Orthopedically lmpaired Spina Bifida:

This child was diagnosed at birth with spina bifida.  During his first three years of life, he demonstrated poor sensation from the level of lesion downward, delayed mobility, compromised hand function, hydrocephaly and shunting with periodic revisions on the shunt, incontinence, and some non-specific problems with visual perception and attention span, but appeared to have age-appropriate intellectual functioning.  The child required assistance moving from room to room and getting on and off furniture during the first three years of life. The family was comprised of a separated couple, who were contemplating divorce and four children, two living primarily with the mother and two in foster care.  Both parents had a high school education. The father was alcoholic; mother was diabetic.  Mother was overwhelmed and perceived having no informal supports.  The family qualified for Medicaid with a spenddown (excess).
 

Speech-Language lmpaired:

The child had recurrent ear infections but no other health problems during the first two years of life.  The child demonstrated speech and language delays at age 2 years, but no other specific developmental delays. The family was comprised of a single parent and two children under the age of 3 years.  The family lived alone, isolated from extended family; mother did not report any network of friends.  The mother completed a high school special education program for students with mental retardation, but was unemployed. The mother held a positive attitude toward the children.  The mother was physically and emotionally healthy but stressed about accessing recommended services for the child.  The mother perceived little support being available to her since she was alone and mentally retarded herself.  The family qualified for Medicaid.

Other Health lmpaired/Medically Fragile Child:

This child had a history of very low birth weight and prematurity. During the first three years of life, the child demonstrated some developmental delays (not mental retardation) and cerebral palsy.  The child required extended hospitalizations and had low-to-moderate oxygen-flow needs at home.  The child had oral feedings supplemented with naso-gastric feedings and continuous feeds at night.  The family required assistance related to care of the child at home with his necessary technology/equipment (i.e., tube-feedings).  The family had a middle income with a major medical insurance plan that specified some restrictions.  Parents were both college-educated, in a stable marriage, with extended family and friends In the community. Never-the-less, this couple perceived having little informal support; they perceived family and friends as "uncomfortable" around the child.  The family required periodic respite, day care, and support relative to the care of their child.  The mother was sad and at times depressed, but other wise both parents were physically healthy.  The parents held a positive loving attitude toward this, their only child.

Down Syndrome:

Associated with the diagnosis of Down Syndrome, this child had a moderate degree of hypotonia, a cardiac condition which required surgery, and recurrent ear infections requiring Insertion of tubes in the ears at age 2 1/2 years. The child was delayed in motor, speech and intellectual development, but showed progress in these areas at a slow but steady rate.  The child was generally healthy aside from the persistent upper respiratory infections and possible allergies. The child lived with an older sibling (age 4), his mother and the mother's friend.  At the age of 22, the mother had a high school diploma and a full time job with paid health insurance.  The mother (and friend) were healthy physically and emotionally.  There were extended family and friends in the community and the mother was resourceful in accessing existing supports.  The mother was often ambivalent towards the child, showing concern and simultaneous irritation with the demands the child presented.