Alaa Mahmoud, a 10-year-old female child, suffering from Down syndrome, her 9-member family fled Sbenieh around 5 years ago and moved to Al-Mazarae neighborhood, Jaramana.

One of the mother’s friends who regularly attended sessions and activities at Athar Al-Farashah Community Center, attached to the Syrian Society for Social Development (SSSD), introduced her to the center, particularly the groups targeting people with special needs.

Upon visiting the center, the mother was enrolled in the friendship groups, where she talked about Alaa’s stubbornness and her violence with her siblings. The staff gradually integrated Alaa in the children activities and with close follow up she was later enrolled in the Home-Based Rehabilitation Program (HBRP).

Upon evaluating Alaa’s condition, targets were set and a family plan convenient to the mother was developed and explained, as well as an individual plan. The mother was also provided with an individual target-activity chart.
Eventually hard work and close follow up paid off and Alaa was able to meet most of the targets:
1- Alaa let go of quarrel with her siblings and peers and is constantly working on improving her communication skills with others.
2- She is able to follow the directions of mind and physical games when playing with her peers.
3- She is capable of identifying geometric shapes, drawing squares and circles, and assembling small puzzles (5-10 pieces).
4- She is capable of differentiating numbers and letters and counting (ascending order).
5- She is capable of responding to questions starting with “what if” using the corresponding, proper verbs.
6- Her ability of understanding jokes and funny incidents was developed.
7- Her physical ability was developed: she knows how to play jump rope, how to hop, and how to balance on very tight surfaces.
8- She was trained to observe and appreciate the fascinating world of nature.
9- She now chooses her clothes on her own in response to the weather conditions. She also knows how to change water temperature while washing her hands and taking a shower.
The mother talked about the great relief her family felt due to Alaa’s substantial developments; behavior improvements, awareness development, better interaction at home and in groups.

Two-year old Etidal, a person with Down syndrome, lives in a family of six. The family was displaced from rural Aleppo and lives currentlyin an unfinished house in Jaramana, Daff al-Sakher. When they came to visit the community center to receive some services, the girl was registered, referred to the Rehabilitation Program and integrated into a Friendship Group. In fact, all children were enrolled in age-appropriate activities to obtain services offered at the CC.

When interviewing the mother (with the girl present), the Program and what it can offer was explained to her, especially as it is applied at home mainly and helps the whole family develop some objectives along with the Dawn person.

An evaluation was conducted with both mother and girl, and on the basis of that, a family plan suited to Etidal’s needs was developed. Those needswere explained to the mother and she was provided with appropriatetools and games to achieve the desired objectives.

Through follow-up and practical sessions with both girl and mother, it was established that the girl achieved several objectives:
- She is no longer afraid of leaving her mother at home in her familiar environment with familiar people.
- She no longer crawlsaround the house or move carried around, but walks autonomously and runs to escape or play.
- When talking to her, she nods or shakes her head to affirm or negate, and tries to communicate with the caregiver through sight, waiting for the confirmation of something, and tries to draw attention by applauding or disappearing behind hands.
- She expressesher needs (hunger and thirst) in words, sounds and gestures instead of crying; she names some objects, mimics some simple sounds/words and songs and mentions some names, especially those of her siblings in their absence.
- She is no longer afraid when changing the position of her body from sitting to standing and from lying down to sitting in order to do something.
- She is no longer afraid from hiding to play and loves to play with her siblings, fits with the group, and follows the rules by imitating some of the children’s or siblings’ movements.
- She has become more aware and in control of her surroundings: when seeing sunlight coming from the window she drawsthe curtains; when seeingtrash she throws it in the trash bin; when feeling cold she brings a blanket to feel warm; etc.
- She used to be indifferent to pictures or any drawings she saw. Now, however, when she sees a picture her mother had talked to her about, she points to it with her index requesting from her mother to bring it and talk to her about it again.
- Thanks to the increasing attention given to her and to finding a suitable place where she can play, away from unsafe sources of contamination, the girl’s health improved and she was finally rid of a chronic intestinal infection.

The family’s happiness with this change was immense. It facilitated a lot of things for them and created a relaxed atmosphere within the household. This is why the family continues to help Etidal, cooperating by enjoying playing with her or doing any activity that improves her performance and offers her more autonomy in some simple daily activities.
Work is still going on to plan forward towards subsequent objectives.

