No Boundaries for Disabled Teenagers
Project location: ITALY
Project start date: September 2001 - Project end date: June 2002
Project number: 2001-11
The project deals with a group of about 30 adolescents aged 11 to 18 years and will be divided as in the previous project, into the following phases:
a) COGNITIVE AND DIAGNOSTIC PROCEDURE: interviews made by the children's
neuropsychiatric, psychologists and cognitive therapists with young people and aimed at neuropsychological and psycho diagnostic evaluation (also through tests). The interviews will be made when young people begin again to work.
b) FORMULATION OF PROJECTS AND RETURN OF WORKING PROGRAMMES TO FAMILIES AND YOUNG PEOPLE INVOLVED.
c) REHABILITATION PROCESS: Each adolescent will come to the Centre three times a week on overage, in the afternoon, for one-and-half hour each day. During this time, they will benefit of group or individual neuropsychological interventions-according to individualized projects -and
psychotherapeutic treatments through:
1. Computer laboratories;
2. Occupational laboratories;
3. Individual or group activities with cognitive therapist;
4. Individual or group psychotherapies;
5. Individual or group expressive such as : music therapy, arts therapy, dance therapy, and theatre- laboratory.
At the same time, the following interventions will be planned:
6. family group or individuals psycologic interventions aiming at sharing and elaborating their experiences and inner difficulties, in particular those linked to the handicap of their children
7. Didactic- rehabilitative collaboration with schools attended by these young people, through phone contacts and meetings with the teachers.
8. Research and identification, in close contact with families, of protected suitable job or occupational situations where these young people could be inserted when our intervention has reached its end, and possible intervention of insertion.
Rehabilitation processes will be evaluated every fifteen days through team meetings in which all technical and rehabilitation personnel working at the project will take part.
d) EXPERIMENTATION ON THE TERRITORY: Young people, in small groups and
helped by reference people, will experiment the skills acquired through outings on the territory aimed at the knowledge and use of public means and offices.
Socio-educational rehabilitation project for adolescents suffering from light cognitive retardation, border line and behavioural disorders
Person in charge of project: Dr. Calzaretta Teodorino Carmine
The Camelot Project has reached the end of its fourth year.
This year our socio-rehabilitation programme has been really positive for most of our receivers thanks to an uninterrupted implementation of our therapeutic activities as decided in our initial assessment. Our receivers could express their skills and capabilities in a more detailed and clearer way, though deficits still remain and need to be addressed in the continuation of our programme. In fact, thanks to focussed and individualized programmes as well as wider group settings, this year we could enable each receiver to implement his/hers cognitive, motor, relational and emotional capabilities in a more profitable way. A greater precision in individual assessments as well as a greater possibility of extremely significative intra and extra moenia activity settings have been of crucial importance. Among these settings we mention outings focussed on the attainment of self and social independence (supermarket, movies, etc.) as well as weekends spent in tourist places and visits to artistic cities (Naples, Florence, etc.) Contacts with local health structures, school structures (Working Group on Handicap (WGH)) and play and recreational associations have been important this year as well as in previous years. Psycho-educational and therapeutic meetings with family and parents played a significant role as well. This year our original group formed by six adolescents was enlarged to include six additional patients (three boys and three girls) whose neuro-psychologic and language assessments are still underway, whereas four receivers of the original group dropped out our project due to family reasons.
INDIVIDUAL THERAPEUTIC PROJECTS
As expressed in the initial report, our Parental project programme has remained unchanged. However, upon suggestion of the families themselves, "the dream" was the dominating topic of our meetings this year. The dream is seen as possible escape from a daily routine permeated by tasks, commitments and duties connected with the experience of limits that a disabled child continuously proposes. Therefore the dream becomes a possibility to taste life and its manifestations beyond the pain created by these "limits". The dream becomes the possibility to transform the experience of such a deep pain into a possibility to acquire knowledge, understanding and serenity. In the light of what done this year, we could conclude that families and especially parents met difficulties in expressing their dreams and giving them new and more creative shapes and dimensions. In fact, families who integrated the painful aspects due to the presence of "limits" and the "healthy", playful aspects of their family and social life were just a few. Most families showed that their interests, energies, worries were deeply linked to the more and more urgent problems, also in the development sphere, of their disabled children. Their activities with our therapeutic team gave them some creative and playful moments as well as the possibility of meeting their "dreamy" dimension, and this experience has been so significant that we think of repeating it in future programmes. However, the impact of our parental activities on children's individualised projects has been very significant, since what occurs in the family has a deep reflection on the disabled child.
