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Case Study

Down Syndrome

Lexi Mireles

University of Utah
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Introduction

I have had the opportunity to do my clinicals at the South Valley school in South Jordan.

The school looks like your typical high school. There’s a lunch room, class rooms, a seminary

building, etc. The school’s purpose is to provide individuals with intellectual disabilities who

weren’t able to complete high school a chance to further their education. However, the

students aren’t learning things you would learn in a typical high school. They learn things that

they will be able to use to contribute to society such as job etiquette, how to discuss the news,

how to go shopping and other everyday things. They want to make their students independent.

We were all assigned to “Class 3” which is filled with about 16 students, 3 assistant

teachers, 1 student intern (me) and a head teacher. The class has a great diversity of diagnosis

and levels on how independent they are. This is such a great experience for me because I am

able to experience and work with multiple types of disabilities. The school and the classrooms

are very wheelchair friendly and accessible for everyone. The bathrooms have equipment so

qualified teachers are able to assist students while using the restroom. The entire staff is

extremely friendly and inviting to everyone who walks through the school. It creates such a

great learning environment for me because I feel accepted and welcomed at the school. For

this case study, I conducted an intervention for Tyson from the South Valley School. Through

assessment and planning, we were able to find ways to step towards his goals.
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Diagnostic Grouping

 Intellectual Disability: A disability characterized by significant limitations both in

intellectual functioning and in adaptive behavior, which covers many everyday social and

practical skills.

 This disability originates before the age of 18.

o Etiology

 Genetics is the most common cause of intellectual disabilities.

 Infections during pregnancy

 Problems during birth

 Illness

 Injury

Specific Diagnosis

 Down Syndrome- the most common biological cause of CIDS. There are three types of

down syndromes which include:

 Trisomy 21- Caused by an error in cell division. (The most

common form)

 Mosaicism- A combination of cell containing the usual 46 and

some that contain 47. (The least common form)

 Translocation- Partial of chromosome 21 attaches to a part of

another chromosome.

o There is a wide range of cognitive intellectual disability associated with down

syndrome. However, it usually falls between the mild to moderate range and a

small amount within the severe to profound range.

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 Mild –

 IQ of 50-69

 Mental age of 9-12-year old.

 Moderate –

 IQ of 35-49

 Mental age of 6-9-year old

 Severe –

 IQ of 20 to 34

 Mental age of 3-6-year old

 Profound –

 IQ of 20 and below

 Mental age of 3 and younger

Identified Problems (Relevant to recreational therapy)

 Physical characteristics

o Short stature

o Upward slant of eyes

o Small nose

o Flat backside of the head

o Small hands and feet

 Cognitive Intellectual disabilities

 Heart defects

 Respiratory disorders
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 Osteoporosis

Related Factors

 Vision disorders

 Hearing disorders

 Premature aging

 More susceptible to Alzheimer’s

 Leukemia early on in life

Client Interview

I am currently doing my clinicals at South Valley School which is a school for individuals with

disabilities have the opportunity to continue their education after high school. The school

provides service to a wide range of disabilities and severities. The purpose for the school is to get

the individuals prepared for everyday life and how to be a contributing member of society. The

school has been around since 1985, starting as a sheltered workshop in 1973. The school has rich

history and has been a great part of community for many years. The students who attend South

Valley are extremely passionate and have much school spirit. It’s a great environment where the

students are able to really grow and create connections with the staff and other students around

them.

The student that I chose to interview was a 20-year-old boy named Tyson who has Down

Syndrome. Without even knowing anything about Tyson, you can tell he is a very happy and

outgoing human. On the first day of my time at South Valley, he greeted me with open arms
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(he’s a hugger) and made me feel very welcomed in the classroom. He caught my attention on

the very first day and we have grown to become really good friends. Tyson is able to

communicate on his own free will, however, when asked specific questions he has a hard time

focusing or understanding my questions. He is often changing the subject to sports or would

wander off to do his own thing. He is very independent and can do everything by himself and he

likes to keep it that way. Most of what I learned about him was through observation. Although I

wasn’t able to get everything that wanted through the interview, I was able to learn a lot about

him, his abilities and his interests.

Tyson is a fun-seeking, goofy kid who has a passion for life. He lives with his very

helpful family. He loves his family and gave two thumbs up every time I mentioned them. He

also has many friends at school. Especially those in his class. I see him especially drawn to

Austin in our class. Those two have lunch very often together and you can always catch them

pulling jokes on each other or on other people in the school. He is friendly to everyone and loves

to say hi to all of his friends at the lunch room. You can tell he is a very loved individual and

impacts many people around him. Not only is he friends with everyone, he is popular among the

ladies. He is very confident with himself.

