1. Case study: NATHAN
To Professor: Lisa McCaie
By: Lan Chi Nguyen
Course: ECEP 233-063
Due date: April 02, 2014

2. The Needs of Children
Nathan was in cardiac arrest and needed surgery on his
heart when he was born.

3. Nathan is ten months old now. He is behind
in most developmental milestone.

4. Nathan is generally happy and smiles
often

5. Nathan’s families needs
 His parents would like to gain a better understanding
of services and support available to him in Durham as
they are planning move into their house in Ajax.

6. Nathan’s Mother need support
with employment
 Nathan’s mother would also like to find a new job
which would be closer to their new home. She is a
qualified ECE who is planning to work full or part time
after her maternity leave is completed (with in 2
month period of time)

7. What is cardiac arrest?
 Cardiac arrest is a type of heart disease. It is sudden
cessation of all heart activity.
 It may cause shortness of breath, fatigue, airway and
breathing problems.
 Cardiac arrest, also known as cardiopulmonary
arrest or circulatory arrest, is the cessation of
normal circulation of the blood due to failure of the
heart to contract effectively. ( http://en.wikipedia.org/wiki/Cardiac_arrest)
(https://www.heart.org/HEARTORG/Conditions/More/CardiacAr
rest/About-Cardiac-Arrest_UCM_307905_Article.jsp)

8. Cardiac Surgery
Cardiac surgery is surgery on the heart or great
vessels performed by cardiac surgeons. It is usually
done to:
 Treat complications of ischemic heart disease (for
example, coronary artery bypass grafting)
 Correct congenital heart disease
 Treat valvular heart disease from various causes
including endocarditis, rheumatic heart
disease and atherosclerosis It also includes heart
transplantation.
(http://en.wikipedia.org/wiki/Cardiac_surgery)

9. Causes of cardiac arrest in children
and infant include:
 Airway and breathing problems.
 Traumatic injury or an accident (e.g., motor-vehicle
collision, drowning, electrocution or poisoning)
 A hard blow to the chest.
 Congenital heart disease.
 Sudden infant death syndrome (SIDS)
(http://www.sharecare.com/health/heart-
disease/causes-cardiac-arrest-children-infants)

10. Condition are cause newborn with
cardiac arrest
There is many cause are associated with increase risk of
the children of cardiac arrest including:
 Prone sleeping position.
 The winter months
 Infant mothers who is smoking
 Infant who have survived severe apparent life
threatening events
 Infants of mothers who are drug addicts
 Low birth-weight infant
(http://circ.ahajournals.org/content/98/21/2334.long)

11. Do things to help preventing
 Promote healthy eating.
 Smoking Cessation.

12. Preventing continue…
 Keep track with medical condition
 Regularly exercise.

13. Prevent for children
 We should be aware of the need to place infants supine
for sleeping.
 Infants should not sleep on soft surfaces (such as
lambs-wool, fluffy comforters, or other materials that
might trap exhaled air near the infant face.

14. What is cause developmental delay
with Nathan?
Nathan case is one of the most common cause of
developmental delay because of the period of
hospitalization immediately or soon after birth for the
cardiac arrest surgery.(Reading package, Fact Sheet-page
2) The delays were seen in all areas of development,
cognition, language and motor.

15. Nathan’s
 Needs
 Want
 to

16. Nathan with special needs
 Nathan with developmental
delay after cardiac surgery
because the time he was
spend in the hospital
environment. He did not
have chance to interact or
active play as another.
 According to the Ages and
Stages said “ Throughout the
first year, infants grow at a
tremendously fast rate. In
fact, by the end of the first
year they will have tripled in
birth” This is show that
Nathan could miss the rate of
growth.

17. Meeting the needs of Nathan’s and his
family want for him in the class room and
outside of the class room.
 Physical adaptive learning environments
 Teaching strategies
 Using special equipments
 Strategies for inclusions a child and families

18. Physical Environment
 Adaptive learning environment and modification to
stimulate Nathan and easy for him to move around on the
comfortable, safe floor and access to the material as easy as
he could. Class room setting with the child eye level

19. Facilitate a positive and safe play
space
The high quality childcare environment setting will be
benefit for all the children and it also really importance
for children with special needs. It give them opportunities
for healthy and safe development. (Reading package,
page 3)

20.  Materials, toys and equipment, labeling system : should be
bright color and big letters so children can easily recognize
and get use to the visual. For ten months old baby.
 Toys and materials can be adaptively as: stabilize, enlarge,
enhance and simplify

21.  Adaptive devices for greater learning help Nathan to
achieve to his developmental level.
 Safety and safe risk taking through scoping activities.

22. Collaboration
 Collaborative planning for a lot people in the
community involve to provide their needs and build
their positive self-esteem. Including team meeting to
support Nathan’s needs and follow up.

