you want to tell ?
CLIENTS MOTHER:-He often plays with his hands and creating different unusual voices
while sitting idle.

cOUNSELLOR:- Ok Thank youdear ! Now you can go

CLIENT'SMOTHER and FATHER :- OK ma'am ! Thank so much.

INTERVIEW SESSION 4(WITH HIS MOTHER)

COUNSELLOR:- Hellodear !

CLIENT'S MOTHER:- Hello Ma'am.

COUNSELLOR:- Do you have any questions from COUNSELLOR ?
CLIENT"S MOTHER:- What do you think when will he able to speak properly
COUNSELLOR:- You have to keep patience, it will take time but he won't be able to speak
perfectly like other childen.
CLIENT'S MOTHER: - Ijust want my child to understand things or little instructions of

daily life and do his some dailylife chores unassistedly.

COUNSELLOR:- You don't worry. You just provide him with therapies and sessions as

much as possible.
CLIENT'S MOTHER:-Is there any chance of improvement ?
COUNSELLOR:- Yes he can improve till the age of 6 - 6.5.

CLIENT'S MOTHER:- Ok ma'am ! we are having a patience and hope that he will improve.

COUNSELLOR:- Sure !this was your last session

CLIENT'SMOTHER:- Ok ma'am.
COUNSELLOR:-Good Luck ! to your child (with smile)
CLIENT'S MOTHER:- Thank you ma'am .(they left the room with smile )
CASE SUMMARY

The subject was having milddaily development due to this he faces difficulty in his daily
routine activities and academic performnance. Tentative assessment was done and tentative
score / His social quotient was 54.3 score that falls under mild socialquotient category. His
parents were very concerned and takin all the precautions at home, providing him therapies and
sessions at specialschool, also helps him to rehearse it at home as much as possible. As a
result, he was improving day by day.
PLAN OF ACTION

The subject should be provided with specialeducation. He should be given

therapies as per needs. He should be encouraged to participate in different activities
Parents should take precautions at home. Parents should help him to rehearse his
learnings at home.
General atmosphere at hone L

Relationship anong va ous fanuy enbers Serene Ouelsonerlutablke/Over anious/ Easy going

Family involvement
Yes/ No
Per sonal need of the chld

Educabonal actVities
Yos/ No
Yes/ No
Play and lersure Activties

Support ct extended Fam1ly

Yes / No / Not knowm
F1nancial
Yes/ No / Not known
Emobonal

Other (Specity)

Attitude toward the Child:

Parents

Fam1ly Members Cuoad

Neighbourhood

S1blings
Retardaion/ Mental ilness: No.
Fam1ly history of any disabiity /Mental
6. Pedigree Chart

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