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Home-based Rehabilitation for Children with Mental Disabilities

Gimme a chance and see how I get!” Inas’ story

“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

A Little Angel Dropped By… Little Ahmad’s Story

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!

Awareness session in Aqrab - Hama

The Syrian Society for Social Development, in cooperation with the UNHCR held an awareness session at Aqrab Center on the concept of disability (children with disabilities - people with disabilities - talking about the causes of mental disability - correcting some misconceptions about dealing with children with disabilities).
More than one woman participated in the experience of disability of her child, and some did not know the case of their child and why they behave in this way. When mentioning the symptoms,they knew by about the actions of their children and how to deal with them, in addition to the need to introduce the child to a doctor to know what is useful for their children.
The ladies thanked us for this the subject that drew the attention about such thing.

Hand in hand - Hama

As part of the home rehabilitation program, the Syrian Society for Social Development, in cooperation with the UNHCR, held an activityto integratea group of children with disabilities with a group of normal children, after preparing the normal children to meet up with the disabled ones and introducing them to disability.
the activity interspersed competitions (colors - paste - balls) and after the division of teams and set the rules of the session, the children helped each other to win.
During the activity, we observed the acceptance of ordinary children to their peers with need, assistance and active participation among themselves and cooperation to win.

Train trip

Riding train for the first time, the participants of the trip were deeply moved. They felt relieved and energetic, breaking out from their daily routine and unwinding stress. Seeing joy on their children’s faces, the mothers were extremely happy as if they were reborn. “I feel like flying. It is the first time my kid smiles like that,” a mother of a special needs kid enrolled in the program “HBRP for Children with Disabilities” said.
To farther promote the ties of friendship between the parents of the special needs children and the community center staff, SSSD in cooperation with UNHCR organized a train trip from Aleppo to Jebrin, Hama.  Two hundred forty- five persons participated in the trip: special needs children, their parents and siblings, as well as SSSD facilitators. The kids enjoyed face painting. The mothers and their kids were both involved in enthusiastic singing and dancing.
The women collectively expressed that it was the first time their kids accompany them feeling happy and not shouting. Being in an unfamiliar, closed space, one mother was afraid that her kid might be nervous, shout and cry until she would take him back home. On the contrary he was smiling and fascinated by the landscapes out of the window, and was clapping enjoying the group songs.
One of the mothers expressed her gratitude, “It is the first time I go out with my six kids, my husband is always busy. Thank you very much for putting up with the burden of the children and I wish the trip was not over.” Another mother said, “My kid did not quit talking about the trip from the moment he stepped into home up to the moment he felt asleep. The very next day he told me that he dreamt of the train trip.”

Home-based Rehabilitation for Children with Mental Disabilities

This program targets children with mental disabilities, including those with autism, and their families. The main aim of the program is to ensure equal access to, and participation in services and activities for children with mental disabilities on a long-term basis.

The program is based on Portage and PECS concepts that enable families to take the lead in developing and implementing effective plans for the rehabilitation of their children. Children thus acquire motor, communication, and learning skills and develop socially and emotionally.

Family members are empowered and supported psychologically as well. The beneficiary children are integrated into the activities taking place in CFSs to help improving the child’s self-dependency, his capacity to express feelings and ideas. This, in turn, minimizes the risks of abuse, isolation and negligence the child could be exposed to.

The program is guided by UNHCR guidelines on Home-based Rehabilitation Program.

 

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