23. Support
 Staff support and training: understand children’s
developmental, provide flexibilities in routines, schedules
and provide stimulation and novelty activities.
 Staff and parents support the children learning to prepare
their future. Talking to the family about your concerns.
(Reading package and class note)

24. Support inclusion
 Beside Support children and their families by enrich
physical environment, teaching strategies also help support
include children with special need. This would be promote
Nathan social skill in the daycare invironment.

25. The strategies to teaching new skills
 Identifying skill to teach: Developing learning goals and
teaching a child new skill. We should start from small and
short-term task for skill improve. This could help to success
in long-term skills. This would be help best for Nathan’s
developmental as in physical , social, emotional and
intellectual

26. Indentifying Skill to teach
 Work from where you
are, not from where you
want to be
 Choose a single area to
focus on
 Break the skill into
smaller steps
 Decide how to teach
 Build a child’s
confidence
 Motivate and reinforce
 Set short deadlines
 Keep track
 Generalize the skill
 Include others

27. Visual Communication
 This strategies is using to help the children who are
not yet initiating communication to express their
needs or interested. This could apply for Nathan needs
for his language, social and emotional skill

28. Task Analysis
 The breaking down of complex skills into smaller step
to allow the children to success of learn new skills with
their developmental level and enhance for their bigger
task. ( Reading package, Supported inclusion-page 2)

29. Prompting and Fading
 Prompting and fading is used in teaching a new skill to
support Nathan’s physical, language, and intellectual skills.
For example help Nathan holding spoon or scrawl and
stand independently, also with verbal model and gesture
used (class note, week 7)
 In addition we can use hand over hand technique to
support Nathan’s physical prompts, because “modeling and
demonstrate is showing the child how to do the skill or
action while imitating child” (class note, week-7)

30. Reinforcement
 Children need reinforcements to learn new skills, build self
esteem. Reinforcements can help Nathan stay on task.
 Reinforcements mean motivate or encouraging the child.
Any environmental event that maintain and strengthens
behaviours or action such as praise, special activities, food,
music or toy given after the desired behaviour. (Class note,
week 7)

31. Resources support Nathan and his
family in Durham Region
 Resources and consultant
 Family doctor
 Pediatrician
 Physiotherapist
 Occupational Therapist
 Infant Development program consultants
 Social Worker
 Psychologist
 Public Health Nurses
 Early Childhood Educator

32. Resources and consultants
 They gather information in relation to Nathan with
developmental delay needs and promote the inclusion for
Nathan in the child care community.
 They able to assist families and child care staff in identifying
strengths, needs and goals for the child with special need
like Nathan.
 They can access and coordinate resources to support
Nathan, his families and child care staff; they also interact
with related professional in the community.
 They will develop appropriate strategies and service plans to
support inclusion of Nathan. ( class note, Week 9)

33. Family Doctor
 This is the professional close to Nathan and families to
diagnosis his developmental level.
 Can advise parents about accessing and referral for
diagnosis, help the family find support

34. Pediatrician
 A pediatrician specializes in child development and
medical care children.(class note, week 9)
 Nathan had surgery because of cardiac arrest,
therefore he need to have pediatrician to help him
and his family follow up his medication condition

35. Physiotherapist
 Works with children and their families to develop the
child’s maximum level of independence by addressing
physical aspects (movement, muscle strength,
coordination, fitness and respiration) ( class note, week 9)
 This service could Nathan’s physical strength in gross
motor skill after he did not move much in the hospital.

36. Occupational Therapist
 Works with children and their families to develop
the child’s maximum level of independence in all
areas of daily living. such as, dressing, bathing,
feeding, play and school activities. (class wk-9)

37. Infant Development Program
Consultants
 Work with families of children under the age of three with ,
or at risk of developmental delay
 Can provide home visits, assessments, program planning,
and liaison with other families (class wk-9).

38. Social Worker
 Inform and refer parents to service provide and link
families with community-base support and service.
 They also able to help Nathan’s mother with
employment or financial help for family.(class note,
week 9)

39. Psychiatrists
 This professional may provide diagnostic assessment and
reassessment of children, monitor prescriptions and
treatments (class, wk-9)
 They also family counseling can
help family to co- op with the
situation and help Nathan get
to developmental level .

40. Public Health Nurses
 Nathan is 10 months old, He is behind in most
developmental therefore Public health Nurses could
help the parent gain more information on his healthy
growth and development, immunization for him.
 They also provide information in resources, supports
and service in their community.

41. Early Childhood Educator(ECE)
 ECE will be with Nathan most of the day time in the
daycare. Therefore they able to observe, participate in
creating and implementing IPP’s. They make adaptations
in the environment, support families, links with other
professionals... and much more to provide the needs for
Nathan learning and get to developmental level of his age.

