De La Salle University - Dasmariñas

A Case Study about a Child

with Cerebral Palsy

In Partial Fulfillment in the Requirements

for Foundation of Special & Inclusive Education,

The Child & Adolescent Learner & Learning Principles,

Our Christian Faith and Lasallian Identity and Diskurso sa Filipino

By:

Delgado, Roxanne Fate B.

Enderio, Jamaica M.

Sison, Krisha M.

December 2019
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INTRODUCTION

Saturday of the 30th of November 2019 was the day the interview

was conducted. The group was fetched by their client’s older sister,

Chelsey Dela Cruz at the Church located in Bayan. Upon arrival at their

home which is at General Trias, for the family refused to disclose their full

address, they got the chance to meet a beautiful girl.

The client’s name is Sophia Lorin Dela Cruz, thankfully the parents

did not refuse to give out her full name. She is the 4th and youngest child

of Sherill Dela Cruz, the mother and Mike Dela Cruz, the father. Sophia

was born in 30th of December 2003, and she is currently 15. She is

diagnosed with an Orthopedic Impairment, specifically Cerebral Palsy

wherein her muscles stiffens due to certain emotions such as: excitement,

anger and sadness. Their family belongs to the middle class and they are

a nuclear family composed of six. Sophia has three older siblings: 2 older

sisters and 1 older brother. Her father used to be an Overseas Filipino

Worker (OFW) but had to quit due to her condition and also to have

someone look after her since they have also mentioned that they could not

rely much on the housemaids they hired, so her father built a small

business instead which we presume is the tindahan set up in front of their

house. On the other hand, her mother is a call center agent, she mostly
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supports the family financially with the help of their oldest child who herself

is currently working, while her two older siblings are still on College level.

Upon Mrs. Sherill Dela Cruz’s pregnancy, she mentioned that she

is extremely careful with herself, she goes to the doctor and have check

ups regularly and she makes sure that she is healthy so that her baby

will be delivered out healthily. When Sophia was delivered through

cesarean process, just like her older siblings, two days later her skin

turned yellowish, this condition is called jaundice. Jaundice is the

changing of a baby’s skin color two or three days after birth, which can be

developed in normal, healthy babies (Women’s and Children’s Health

Network, 2016).

It was 3rd day of January when they noticed that she was not

drinking from her mother’s breast nor was she crying, they started to worry

and it brought to their attention to bring her to a hospital, then there they

found out that she was diagnosed with hyperbilirubinemia.

Hyperbilirubinemia is a condition in which the bilirubin is build up in the

blood causing the discoloration of eyes and skin called jaundice. (The

Children’s Hospital of Philadelphia, 2019). According to the doctor,

normal bilirubin level is 6 but Sophia’s was 30, so that was times five from
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the normal bilirubin level. From that onwards, aside from

hyperbilirubinemia, they also found out that the child had contracted an

infection from the hospital and it spread out to her brain. Due to this, she

was confined in the ICU (Intensive Care Unit) on the 4 th day of January in

FEU Hospital, Quezon City to undergo blood transfusion and extraction to

lower down her bilirubin level. They stayed there for almost 12 days, four

days in ICU and 8 days in the ward.

After four months, they noticed that she was softer than normal and

she was not opening her palms. They observed her for a while and six

months later, they noticed the delays she was manifesting. They

discerned that there was something different about her: she could not lift

nor move her body thus she could not crawl unlike her other siblings who

were already capable of crawling during that age. These manifestations

had been brought to their attention so they have decided to bring her to a

Developmental Pediatrician. She was diagnosed to have a Physical

Developmental Delay. After a year and a half, they went back to her

pediatrician upon noticing that there were no changes and then that was

when the pediatrician told them that it was not longer a developmental

delay, because her delay is far from her actual age and her development

is slow. She was then classified to have Cerebral Palsy.

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Sophia underwent therapy for her condition in De La Salle

University Medical Center (DLSMUC) before she started her education.

She underwent therapy with three SPED related services:

Speech/Language Pathology for her speaking, Occupational Therapy and

Physical Therapy. They solely focused on OT and PT since speech can

be practiced at home according to her parents. She started her education

at 2013 until now for almost 6 years in Francisco E. Barzaga Memorial

School or FEB located in Zone 2 Dasmariñas City, Cavite. It is a SPED

school with no graded levels, instead they only have SPED A for level 1,

SPED B for level 2, SPED C for level 3 and SPED D for level four.