Andrea, aged 16, has been diagnosed with a light mental retardation and relational and emotional difficulties; he goes to the second year of a vocational school for graphic arts. During this year Andrea has greatly modified his attitude and behaviour in the "Camelot" project. His attendance and commitment have changed and he has better expressed his desires and difficulties, as for instance his difficult involvement in expressive activities. He still shows behavioural problems in less structured settings. In fact, Andrea seems to have begun to take in - though with great suffering - his parents' separation, although deep relational problems with his father still remain. To help Andrea overcome this difficult emotional and relational situation, we implemented and individual psychological support which will be continued in future programmes. All therapeutic activities carried out in the Camelot project have been beneficial for his schoolwork, now deemed satisfactory, as shown by the Working Group on Handicap (WGH) held at his school.
Manual Activities (woodwork)
As concerns woodwork activities, Andrea has completely changed his attitude, motivation and commitment. His approach to these activities and knowledge of tools used for their performance remained consistent and he showed to possess good capabilities in using the necessary tools. Andrea's behaviour has been more fit-for-the-job, and his provocative attitudes were reduced and replaced by emotions expressed with less inhibition and by a special commitment and attention towards other group members. Andrea shows such a greater compliance with rules and a greater awareness of them that he can now be a model for the other group members. His moments of positive relationship with the therapist have increased and now he accepts and work out in a suitable way all messages proposed by the therapist. In the last months the therapist has become an important adult partner for Andrea, so that Andrea now opens his heart to him and in great confidence tells him about his feelings and family experiences. We therefore wish for a continuation of this activity, to provide the child with both the learning of specific competences and the emotional and relational dimension with other group members and the therapist as reference adult.
In this second year of computer therapy, Andrea expressed a more mature and interested approach towards IT activities and often had intuitions that enriched his knowledge. He continued to show a sincere interest in his work and used his capabilities in a more and more independent way both by indicating topics of interest for him and requesting more and more complex inputs. When working in a small group, Andrea has greatly modified his relational skills and has collaborated with and helped his group members with extreme competence and clarity. In the light of the good results achieved in word processing and editor applications, a continuation of proposed activities is strongly desirable. Parental meetings were necessary during the year to provide the needed psychologic support to parents.
Stefano C., aged 14, has been diagnosed a specific learning disability with provocative and opposing behaviour. He goes to year 1 at "P.Bassi" vocational school. His still unsolved problems concerning the separation of his parents have a great impact on his psychologic and physical well-being as well as his participation in our project, which is extremely erratic. His neuro-psychiatric assessment is still underway and carried out together with the Local Health Structure to which he belongs.
Occupational and Expressive Activities
His erratic presence and increased conflict behaviour have not allowed Stefano to benefit from proposed inputs. The only positive outcome of this activity was registered in Stefano's relational and emotional behaviour, since he used this opportunity to express and communicate his difficulties in integrating problematic aspects and situations in which he adapts himself better.
In this second year of computer therapy, Stefano showed an improved relation with the computer and effectively achieved the proposed goals. He attained excellent competences in word processing and in the use of Internet, showing he was capable of a deep independence. Behavioural difficulties are still present in his relations with other group members, though his relation with the therapist has improved. Due to Stefano's interest in this activity and the results achieved, we strongly suggest a continuation of this therapy also to improve his behavioural patterns. As in the previous year, Parental meetings were necessary to provide the needed psychologic support to parents.
Aldo, aged 17, is diagnosed with a Specific Learning Disorder. He lives with his family, formed by his father, his mother and younger sister; his family is a normal and well structured one. Aldo goes to the 3rd year of a Vocational School for graphic designers. Upon meetings carried out by our therapeutic team , Aldo seems to have got himself well included in his class and follow school lessons with his schoolmates.
Occupational and Expressive Activities
During this year Aldo has had a really peculiar learning and knowledge experience as well as the possibility of expressing his deep and inner feelings. Due to an interesting individual programme and a consolidated relation with the therapist, Aldo could satisfactory achieve the proposed goals and also produce a "short guide" of those Rome districts he likes so much. Through this activity Aldo could attain project-designing and implementing competences as well as a reality contact with reality elements (visits to monuments, districts, structures, etc,). This enabled Aldo to achieve a better elaboration of the problems at the base of his aggressive behaviour and his lack of self-esteem. Results achieved allowed him to integrate successfully his school and rehabilitation experiences. In the light of the child's strong interest, we plan for the continuation of this experience.