He has a job that he goes to in the morning. He gets there by bus. There has been an

incident where he forgot to get on the bus, other than that he is able to get to and from work

without any help or reminder. He works with a couple other students at the school at Village

Baker. He gets very good feedback from his supervisors. He often gets high scores on following
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direction, being polite and appearance. What he slacks in focusing on one task for a long period

of time.

He loves playing basketball and drawing. He likes to play basketball almost every day

after lunch. He is very competitive and loves to shoot the ball far back from the basket. He is a

fan of the game “tornado” and he likes to play with a few of his friends. When we are in class he

is constantly drawing in his notebook or writing stories. His stories don’t make a lot of sense, but

he gets excited being able to share these stories with me. When I asked him what he liked doing

he said he liked watching T.V. with family, drawing and sports so I wasn’t too far off from my

observation.

If I were to suggest an intervention to Tyson, I would recommend him to get involved

with Basketball with other individuals with ID or to get involved art classes. Through some

research I found that basketball could very well help someone with Down Syndrome. Basketball

helps with teamwork, accomplishing goals, feeling involved in something larger than

themselves, etc. It is also great at being introduced to other people who also have ID and it can

help with being social. What Tyson would really get out of this is a sense of focus. It will help

him accomplish goals without getting as distracted.

When I researched how drawing could help an individual with Intellectual Disabilities, I

learned that drawing can really help to refocus the brain and actually the fine motor skills could

help with an individual with clumsiness which would be beneficial for Tyson. It could also give

him a way to express himself and how he is feeling which is something that can be hard for him
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at times. The creative outlet can help the brain work differently than when we are just using it for

everyday use.

I was able to get to Tyson on a whole different level and I feel as if I was able to find

several different options that could be beneficial for him. If these don’t work for him, there are

many more options. The more I get to know Tyson, I will be able to learn more of what he likes

to do and other things that he is passionate about. These interviews and assessments are crucial

prior to the next step of the process.

Intervention Planning for the Client

The goal for Tyson was to help with clumsiness and refine his fine motor skills. This will be

beneficial for him because with the combination of both things just stated, it will help him

improve many different aspects of his life. After research, I found that drawing can improve not

just fine motor skills, but also the overall coordination of the body. This was perfect considering

Tyson already loves to draw. Art is also a great way for an individual to express themselves in

another way other than words.

According to the article, Art Therapy Interventions for Working with People who have Down

syndrome, the author states that the 3 immediate goals of art therapy for individuals who have

Down syndrome are to “to expand the individual’s sensory, perceptual, and motor capabilities”

(Tsai, 2015). I especially wanted to focus on the motor capabilities for Tyson considering our

goal for him was to improve motor skills.

Implementation of Intervention
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Over the course of 5 weeks, I would have Tyson draw every day before class started. He

could express himself in any way he felt, and the only guideline was for him to accomplish the

task I would give him. For example, I would give him a story problem and he would have to

draw how he thinks it can be solved. Having something to achieve or path to follow was

beneficial for Tyson because you were able to see real change on how he conducted himself

during class.

Evaluation of Intervention

Not only were his drawing improving, I felt like I could notice a difference with how he

conducted himself physically during class. His handwriting also improved because of the fine

motor skills improvement. Fine motor skills can really improve the overall coordination of the

body. His aim and coordination both improved while playing basketball because of this practice

of using fine motor skills. These tests were taken over a short period of time and it is hard to

truly access the case as a whole with such little time. However, I believe we would find an even

greater result with more time.

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Resources

Tsai, M. C. (2015, May). Art Therapy Interventions for Working with People who have Down
syndrome. Retrieved December 4, 2019, from
https://pdfs.semanticscholar.org/1182/09b14da2e32c074856978e6c31cb7b2c0bbd.pdf.

Richards, S.B., Brady, M.P., & Taylor, R.L. (2015). Cognitive and intellectual disabilities:
Historical perspectives, current practices & future directions (2nd e d.). New York,
New York: Routledge.

Vimercati, Galli, Stella, Caiazzo, Ancillao, & Albertini. (2015). Clumsiness in fine motor tasks:
Evidence from the quantitative drawing evaluation of children with Down
Syndrome. Journal of Intellectual Disability Research,59(3), 248-256.