Sophia is currently under SPED C, level 3 because of her achievements:

she can color without messing it up, she can type and send messages,

she can understand very well and she can write, though, illegibly but it is

readable.
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METHODS

Data Gathering Procedure

The researchers looked for possible clients from different SPED

schools and from personal/social media friends. One of the group

member’s dorm mate recommended one of her classmate’s siblings with a

case of cerebral palsy. After which, the researchers then created interview

questions and bought a complementary gift for the child. The day after, the

researchers finally conducted an interview over at the client’s home and

was able to directly observe the child, as well as know her current

situation.

The following are the supporting evidences:

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Figure 1. Identification card of the client in school

Figure 2. Identification card of the client for her therapy

The following are the questions asked during the interview:

 What is the full name of the child?

 What is her age?

 When is her birthday?

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 What is your address?

 What is the name of parents or guardians?

 What type of family you belong in, is it nuclear or extended? Are

you in a middle-class family?

 What are the occupations of parents?

 Is Sophia studying?

 What grade or level she is?

 What is her school’s name and address?

 How long does she already been in a SPED?

 How did you discover your child has a disability?

 How did you notice the presence of delays and the manifestations

of the disability?

 What atypical development was first seen in the subject?

 How it brought to your attention that there is a need for your child

for classification?

 Does family history indicate the same condition?

 What triggers you to consult a Doctor or Developmental

Pediatrician for your child?

 What challenges you and your family encounter having a child with

disability?

 How does it affect to your other children?

 De La Salle University - Dasmariñas

 What therapies or medications or treatment that your child

undergo?

 What progress has seen in your child since his first consultation

from a Developmental Pediatrician?

 Is your child socially active?

 What are your child’s weaknesses and strengths?

 Were there times you have been felt mad or tired?

 How did you handle those things?

 How did it affect your faith having a child with disability? Did it

strengthen your faith in God?

 How did you experience God’s Kagandahang Loob?

Respondents of the Study

The respondents of the study are the client’s family members, Mrs.

Sherill Dela Cruz, Mr. Mike Dela Cruz and her older sister, Chelsey

Dela Cruz.

The observation was done on the same time as the interview, on

30th of November 2019, which lasted for almost 2 hours at their home

in General Trias.
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RESULTS

She did not cry nor smile before, her palms also remained enclosed

instead of opening them regularly. The development of her darwinian

reflex was not evident during her four months after birth. At her sixth

month, she could not roll over nor balance herself yet, but when she had

started her therapies and medications, her development had skyrocketed

and there was finally progress in her growth and development. She can

now respond with emotions that befits certain situation, she laughs when

she feels the need to laugh, cry when she needed to cry.. She can move

her hands, grab things she wants to get, munch on food which her hands

can grab a hold of, she can also scribble on a paper or booklet using a

pen, she is socially active, and she is very friendly. You can see how

pleased she would be through her smile when someone tries to converse

with her. She can speak and mutter out simple words comprehensibly

despite her troubles with speaking. Like any other person around her age,

she can type on a phone and express her feelings through emojis or

stickers, she even owns two facebook accounts. She can make good

power point presentations and she is much more demanding in terms of

load for texting unlike her elder sister Chelsey and they found it exciting

knowing that their child is getting well. She can wear her shorts or pajama

by herself, there are even times when they get surprised that she is
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already wearing her pajama without them having to tell her to do it, but

she is unable wear t-shirts by herself. Her memory is pretty sharp too.

According to her sister when you promised something to her, she will not

forget it for four months. When she sees something that you are doing,

later on, she will be doing that too. It is just that her body would not

coordinate well with her mind. But on the other hand, when she is

surprised or too happy or you gave something to her she can not control

her emotions, to the point that her muscles stiffen and she can not help

but sometimes bump her head against the wall. This is because she has a

difficulty in controlling her muscle movement. Sometimes she can not feel

the pain after a few minutes or a few hours, for her reaction time is often

late, according to her father. Those are the typical development seen and

was demonstrated by the subject from her birth up to the present.

In her cognitive affectation, the atypical milestones that are only

manifesting until now is her speech and language. It is still evident in the

way she speaks, and how she pronounces the words, sometimes she

would uncontrollably prolong the last letter of a word. (E.g Helloooo..).

There is no problem manifesting with regards to her sensory domain. Her

memory is sharp, she can easily catch up and she can understand well.

Basically, she has no intellectual disability.

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In her psychomotor or physical affectation, Sophia is very strong

that she does not have self-control with the movements of her body

especially when she experiences excitement. Her body muscles would

stiffen from excitement and happiness and due to her stiffened muscles,

she can not really walk so her father often carries her around the house.