We met Youssef’s mother after SSSD ORVs had monitored her son. She had come to the community center to get help for him, a 5-year-old Down syndrome boy living with a displaced family from Saqba (Damascus Reef) at one of their relatives’ because they could not afford to rent a house. He was then referred to the Home Rehabilitation Program by the Child Protection case manager.

After talking to the mother during several sessions to explain the Program’s purposes and the way to use it, a direct evaluation of the boy’s condition was conducted and several questions were put to her in order to develop an implementation plan that she could apply with the child at home through a definite routine. The mother was also handed some of the Program tools to ensure her full cooperation and help her achieve the desired objectives.

Then the boy was integrated into a Friendship group and regularly followed up among his peers during group activities. After a specified period of time had elapsed, and reviewing the objectives set before, it turned out that the boy had reached them all:

• The boy is now able to solve his problems by asking his mother for help, while he used to beat other children in previous stages.
• He listens to his mother’s injunctions regarding behavioral control and abides by the rules she sets for him, such as sitting down when someone comes to the house, not messing up with his father’s things, etc.
• He is able to classify tools as carpenter’s tools, kitchen utensils, physician’s instruments, etc.
• He can count up to 3 and has integrated the number concept (he can handle cubes and other objects counting from 1 to 3).
• He can formulate words that express sizes and amounts, such as: big and small, much and little. For example, a large spoon for eating and a little spoon for tea; “I will pour a little tea”; “My big brother”; etc.
• When back home, he talks about things and persons he encountered, especially familiar ones. For example, “Brother played with us with the ball”; he relates the songs he learned and his new experiences to his brothers; etc.
• He can use opposites when speaking about persons and things: “My mate is big,” “That man is tall/short,” and can identify images that illustrate opposite concepts using given tools.
• He can identify and read more than 10 characters, including his name’s (direct application with the boy).
• He can rely on himself in doing some daily tasks without help from adults (washing hands, putting on his clothes, folding clothes, helping in setting the table, etc.).

Working with both mother and child continues in order to set new plans to achieve the subsequent objectives. The dramatic change in Youssef’s life was expressed by the mother thus:
“When I came to the center and learned about the Program and the importance of the plan for my child, the way it works and its objectives became clear to me. I benefited from the plan a lot and experienced immediate results during its application at home. This provided me with effective solutions to several points I observed on Youssef, and this prompted me to make simple tools for my son to serve those objectives. I found myself spontaneously involved in making simple plans to develop some of his skills, in addition to the tools and games that already served the objectives.”

One of the mother’s tools to develop Youssef’s perception and skills is a special notebook in which she puts down all the elements that the boy recognizes, like fruits and animals, with pictures taken from old manuals and captions including the name of each item and some information about it. For instance, “A cow give us milk and says muuu,” etc.

The mother, Youssef’s Guardian Angel, continues to follow up her son’ blooming in the framework of the Rehabilitation Program and seeks to integrate him into the school curriculum.

