I. Introduction This case study is about a child that was born premature, at the twenty-fifth week of pregnancy. With the complication of being born that early the baby girl had many problems her first couple of months of life. Being in the hospital for five months she was fighting for her life each and every day. The child was hooked up to numerous machines to keep her alive. Doctors gave her plenty of attention while she was in the hospital. After being there for five months they began to start seeing improvement in her ability to breathe on her own and gain weight so she was released from the hospital. Now she is a normal happy and healthy four year old.
The purpose of this case study is to understand the development of a premature child now that the child is in a classroom setting. This case study was conducted during my early field experience observation hours, which is a requirement for all core pre-education classes. This study investigated three research questions: (1) is there any difference between the ways this and her peers who were born full-term interact with each other? (2) Is there any difference in the way that this child interacts with teachers and other adults compared to the other children? (3) Is the premature child’s development delayed?
The methods used to conduct this case study were observations and an analysis of the participant’s behavior with teachers, peer, and other adults. Also I had brief interaction with the child. Personal information was gathered about the child from the participant’s teachers, and parents; which includes age, gender, race, education, personality traits, and family background.
II. Participant and Developmental Perspectives
The participant is a four year old African American female named Jane Doe. She was born on November 24, 2007. She was delivered prematurely at twenty-five weeks of gestation. This classifies her as extremely premature because she was born between twenty-three and twenty-eight weeks of gestation. Statistically, only a little over sixty percent of premature babies that are born that early survive. African American babies are more likely to survive compared to all other races, especially African American females. Jane Doe’s mother stated that she also gave birth to a male child during this gestational period, who unfortunately did not survive. Being premature comes with serious health risks such as anemia, internal bleeding into the brain, infections, low blood sugar, respiratory distress syndrome, jaundice, and severe intestinal inflammation.
Fortunately Jane Doe was not born with or developed any of these conditions; however she still stands a higher chance of developing this long term risks such as delayed growth and development, mental or physical disability or delay, and vision loss or blindness. Physically, Jane Doe is like any other four year old. She has brown eyes and brown hair. She weighs thirty-nine pounds and is approximately forty inches tall, which is remarkable because at birth she only weighed one pound and thirteen ounces and was twelve inches long.
Her height and weight are right on target for her age. Her head is slightly larger than most children her age but that is due her being mature, and her brain development is normal. She has no development delays. She hit all her developmental milestones on time, except for creeping in which her mother consulted a physical therapist and was told that not all children creep but as long as she can crawl she would be fine. Her only current health issue is acute asthma in which she is treated with a nebulizer. She can climb stairs up and down without assistance. She is able to perform self-help skills such as dressing herself, using the bathroom, washing her hands and feeding herself. Jane still needs takes naps but she often tries to fight them.
Jane is very smart. She understands the concept of shape and size. For example, she can tell you that one thing is bigger than the other and she sorts things according to their color. She does not fully understand time yet, but she does know the seasons and the days of the week. Jane can also use sequence word such as first, last, next, soon and later in regular conversation. She speaks very clearly and is able to have full conversations. She is very conscious of the daily schedule and what is supposed to happen next. She has great memory and a very creative imagination. She engages in parallel play but is showing a new interest in dramatic play.
She enjoys acting as if she is a mother or a teacher. As any four year old, Jane can be difficult to deal with, especially when she is upset; however. She can verbalize her frustrations with others. She makes decisions based on her mood. She has a very dominate personality. She enjoys being around people. She responds very well to positive attention and praise from adults. She is not afraid to ask for help; however she does not want things to be done for her, simply just guidance to do it herself. She is very social and has many friends. Jane still has some separation anxiety and when important people leave because she does not understand why she cannot come too. She also gets upset when she is not ready to leave but it is time for her to go.
She enjoys playing with children, but since she is an only child her mother stated that she is around adults majority of the time and is sometimes more comfortable around them. She becomes frightened when she hears loud noises such as the toilet flushing, or sees bugs. She also says that there are monsters. Jane is also very possessive. If she sees another child playing with a toy that she enjoys she will snatch the toy away from the other child or if her friend is playing with another friend she may become upset. However she is learning to share and play with others. She can be very jealous sometimes if she feels as though another child is getting too much attention. She may lash out verbally but she is very rarely physically.
