TIIE-EL-Case study

1. Padma - Case of a child with possible learning difficulties

Padma's parents are in Gulbarga, Padma's mother has six daughters; she is the third child, who was delivered at home through vaginal delivery. Her aunt adopted her because they do not have a girl child after four sons, Padma was adopted as fifth child and father's holy pet daughter, the father takes care of her very well, getting anything she asks for, and not scolding her for anything.

She started speaking when she was 9 years old, and starting last year, she began interacting with everyone and doing work on a mental basis, at times acting moody.

Despite her age, she is cognitively behind her classmates. Her class teacher has stated that Padma has difficulties in reading and writing. The teacher gives her one or 2 pages of homework daily to trace numbers and Kannada alphabets. Though she remembers that in the short term, she soon forgets and makes mistakes in repeating the same word.

She does not write anything by copying. If  anyone forcefully insists that she writes, she tries to write something, but it is unrelated to the task given.

When we interacted with class 7 students through the ‘Are you listening?’ (listening) activity, Padma participated with a lot of interest and was able to identify a few objects that she heard in Kannada such as Fan, Kurchi (Chair), Motte (Egg), Kannu (Eye). In the ‘Pick and Speak’ (speaking) activity, she could speak a few words about the Pongal festival, which she celebrated recently and what she likes about it such as eating food, sweets, wearing new dresses, and going to the temple. She also participated in the

colouring activities and classroom games. But she was not interested in reading and writing work, and she failed to recognize any letters in reading activity. In the worksheet activities she was not able to recognise any shapes, patterns and colours. Despite the facilitator explaining the activity multiple times, she was unable to understand it to complete the task.

The teachers initially made her sit in lower grades (grades 1-3) as a possible solution. However, they had to have her sit in 7th grade again as she would disturb children from the lower grades by bullying/ beating them. It was also observed that her peers from 7th grade often tease and beat/ bully her for minor mistakes. If they continue to bother her, she scolds them using vulgar language, perhaps because she lacks the ability to distinguish between what is right and wrong.

She enjoys wearing smartwatches, colourful dresses, using mobile phones, and wishing for her skin to be white. She becomes Hyperactive and restless at times but keeps quiet in class without talking to anybody in class.

She keep on telling something what they family mentioned about her brother marriage several times, such as“ nan ourige hogthini nan Annana Madve ede , mathe baralla - alli yella nanna chenagi nodkonthare yaru odyalla, thinnkoke yella chenagi kodthare”. At times, she would talk about things that are not related to the context. She prefers outside food and does not eat properly at home or at school, though she enjoys eggs at school. She grabs and eats the things lying on the floor, she often eats soil/ mud.

Sensing that there might be an underlying issue that needs to be diagnosed by a medical professional. We decided to take Padma to the appropriate hospital after getting consent from BIERT and their school teacher. We took her to the NIMHANS for a diagnosis, with the help of her parents.

During the discussion with the doctor, it was brought up that she had developmental delays as a child, and all of the milestones were reached very late, and the immunisations that were supposed to be given at different stages were not given to her at all.  She was also refereed by NIMHANS for Indiragandhi Hospital for further evaluation by the paediatrician to rule out any health issue associated with her development. Padma was diagnosed with intellectual disability by NIMHANS after having teacher and parent counselling and getting an IQ test. I applied for a UDID card, and I am hoping to receive it within the next two months.

Since Padma has completed her seventh grade at the current school, she is expected to transfer to a new high school next year, and the doctor has advised that it is not advisable to move her to a new school as it will not help her in anyways and she may just be sitting in the class. So her parents have decided to enrol her in a residential school, which will allow her to learn from the individual caretaker. We found Samartham trust is good to admit Padma, but getting seat in that trust is challenging so hopefully next academic year we will try to admit Padma to that trust.

   • What are some teaching strategies that can be used to improve Padma’s reading and writing skills?

   • What are the measures that could be taken to improve Padma’s social skills?

   • How can the parents be made aware of padma’s situation, its possible implications in the future and ways in which to support her as she grows up?

2. Shanmukha - Case of a child with possible learning difficulties

Father is working as apartment security guard and mother is House wife. Until grade 4 he was in Andhra Pradesh, studied Telugu medium but struggles with reading and writing in Telugu. After the pandemic, his family moved to Karnataka then he admitted to Uttarahalli government school, but he did not attend the Classes regularly. He was made to join Byrasandra school after the family was shifted near Madhavan Park in Jayanagar. Elder brother Is studying in 9th std in Vijaya high school. Elder brother is academically good and has been studying here since he was a young child while living with her aunt. In the home, he will be good at doing all the given tasks he also joins with others during playtime and eat well; His parents mentioned that other than writing or reading issue, they have not noticed any other issues.

He can understand and speak Kannada, but his accent makes it difficult for teachers to understand him since at times he tends to speak too fast.  It was observed that Shanmukha is unable to fully understand instructions given by the teacher and his responses are very slow.

In one instance during the baseline study, he could only partially follow the facilitator's instructions. He was unable to recognize two-digit numbers and was unaware of any number operations (not even single digit addition)- concepts that are covered in lower primary grades. In a language reading exercise, he was only able to identify a few letters. He was unable to identify the given words, or construct words from letters in Kannada or in English.