Manual Activities (woodwork)
Aldo showed more and more his strong motivation and even proposed some activities to be performed, which is to be considered an important step forward. He reached good knowledge and activity organisation levels as well as full awareness of all working phases and was able to operate independently. Some behavioural problems still remain difficult to solve since they come from emotion management deficits (sexuality and aggressiveness), but he can better express them now. Aldo's interest in this activity is so strong that we can increase the number of sessions in view of Aldo's future employment possibilities.
Andrea, aged 15, is the only son of divorced parents. He presently lives with his mother and sees his father on a regular and continuous basis. He has been diagnosed with a Prader Willy Syndrome, associated to an Average Mental Retardation and a specific trouble of the linguistic and behavioural area. His emotion management results to be particularly compromised. He is in year 1 of a Business School.
During this year Andrea seemed to be calmer, more collaborative, more proposal-making and more attentive, and he could often respond to the tasks in useful and adequate ways. In comparison with his early project stages, now Andrea is more "controlled", less "overexcited" and more able to find better emotion handling strategies. Andrea has significantly adjusted his behaviour to the various situations he lives; in fact, during experiences external to the Camelot setting, Andrea could implement adequate behaviours and autonomously control his impulses and act in an adequate way, for instance, when in a supermarket. We suggest to continue this therapy since it is of great importance from both cognitive and emotional/relational viewpoints.
Andrea ha recently showed improved manual skills (work and prepare objects), improved learning capabilities as well as improved relational capabilities. Provocative attitudes towards other group members can be considered as disappeared and his attention is almost exclusively focussed on the tasks to be carried out. Andrea can use materials and tools in a suitable way and in some phases of his work he shows intuition and deduction capabilities that allow him to overcome problems without the help of the therapist. His clear satisfaction for the work he produces can be used as positive element to strengthen this activity. In subsequent project phases, in fact, this activity could have a positive impact on his cognitive strengthening as well as his behaviour.
Lately Andrea has shown to have improved his group relational capabilities; he pays more attention than in the past on his work, and shows a better self-control in emotionally difficult situations. He reacts less to other group members' provocative behaviours; he is very empathic and can better modulate the anxiety sometimes produced by the group. He is enthusiast about this activity and strengthened by the positive transfer with his therapist, and therefore he succeeds in accepting setting modifications and working also with other therapists. Work carried out has been significant and functional to his learning, relational and emotion-handling capabilities. In the light of results achieved, we suggest a continuation of this activity, also in a restricted group.
Federico, aged 13 years and 11 months, is the sole child of divorced parents. He lives with his mother and sees his father on a regular basis. He is diagnosed with a Mixed Type Specific Learning Disorder and suffering from prior language disorder. His parents are separated; he lives with his mother and sees his father on a regular basis. He is in year 1 of a Hotel and Catering College.
Occupational and Expressive Activities
The patient seems to have grown, and some of his childish behaviours have diminished. His relation with therapists and group members has improved, as also his emotion handling skills, and, what is more important for him, he shows a better self- confidence. He is more available to others and responds to adult's requests with good results. In the light of results attained, we suggest a continuation of these activities.
Federico shows greater relational capabilities not only towards the therapist but also towards his group members. Though some childish behaviours still remain, Federico seems to have not only greater empathic capabilities but also greater abilities in balancing pleasure and reality. This activity has enabled Federico to express topics linked to aspects such as aggressiveness, sexuality, male-female dimension, social roles, etc. The main goal attained was a strengthening of self-esteem and proposal-making capabilities as well as the contacting of some dimensions of his"self" that he usually kept hidden. We suggest to continue this experience, not only to get the achieved goals settled, but also to strengthen his listening capabilities and his acceptance of changes and unexpected events, which the patient still lacks.
Cognitive and Computer Activities
The patient shows to have grown up a lot, both in his language capabilities and in his behaviour. He collaborates more and pays more attention to what he does and is more tolerant about frustration. During our meetings Federico made more proposals and was more interested in the setting, though some mistrust towards his group fellows remains. Federico showed to possess greater verbal capabilities to express his feelings; unlike past situations, these capabilities allow him to solve conflicts with some group members. Activities carried out have also treated his motivation sphere and tried to soften anxiety, which often arose when he had to perform some tasks or face some difficulties. The fact that he has reached an almost total independence in performing some cognitive tasks can be considered as an important achievement. We suggest the continuation of this experience to strengthen autonomy (money knowledge, watch reading, etc.). His cognitive strengthening and greater self-esteem have enabled Federico to use the computer in a more autonomous way and increase the use of this tool. Psychological support to his parents has become more and more effective.