42. Nathan’s Parent
 The family need to sign form 14 early to get access to the
service as soon as possible for Nathan to get help from all
the professionals. This will allow the family to gain access
to different services which can help them with support as
they go through this difficult time including financial.
 Nathan’s parent is the best resource for him. They are the
primary care for Nathan and know best about Nathan
abilities, strengths, and needs .

43. Meeting the needs of Nathan and
his family
 http://www.wordle.net/show/wrdl/7710367/Inclusion-
_meeting_Nathan_needs by Lan Chi Nguyen

44. Durham Area Map
 Nathan’s family planning to move into their new house
in Ajax.
http://www.durham.ca/default.asp?nr=/corpoverview/mapsregion.htm

45. Grandview Kids
Grandview Children’s Centre is an independently operated
not-for-profit organization. They are the only children's
treatment centre in Durham Region providing
specialized programs, outpatient clinical treatment, and
support to thousands of children and youth with special
needs and their families. (http://grandviewkids.ca/welcome/about-
us)
Oshawa(Main Site)
600 Townline Rd. S.
Oshawa, ON
L1H 7K6
905-728-1673
1-800-304-6180
Fax: 905-728-2961
Port Perry
(Lakeridge Health
Port Perry Hospital)
451 Paxton St.
Port Perry, ON
L9L 1L9
905-985-7321 x 5568
Whitby
(Whitby Mall)
1615 Dundas St. E.
Suite #203
Whitby, ON
L1N 2L1
905-440-4573
Fax: 905-440-4601
Bowmanville
(Knox Christian
School)
410 North Scugog
Court
Bowmanville, ON
905-728-1673
1-800-304-6180

46. Continue....
 assess, diagnose, prescribe and provide clinical treatment, specialized
programs and therapies and specialized equipment for children and
youth with communication, physical or developmental special needs;
 provide access to specialists, consultation and support for families;
 build capacity in the community through information, knowledge
exchange and consultation to professional and other organizations;
participate in research activity and teaching in the field of children’s
rehabilitation. (http://grandviewkids.ca/welcome/about-us)
Ajax
(Grandview West)
570 Westney Rd. S.
Ajax, ON
L1S 6V5
905-619-6551
Fax: 905-619-6552

47. Regional Municipality of Durham
 Health Durham region: Provide information for parent
families all kind of services relate to children with special
needs and families needs. Provide resource for educator to
help the parent and a child to get access to the service for
children with special need.
(http://www.durham.ca/default.asp?nr=/corporate/contactus.htm)
Contact: Health Department
605 Rossland Rd. E
Whitby, ON L1N 6A3
Phone: 905-668-7711
Or 1800-841-2729
Fax 905-666-6214
Email: health@durham.ca

48. Regional Municipality of Durham
 Child Care and Children's Programs: Provide the map for
all childcare centre locate in Durham region.
 Provide information for childcare and early learning
professional.
 Provide information for parent.
Contact for social services:
Including Childcare and children’s
Program.
605 Rossland Rd. E
Whitby, ON L1N 6A3
Phone: 905-668-7711
Or 1800-372-1102

49.  This organization is support for individual disabilities
and protect their right.
 Provide many services for young children from birth to
eighteen years old.
 Help the families access support services from
government.
39 Wellington E, Oshawa, ON L1H
3Y1 (905) 576-3011
Fax: 905-576-9754
Email: infor@communitylivingoc.ca
Website: www.communitylivingoc.ca

50. Community Living - Ajax, Pickering
and Whitby
 Community Living in Ajax, Pickering and Whitby have the
same service for individual children and families with
special needs as Oshawa.
 Provide the services available for all families who are living
in Ajax, Pickering and Whitby to easy to access to their
needs.
 36 Emperor Street, Ajax, ON. L1S 1M7
 Phone: (905) 427-3300
 Fax: (905) 427-3310
 Email Address: info@apwcommunityliving.org
 http://www.cl-apw.org/index.html

51.  Lake Ridge Community Support Services (LRCSS) provides
high quality treatment, education and evaluation research
services which facilitate the participation and growth of
individuals with a diagnosis of Intellectual Disability or Autism
Spectrum Disorder within their community. Staff provide
support to individuals, community agencies, families,
educators and other professionals. (http://www.lrcss.com/AboutUS.html)
Contact information:
900 Hopkins St, Whitby, ON
(905) 666-9688
Website: www.lrcss.com