In the English writing activity, despite being provided hints or alternative words and phrases, he was unable to write any of the words dictated by the facilitator. On being asked to write in Kannada, he made few mistakes like ordering or sizing some alphabets incorrectly, and not using proper spacing. It seems that he finds it difficult to copy down anything the facilitator has written on the board.

Shanmukha also faced some difficulty in identifying the shapes, tiles, and number patterns. Even though he wrote some numbers, there were sequencing mistakes in his answers.

In spite of the teachers being aware about the challenges faced by him, we could not ascertain if any special efforts or provisions are being taken by them to accommodate students like him.

In the classroom activity, Eshwar was made to work on his number sense and counting. He was made to count and write the no. of given objects he would decode the objects with numbers up to 10 with help and when asked to write no. of objects/ circles for the given number would write 3 circles for 13 and 4 circles for 14. Hence, it was clear that he had confusion with numbers after 10. Also, while writing the objects/circles every time he would seek facilitator stake to give a conformation to write next number. This showed that he has not got the concept of stopping, Place value, and counting and decoding numbers till 10 to some extent and more inputs to be given along these lines in the upcoming sessions.

In Nimhans, a Psychiatrist counselled his father and teacher and recommended an IQ test. Since Eshwar is from Andra and has Adhar and ration card from Andhra, He was refereed to Venkateshwara medical College in Tirupati for getting his IQ test done.

   • What are some teaching strategies that can help students like Shanmukha overcome learning gaps and improve their skills in language and mathematics?

   • What kind of support should be offered to the school, and within the school system to identify signs and symptoms of specific learning disabilities?

3. Child Amrutha - Case of a child with possible learning difficulties and often quiet

Amruta lives with her mother along with her 3 sisters and 3 brothers (Mother’s brother sons, including mothers brother) in the same house in Gulbarga colony. Amrutha’s mother work at two places – during morning hours,ie.., 7.30 to 4 pm  she goes for a school to take care of children while onboarding and getting out from Van and during evening 6 pm to 10 pm she works in  Adigas hotel in cleaning vessels and moping etc, she has 4 children all are girl child. Amrutha is the 3rd  child her weight is 21 kg and height is 115 which is 3 times less than the child of the same age group (12 years). Except Amrutha all her sisters have normal height. But her  first Older sister has vision problem(complete blind from birth and recently got UDID card, for getting UDID card paid 6000 rupees to the 3rd party member in one of the government hospital in Bengaluru – showing right direction to seeking help from government facilities for the needed children is an business or responsibility???). When Amruta was 8 year old she fell down while playing and got some injuries at hip(Sonta) and she didnt disclose this to her family, as she mentioned that pain after few days mother got to know about it and have made surgery at Indiraghandi hospital but her mother didnt maintained any document on it. She does not eat well in home and in family mother is not available all the time at home, her sister only helps her in case she needs any help.

When we started interaction with her she processes and receives information slowly. She usually sits alone and keeps to herself, but after 3 to 4 interactions, she is responsive during one-on-one interactions.

She partially followed the facilitator's instructions and participated in the baseline activities. She spoke a few words for a selected objects during the speaking activity. In Math assessment activity she was unable to recognize two-digit numbers and was unaware of any operations not even single digit addition. In a language reading exercise, she was only able to recognise a few of letters, not words. In the word grid activity, she wrote letters exactly as they appeared on the worksheet instead of framing/ making words by using letters both in Kannada and English. She finds it difficult to copy down anything that is written on the board.

She is did not write the dictation words or sentences in the writing activity, even though the facilitator prompted with hints or alternative words. After the facilitator suggested writing the Kannada letters, the child did so while making the following mistakes: -  ಳ as ಶ , and ಳ and ಶ are same,  missed ಲ,  ವ as  ನ , ಒ  as ಬ .

She struggled with shape recognition, colour matching, and the various colours used for similar shapes on the worksheet. She also had difficulty in recognising any patterns such as tiles, numbers, letters and shapes, even after explanation with an example. She was unable to mark the points in left, right, downward and upward directions during the dots and distance activity, but she was able to count and join dots horizontally. During conversation got to know she didn’t like reading writing activity.

In classroom activity, Amruta was made to work on her number sense and counting. She was made to count and decode the no. of given objects. She was struggling to decode the numbers. While counting 1, 2,3  she would say correctly but while decoding she would get stuck. She would orally count the no. of drawn objects correctly. But, decoding she seemed to be familiar with till 5 and she was struggling to decode numbers after 5 i.e, when there were 8 0r 7 objects she would count the number as 8 or 7 but while writing, she used to get stuck and ask me what she should write. She needs a lot of support to strengthen her number sense and counting after 5 and also strategies to work on her decoding ability in order to build her number sense.

We consulted a Psychiatrist at Nimhans for Amrutha's difficulties, and they did detailed counselling with her teacher and mother. They noticed that she is not open to the psychiatrist's questions because of her shyness, and they suggested that we check her secondary sexual characters growth level at Indiragandhi hospital because she appears to be very short in comparison to other children her age. There is no problem with her test at Indiraghandi. Based on all of this counselling, Nimhans psychiatrist suggested an IQ test for her, but since there was no time slot available at Nimhans, they suggested taking Amrutha to Victoria hospital and get her IQ assessment done after screening.

Questions :

   • Could the child’s difficulties be induced by emotional trauma?

   • In what ways can we support/interact with such a child where she only responds in individual interactions?