Giovanna, aged 18, is diagnosed with consequences from serious head injury and widespread problems to cognitive unctions as well as optic atrophy to her left eye. She lives with her family, her parents and an elder brother; she goes to year 3 of a vocational school for tourism and trade. In the last months a state of depression arose and had great negative impactson her rehabilitation, also due to her continue and significant absences.
The proposed therapeutic goals have not been achieved sufficiently, also due to the erratic presence of the patient, probably due to the state of depression she went through. It seems that she has lately expressed a renewed interest this activity, also thanks to a specific intervention linked to the aesthetic care of her person. The fact that her friends have difficulties in accepting Giovanna's limits is not helping her to fully participate in activities.
Although she seems to have a good relation with the therapist and although she possesses good manual skills, at a certain point she decided not to participate any more in the activities.
Occupational and Expressive Activities
the other group members showed a lack of acceptance about Giovanna's limits, and this causes her limited participation in these activities. Due to this situation, we suggest individual therapy.
Her state of depression and erratic presence in the activities did not allow her to reach the proposed goals, although when present she showed interest, participation, communication skills and a good use of tools. Since she is not well integrated in the group, we propose an individual therapy for next year or her presence in a group that could help her.
In this activity she participated in two subgroups: a theatre therapy group and a theatre/music therapy group. This second group seemed to be her chosen setting, since the presence of two therapists allowed Giovanna to have a rehabilitation therapy more in tune with her needs. In fact, although experiencing some difficulties, Giovanna showed good participation, listening capabilities, good expression of her experiences, sometimes in a surprising way.
She showed she could establish positive relations with the adults and members of her same age as well as soften her "whims" and difficulties through the listening of other group members. Although an individual therapy is strongly suggested, in the light of what above we can also think of a continuation of her activities in this second group.
Alessia, aged 16, is diagnosed with a Learning Disorder and associated Attention Deficit. She lives with her parents and an elder brother. The family feels the effects of the parents' highly annxious behaviour. She is in year 2 of a Vocational School for Social Sciences. From the meetings held with the didactic team through the Working Group on Handicap (WGH), it appears that she has improved her PEI and also her relations with her classmates.
During this year, Alessia greatly improved her cognitive, relational and reality management capabilities.In fact she was more collaborative and more interested in the activity, and showed an adequate behaviour full of interest and enthusiasm.Alessia has become more friendly, and shows care for her companions experiencing difficulties; she has refined her communication skills and seems able to listen to others and intervene, also with empathic skills, in a "tonic" dialogue. Her contact with real events is still creating problems, especially when she tells about herself and her experiences.Since her intelligence is mainly practical and situational, Alessia can fully perform non-complex tasks requiring abstract thinking.Some goods capabilities linked to personal and social independence allow her to enjoy autonomy in small daily tasks. In the light of results achieved, we plan for the continuation of this therapy. As initially decided, support meetings have been held with her parents to help them manage their anxiety.
Flavia is a 15-year-old girl diagnosed with post-vaccination Autistic Syndrome, serious development block in several psycho-cognitive, behavioural and relational areas. She lives with her parents and an elder brother. Flavia is in year 1 of "L.Pirandello" pedagogic school.
Flavia participates in the Music Therapy doing both an individual programme and a small group activity. In both cases her relation with the therapist has strengthened and has been improved by elements such as prolonged eye contact, used to get support as well as to share experience and confidence. Her relation with other group member is good; Flavia shows caring and a liking for them and calls them by name, smiles to them and sometimes kisses them on their cheeks. She likes very much the activities carried out individually as well as her participation in the small group and her interest and attention seem to have improved both in quality and quantity. She uses spontaneously all music instruments. These have been changed during the year and she gives priority to the use of her body movements and her voice as chosen communication tool in indidividual meetings. Since the proposed goals have been only partially achieved, we suggest a continuation of therapy.
Flavia shows attention and a friendly attitude, smiles in tune with witty remarks and participates in group attivities within the setting. She undestands and adequately performs the requested tasks. The presence of a new group member led Flavia to withdraw into herself, withdrawal expressed by a greater passiveness and a peculiar attitude (head deep set between her shoulders, arms along her bust and tensed, the palms of her hands and her eyes lifted up). She has a positive and caring relation with her therapist. We suggest a continuation of group activities more and more matched with her needs.