III. Theories and Child’s Behavior
Albert Bandura’s social learning theory says that one learns a behavior from others by observing and imitating behaviors, especially aggressive behavior.(ref: Ormrod, J.E. (1999). Human learning (3rd ed.). Upper Saddle River, NJ: Prentice-Hall.) Observing is simply watching a behavior performed by another individual. After observing the behavior of another the individual will imitate or repeat the same behavior to fit in with a crowd or group. Bandura stated that children who come from an aggressive environment often repeated that behavior when placed in other settings. Bandura believed that children gradually become more selective in what they chose to imitate. Jane shows signs of this theory when she observed that the when she does something that her mother does not like her mother points to her and tells her no, now when other children do something that she does not like she imitate the behavior that her mother displayed.
Also one of the other children in the class was using inappropriate language (which was likely observed from someone else) and Jane imitated that behavior as well. Sigmund Freud’s psychosexual theory stated that everyone is born with a natural sexual energy. That sexual energy has stages and if an individual experiences any anxiety related to a stage it can affect them all the way into adulthood. (heffner media group, 2011). He refers to this sexual energy as libido. Freud’s five stages are oral, anal, phallic, latency, and genital. The oral stage says that an infant’s pleasure centers on the mouth. This stage lasts from birth to eighteen months. The anal stage says that the child’s pleasure focuses on the anus. This stage lasts from eighteen months to three years old. The phallic stage says that the child’s pleasure focuses on the genitals. This stage lasts from three to six years old.
The latency stage says that the child represses sexual interest and focus on social skills. This stage lasts from six years old until puberty. The final stage is the genital stage and this is a time of sexual awakening for an individual. This stage lasts for the rest of their life. This theory was based on another theory based on troubled adults. Jane proves this theory because she is currently in the phallic stage and she is very curious about the anatomy of boys and girls. Erik Erikson’s psychosocial theory stated that a child gained attitudes and skills by solving psychosocial issues in their own way. He believed that development did not end after adolescence but was a lifelong process. (Cherry,2010). Erikson expanded on Freud’s theory and also had stages.
His stages are trust vs. mistrust, autonomy vs. shame and doubt, initiative vs. guilt, industry vs. inferiority, identity vs. identity confusion, intimacy vs. isolation, generativity vs. stagnation, and integrity vs. despair. The first stage is trust vs. mistrust; this stage is for the first year of life because infants are completely dependent on their caregivers. If the child trusts their caregiver they are less likely to have trust issues for the remainder of their life. However, if the caregiver is neglectful the child will develop mistrust. The second stage is autonomy vs. shame and doubt, this stage is from one to three years old because during toddlerhood is when children have more of a personal control. Erikson believed that learning to control oneself can lead to a sense of independence.
However, if this is not achieved it will cause shame and doubt. The third stage is initiative vs. guilt; this stage is from three to five years old because this is the age where children start to assert their power. This can make children feel as if they can lead others. However, if the child fails they may begin to feel guilty. This is that stage that Jane is currently experiencing. When playing with other children she may try to direct the children into doing something the way she believes it should be done. Sometimes she is too assertive and the other children do not respond to her. However when she gains respect and does not abuse her power the other children usually follow her.
IV. Summary of Findings
This case study investigated the development of a premature child in a classroom setting. During this observation I found no difference in the development of this child and the development of her peers. She displays the same methods of play as other children her age and she has the same social characteristics. Her social skills are still developing and I do not believe that she will ever have a problem developing friendships. Jane’s interaction with adults is also very normal. She responds very well to positive attention and praise from adults. She is not afraid to ask for help when needed. She understands authority figures and when asked to perform a task she usually complies with little hesitation. Jane is also on target with her development. She achieved all of her milestones on time and has exceeded everyone’s expectations. She knows the days of the week, the colors, the seasons, and is even beginning to read. She does not display any evidence of developmental delays.
Even though Jane was born with many obstacles, she was able to overcome every one of them. When she was born the doctor did not think she was going to make it to her first birthday. She did not give up. For five months in the hospital she fought to survive. Even when she survived the doctor believed that she was going to have developmental delays or physical disabilities. Today, she has neither. She is an enthusiastic, adventurous, bold, silly, eager and fun four year old.