In her psychosocial affectation, no problems are much seen for

according to her family, Sophia is a socially active child and she can go on

and tell stories to people she talks to.

In her self-help affectation, slight problems are only seen still

manifesting. She can eat by herself, do her hobbies by herself, but she still

needs assistance when taking a bath and although she can put on her

bottoms, or her pajama, it is only while laying down and she still needs

help when wearing her tops.

The first time these atypical milestones were observed, the parents,

especially her mother was in denial at first, which even lasted for one and

a half year. It was hard for her to accept the condition of her daughter and

she over thinks a lot about what could possibly happen to her child. It was

hard for her to accept the fact that this is already a sign or a symptom that
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she is differently abled but they did not want to conclude, because while

she was still pregnant, she underwent regular check-ups, she takes up

vitamins and she is even well cared by her family. They have many friends

who are doctors who usually assists her whenever she went for a check

up and even when she delivered her daughter. She was hoping that she

does not have any major problems just like the doctor expected her to

expect after six months or after a year. In 2011, Sophia had an

unexpected seizure, she was close to being able to walk but because of

this, she is not able to walk now.

Upon knowing their child’s condition, the researchers asked how

their faith with God was tested. Mrs. Sherill Dela Cruz admitted that they

almost lost hope and faith in Him. She even went to the point wherein she

questioned God’s actions: “Why me?” “Of all the people in the world, why

my family?” “Pagsubok ba ‘to?” It was financially hard for them because

of the therapies Sophia underwent were expensive, however, through

these hardships, their family was even more united. They became much

more patient and understanding than before. Sophia became the reason

why their family became this stronger and whenever they engage in fights,

they would think about Sophia’s condition and this would make them

resolve their arguments with each other immediately.

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During Sophia’s younger years, Mrs. Sherill mentioned that she

was taking dopamine to relax her muscles. However, her motherly instinct

told her to stop injecting dopamine to her daughter because she did not

want her to be dependent on the drug whenever her muscles would

stiffen. She does not want her daughter to have too many injection marks

all over her body.

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DISCUSSION

For students with Cerebral Palsy, lack of mobility is often the

disability, so they need to have an assistive technology equipment by

means of going to school or from place to place. In Sophia’s case, she is

not capable of walking and writing legibly, so she needs a wheel chair and

she needs hands on support from her teachers. Some strategies that

could help her improve her writing ability is to do demonstration, showing

her how to write a word or a phrase then observing her how she do it.

Another strategy is to have a writing partner, where they could share

some interests about themselves and have fun learning writing together,

since Sophia is socially active and very friendly. Sophia also has a

difficulty with speaking, so it is appropriate to expose her to an audio type

of learning and big books with audio. For the classroom setting, the

classroom should be spacious for them to move freely. The teachers

should provide small play ground or a playing activity inside of the

classroom so even in the school they can enjoy and improve their

interaction with their classmates.

Sophia is not yet suitable to enroll in a regular school because of

her incapability to write legibly, to speak clearly and walk. The suitable

inclusive education for the client is both accommodation and modification,

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knowing that Sophia is wheel chair bound, she should be in a setting

where there is enough room for her to move around, so her movements

would not be restricted to one place. A 1:1 aide would probably be needed

but it is still important to encourage independence as much as possible

and also considering her ability to color well as her strength, introducing

an activity or test that would require her coloring skills: for example is a

multiple choice test that would require her to color the right answer, in that

way, her coloring ability will improve more, not only that, but she will have

the same outcome and she is able to keep up with the tests and activities

required in her school. For her speaking ability to improve, on the other

hand, she should be exposed to a peer-group interactive activity where

there is an exchange of information about the lessons discussed.

Honestly, we have a different pair of eyes for people who are

differently abled. We don’t see them that pitiful, why? Because their

difference is something beautiful for us. We even at times, see them very

blessed as to God’s manner in making them feel His love. Their condition

may seem some sort of misfortune for to others but actually, they are

angels in disguise that let us, who may be physically and mentally are

different than them, be on the right track, the track God wants us to never

abandon. Furthermore, the difference between us and those who are

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differently abled made us even more amused with the versatility of God’s

love. Realizing the incomparable art of love engraved in it never failed to

let me believe and have faith in His goodness more.

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REFERENCES

Children’s Hospital of Philadelphia. (2019). Hyperbilirubenimia and

Jaundice. Retrieved from https://www.chop.edu/conditions-

diseases/hyperbilirubinemia-and-jaundice

Women’s and Children’s Health Network. (2016). Why is my baby

yellow? – Neonatal Jaundice. Retrieved from

http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p

=438&np=464&id=2815