52. Preferences
 https://www.healthtap.com/user_questions/7938-what-is-the-best-way-to-get-
rid-of-chest-congestion-in-10-month-old-baby
 http://ecdevelopment.org/index.php/playing-with-your-baby-while-promoting-
development-2/
 http://happyhomefairy.com/category/the-happy-baby-updates/page/3/
 http://www.about-cerebral-palsy.org/children-with-cerebral-palsy/childrens-
developmental-delays/
 http://littlethingsinlifephoto.com/2011/08/baby-studio-photography-with-eli/
 http://circ.ahajournals.org/content/102/suppl_1/I-253.full
 http://blog.iridiamedical.com/2012/10/03/sudden-cardiac-arrest-prevention/
 http://www.prsd.ab.ca/view.php?action=object&id=8489&stream=Homepage%2
0News
 http://www.quickanddirtytips.com/parenting/tweens-teens/teaching-your-kids-
good-manners
 http://blog.pathfinderclinic.com/2012/04/healthy-baby-contests-judging.html
 http://co.humboldt.ca.us/hhs/phb/publichealthnursing.asp

53.  http://www.truehealthyproducts.com/3133/learn-three-ways-to-avoid-cardiac-
arrest-that-will-surprise-you
 http://www.clker.com/clipart-no-smoking-sign.html
 http://blogs.davenportlibrary.com/pr/2013/05/21/trivia-tuesday-sleeping-like-
a-baby/
 http://www.yummymummyclub.ca/sites/default/files/styles/large/public/field
/image/special_needs_kids.jpg?itok=J8SuGS68
 http://playingandlearningbeginsathome.blogspot.ca/2012/12/baby-safe-
christmas-wrapping-paper.html
 http://www.daynurseries.co.uk/news/article.cfm/id/1558218/expansion-and-
move-for-two-city-nurseries
 http://socialservices.regionofwaterloo.ca/en/childrensServices/supportforspec
ialneedschildren.asp
 http://flemingcollege.ca/news/ece-toddler-program-learning-for-students-
parents-and-children/
 http://ywca-
saskatoonemploymentlearningblog.blogspot.ca/2013/01/interview-questions-
social-worker.html
 http://www.ona.org/news_details/support_algoma_public_health_nurses.htm
l

54.  http://www.sunshinebutterflies.com.au/category/gold-coast-community-
fundraising/
 http://www.mticareercollege.com/English/Programs/ECCE/Program-ECCE-
Addictions-Worker-Diploma.aspx
 http://creatingreadersandwriters.blogspot.ca/2013/06/building-best-part-of-
classroom.html
 http://cascadechildrenstherapy.com/services/occl-physical-therapy/
 http://www.essentialbaby.com.au/baby/baby-stages-of-development/your-
childs-first-steps-20121022-280yb.html
 http://www.frsd.k12.nj.us/Page/4813
 http://renownscribbles.org/managing-childrens-behavior/#.Uzr-aBLjM8s
 http://grandviewkids.ca
 https://www.facebook.com/durhamregionhealth/photos/a.376408519065702.87643.1070
74669332423/376408529065701/?type=1&theater
 http://pettiscountyhealthcenter.com/child-adolescent/child-care-consult/
 https://mdportal.lpch.org/default.jsp?contentPath=/forPatientsVisitors/PatientServices/
FamilyCenteredCare/familyCenteredCare.html
 http://www.weewestchester.com/category/wisdom/milestones/
 http://howtohelp.childrenshospital.org/falmouth/page/Elizabeth-Ciurylo.htm
 http://otontario.ca/osot/index.php/funding-for-ot-services/

55.  http://www.npr.org/blogs/thisisnpr/2013/04/02/176025998/an-open-letter-to-
backseat-babies-everywhere
 http://www.slezingerworld.com/contact-me
 http://www.edutopia.org/blog/what-parents-want-teachers-to-know-joe-mazza
 http://essientv.com/2013/02/21/helen-asks-does-giving-too-much-praise-to-
children-harm-their-self-esteem/
 https://play.google.com/store/apps/details?id=com.codegent.apps.kizzu.baby100w
ords
 http://theplayroomblog.com/2012/05/24/8-μια-κρυφή-διάλεκτος-twin-talk/
 http://families.naeyc.org/families-today/when-baby-walks-cheers-and-challenges
 http://blogs.telegraph.co.uk/news/graemearcher/100232511/advice-for-only-
children-invent-a-sibling-so-you-can-pass-for-normal-in-group-outings/
 http://www.lrcss.com/AboutUS.html
 http://www.sheknows.com/parenting/articles/815262/developmental-delays-and-
regressions-1
 http://www.thebestdegrees.org/how-to-become-an-occupational-therapist/
 http://belfastschool.co.nz/in-the-classroom/learning-support/
 Class notes and hand out: from week 1 to week 9
 Reading package.
 Age and stages .
 Connect ability inclusion workshop: www.connectability.ca/category/kids