THEME 4: ADAPTIVE DEVELOPMENT DOMAIN

The stages of adaptive development of preterm born children occur at a slightly later age than the development of children born at full-term (Thun-Hohenstein, Largo, Molinari, Kundu, & Duc, 1991). Children who were born premature may experience difficulties in the adaptive development domain (Ribeiro, et al., 2017).

The psychologist mentioned that Lebo fidgeted and everything he fidgeted with, he put in his mouth (PR:L10-11). Mrs T also noticed that when she tried to correct his pencil grip, he chewed the pencil grip off the pencil (TI1:L69). When Lebo joined the LSEN class, he could not adapt to the stricter routine (TI1:L39) and this restriction caused him a lot of stress (TI1:L40). Lebo would just get up and walk out of the class (TI1:L40-41). Mrs T mentioned that he could not understand that he had to be in class and sit still and do activities (TI1:L42).

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Lebo’s way of eating was also very immature (TI1:L69). He ate with his hands and messed a lot (TI1:L69-70). Mrs T teaches table manners and the “right, correct way to eat, the correct way to handle food” (TI1:L94). To assist with this, Mrs T did an activity on “Things We Can Do”. The learners are allowed to use utensils that they may have never had the opportunity to work with at home, such as knives to cut up fruit, and boiling water to make jelly or instant noodles (Figure 4.30.; Figure 4.31.) (OBS37, OBS37, OBS38).

Figure 4.31. LSEN class making jelly in activity ‘Things we can do’

When Lebo started in the LSEN class, he was unable to tie his shoelaces or dress himself. His grandmother assisted him with all these tasks. Mrs T created a ‘shoe’ out of cardboard which was laminated (Figure 4.32.) (OBS42). This allowed Lebo and other learners to practise tying their shoelaces. The learners were excited as they got to choose the colour shoe that they wanted to practise on.

Figure 4.32. Tying shoelaces

Mrs T created two A3 activity boards to assist Lebo with these adaptive boards, as well as an activity smock. The first activity board (Figure 4.35.) (OBS40) has zips in all different

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directions (vertically from top to bottom, vertically from bottom to top, diagonally from left to right, amongst others). Lebo was expected to do this board in two different ways, using his left hand and then using his right hand (Figure 4.36.; Figure 4.37.). This gave Lebo a chance to cross his midline when completing either activity. The second activity board (OBS41) allowed him to practise fastening other kinds of fastenings that he may come across, such as metal fastenings, buttons and Velcro. There is also an activity smock (Figure 4.33.) (OBS39). Lebo was allowed to wear the smock (Figure 4.34.) and experience buttons the way he would, on his clothes, and not just on a board in front of him.

Figure 4.33. Activity Smock

Figure 4.34. Lebo wearing and using the activity smock

Large Buttons

Button

Shank

Button Hook and Eye

Press Stud _Velcro

Open Ended Zip

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Figure 4.35. Adaptive activity board 1

Figure 4.36. Adaptive activity board 1; Lebo using his right hand

4 1 2 ₃ 4 5 6 7 8 9 10 11 ₁₂ 13 14 15 16 17 18 19 20 21 22

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Figure 4.37. Adaptive activity board 1; Lebo using his left hand

Table 4.6. Direction of zips on activity board

Zip Colour and Direction Zip Colour and Direction

1 Yellow - Vertical from top to bottom 12 Red – Vertically from top to bottom

2 Brown - Horizontal from left to right 13 Blue – Diagonally upwards from left to right

3 Pink - Horizontal from right to left 14 Dark blue – Diagonally downwards from right to left

4 Red – Vertical from bottom to top 15 Light green – Diagonally upwards from left to right

5 Black – Diagonally downwards from left to right

16 Dark green – Horizontal from left to right

6 Light pink – Diagonally upwards from right to left

17 Light green – Horizontal from left to right

7 Dark blue – Diagonally downwards

from left to right 18

Light pink – Horizontal from right to left

8 Light blue – Vertically from top to bottom

19 Purple – Vertical from bottom to top

9 Yellow – Vertically from bottom to top 20 Brown – Vertical from top to bottom 10 Silver – Vertically from top to bottom 21 Black – Vertical from bottom to top

11 White – Vertically from bottom to top 22 Open ended zip – Vertical from top to bottom

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Figure 4.38. Adaptive activity board 2

Table 4.7. Items on activity board 2

Description Description Description

1 Plait 8 Velcro 15 Bikini clasp

2 Large buttons 9 Shoelaces 16 Dungaree fastener / clip

3 Bow 10 Open ended zip 17 Clip buckle

4 Hook and bar closures 11 D-ring belt 18 Carbine buckle

5 Press studs 12 Pinless coat buckle 19 Egg hook

6 Toggle buttons 13 Buckle belt 20 Plastic hook

7 Shank buttons 14 Plastic swivel buckle

While the first adaptive board was constructed using only zips, the second adaptive board (Figure 4.38.) used other clothing fastenings that any learner in the LSEN class may experience. The large buttons are fastened from both the right-hand side and the left-hand side. The fabric plait allows for learners to cross their midline while the shank buttons could also be fastened from the left or right-hand side. The toggle buttons could also be fastened in the same way. The tying of the shoelace is a reinforcement of the ‘shoe’ activity (Figure 4.32.) and the open ended zip is a reinforcement of the first activity board as well as the activity smock. The variety

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

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of belts and fastenings all assist the learners with fine motor skills and crossing the midline (Figure 4.39.).

Figure 4.39. Lebo using the second activity board to increase adaptive skills