“When we look at her now we can hardly believe our eyes!”
Thus said the mother of 8-year-old Inas, a girl with special needs, mental retardation and speech disorders. She currently lives with her family composed of 5 people in the Unfinished Buildings in extremely difficult living conditions after they were expelled from Rural Damascus (Hazzé).
The family was accompanied by ORVs to the community center near their home and introduced to SSSD services and activities.
The mother and her children expressed their delight when they came to the community center, discovering what it offers in support of people, which results in positive changes in their interaction with the milieu, particularly since they are strangers to the host community.
When the Domestic Rehabilitation Program was introduced in the CC, Inas’ mother was initiated into the Program within several sessions explaining its working mechanism and what it will offer to the girl in terms of skills and abilities. She quickly understood that it was indispensable that she becomes her daughter’s companion and follow her up home in order to achieve the desired goals.
Then we conducted the Portage Program Developmental Assessment with both mother and girl through some questions and direct application using some tools.
After preparing the girl’s household plan and presenting it to the mother, its working mechanism according to a daily routine was explained to her and some helping tools and tips presented. I personally helped the mother to recycle some tools, such as dolls made from old socks, numbers and letters from old books, pictures with words to help the matching process, in addition to the toolkit, which is extremely rich and helpful in achieving the goals.
After several follow-up sessions and re-evaluation of the girl, the achievement of some of goals that have been worked out was as follows:
ü Inas could not solve her problems without a certain amount of physical strain; now she asks adult assistance to help her solve her problems.
ü She did not follow the guiding rules of mental and physical games; now she can participate in competitions with the group and execute all tasks that are assigned to the group, whether racing or games that require assembling or matching pieces.
ü She did not talk about herself positively; now she tells her mother about some of the positive activities and tasks entrusted to her and information she has become familiar with. E.g., “I put my stuff in order”; “I played with my sisters while you were shopping”; etc.
ü She did not participate in role-playing; now she plays with her siblings and names the characters.
ü She did not describe the functions of things; now, when asked about the function of each tool, she responds correctly. E.g., “We use a pencil to write and draw”; “We use soap to clean hands”; “We use a toothbrush with toothpaste to clean the teeth.”
ü She could not use language to negotiate while playing with others; now she plays with other children and talks to them.
ü She did not follow instructions to perform tasks; now she meet her mother’s demands, which include more than one task. E.g., “After going out of the bathroom, please wash your hands and bring water to your little brother.”
ü She could not speak using long sentences; now she can tell me a story she learned or a situation she was exposed to.
ü She did not know how to cut and paste simple forms; now she knows to do that thanks to her presence in the activities and helps her mother.
ü The whole process reflected positively on the girls’ relationship with her siblings; she can now communicate with them better and share time, hobbies, and games with them.
Through activity follow-up and reviewing the plan periodically with the mother, the latter expressed the positive development in the girl. The next goals are currently worked out for further development, such as giving the girl some specific games to serve the goals planned and help achieve subsequent goals.
Since the mother is completely illiterate, the plan was explained to her and she has been followed up constantly. When the mother realized that she should be educated if she wanted to help her child, especially in simple educational matters, she asked to be helped through a literacy course. She is currently part of a women literacy group. She and her child are being followed up regularly at the community center so that she could transfer this knowledge to her children at home. She now searches for educational songs all by herself and prepares simple tools from empty boxes to serve the worked out plan.
Domestic Rehabilitation Program Specialist: Ibtihaj al-Harith

Five-year old Ahmad had development problems, nerve shortness, a mild cognitive retardation, and a hydrocephaly that affected the auditory nerve and hearing.
Ahmed lived in Jaramana, Daff al-Sakher, within a family of five, displaced from Aleppo, in a rented house under harsh material and health conditions.
We met Ahmad when he came to the community centre with his mother who was asking for help. A neighbour had told her about the services provided by the CC for children with specific needs in order to help them realize the best of their potential.
Soon after, Ahmad was integrated into the Friendship Group. At first, the boy was afraid of unfamiliar people (non-family members) and cried whenever someone approached him. After being integrated in the Rehabilitation Program, his condition was assessed using the Portage tools.
We made a family plan for Ahmad to help develop some of the points where he showed weaknesses. The plan was explained to the mother: It consisted in applying a daily routine and providing some means to achieve objectives using simple tools that are available at the CC or at home. The mother was fully cooperative and contributed to the development and improvement of her son’s abilities.
After several follow-up sessions, the mother came to tell how some objectives had been reached. When reviewing the plan, it was clear that the boy had effectively realized the plan’s objectives in full. By realizing these objectives, the following changes occurred:
• He formerly did not like to be separated from his family. Now he had become involved in activities and played with the group, even in his mother’s absence.
• He could not use his fingers because of the nerve shortness. Now he could use scissors to cut paper, play with tools and execute some tasks autonomously.
• He was unable to respond to complex requests. Now he was able to respond to requests that required more than one instruction.
• He did not know word antonyms. By now, he had learned antonyms of words he already knew.
• He did not know street rules. Now he had become aware of street rules.
• He did not know how to execute some movements that fit with the songs he learned. Now he could do that, doing the appropriate movements for each particular song.

It was fortunate that all the family, especially Ahmad’s siblings, cooperated to help him improve his abilities as soon as possible. His mother said that Ahmed’s sisters are credited with teaching their brother how to make a cardboard basket to throw in it a paper ball they had made for him to help him exercise his hands.

The mother also said that her other two children had improved, becoming more cooperative with her, which was a remarkable change that occurred after their participation in the CC activities.
In a moment of happiness, Ahmad asked his mother if he could wear the Eid clothes before the Eid, so he could come to the follow-up session at the CC and show the “sister” his new clothes, insisting by wearing them to express his delight in coming to the CC.

Sadly, this was the last picture taken of him, during his last activity. The following day, he fell from the stairs, which caused him a severe brain haemorrhage that killed him on August 31, 2017. Ahmad passed away, leaving in the hearts of those who loved him a beautiful memory and much sorrow. He will be remembered in every corner in which he left a trace.
RIP, Ahmad. A little angel dropped by!