Flavia has good manual skills and abilities with different materials. She can clip out images from a paper and make a collage. Her erratic presence in this activity has non allowed her to reach the proposed goals. She should continue the therapy to develop her manual skills.
Mirko, aged 19, is diagnosed with a serious Average Mental Retardation and complete blindness since birth. He lives with his family, his parents and a younger sister. His family seems to be completely centered around his rehabilitation needs and shows a strong social and relational isolation, aspects that are equally pronounced in Mirko. He presently goes to several learning and rehabilitation centres. He started an individual psychoterapy 6 years ago and still continues it.
Mirko participates in the Music Therapy doing both an individual programme and a small group activity. In his individual programme Mirko experienced sounds different from those he heard last year; the therapist used amplified instruments that stimulated Mirko and renewed his interest and destre to explore and look for different sounds; this make it possibile to start a new therapy in which integrated technologies and classic instruments will better meet the inputs suggested by Mirko. In the light of what above, we suggest a continuation of therapy. In the small group therapy, characterised by the presence of two therapists, Mirko showed a liking and caring for a girl of his same age that he often calls by her name; he also shows happiness and involvement in the activities. His relation with the therapists is good, though he shows a preference for his male therapist. He shows prolonged attention when he participates in the production of sounds aw s well as when he spontaneously decides to listen to sounds. Mirko has also improved his language skills. Conflict behaviours, though decreasing, are still expressed at the end of meetings. Therefore, proposed goals were just partially achieved and we suggest a continuation of therapy.
Mirko likes to work in a small group and can make proposals also when no music instrument is available. He pays great attention and responds and rapidly performs the requested tasks. Conflict behaviours still remain, as well as a withdrawal towards others, which is expressed in his bending-forward attitute at the end of meetings. Proposed goals were just partially achieved and we suggest a continuation of therapy.
Mirko participated in these activities as member of a small group. Though the reference adult was present in the activities and played a basic role of mediation at the beginning of activities, it was almost impossible to involve Mirko in these activities.
Martina is a 14-year-old girl diagnosed with a fair-light cognitive retardation and language disorder, probably due to emotiveness. She lives with her family: father, mother and younger brother. She is presently in year 1 of the third School of Arts.
Martina has a positive relationship with the therapist and with the other group members; also her approach with the computer is good. The girl is very slow in the carrying out of assigned taks and has a poor working method. With the help of the therapist she succeeds in performing adequately in her tasks. This activity must be continued to strengthen and develop the acquired competences.
Martina has assiduously participated in the activity with positive results. She is more mature in comparison to the beginning of the year, more able to develop the tasks given to her and more able to hold up the comparison with the group. Its language difficulties seem to have slightly decreases, while the perception she has of herself, her body and of her abilities remains a problem. Her anxiety in carrying out a task remains anyway very high. In the light of these difficulties, we deem it necessary to continue this therapy.
Occupational and Expressive Activities
As concerns this activity, Martina confirms her quite good skills in fulfilling her tasks. It is therefore important to continue this therapy and enrich it with a wider range of inputs and requirements. It must be noted that she has a high level of anxiety in carrying out her work and precise relation difficulties with her group members, since she cannot hold up the conflicts she meets in the rehabilitation setting.
In this activity she showed a growing interest and the pleasure of participating in it. She responds in an adequate way to sound and music stimuli and uses available music instruments in a proper way. Progress was achieved in her attention deficits and now Martina can perform for a longer time and better express her feelings and emotions through music and sounds. Her use of voice has improved as well as her dancing and body skills; in fact she uses her voice with self-confidence in group singing as well as in solo performances, and her use of dance and body movements expresses a joyful relation with her body movements that she now uses without difficulty.
This activity must be continued for the following purposes:
- Develop positive emotional relations with the therapists and other group members
- Develop self-esteem
- Foster creative movement experiences in which Martina can improve the awareness of her creative skills and experience greater awareness and a better relation with her body
- Foster the expression of her feelings through the use of music instruments and of her voice
- Increase her attention in listening to her own and people's music productions.
In the last year Martina achieved very important results. She is more friendly, more caring, more smiling; her anxiey decreased and by consequence also her stammer decreased. Her tales are less redundant, less stereotyped in their contents and ways of communication. Martina seems less childish in her behaviour and more attentive and more friendly to others; in fact she shows greater availability and less mistrust, and shares her behaviours and feelings with others. In the light of results achieved, we suggest to continue this activity to further strengthen the interation of Martina's psychical and physical aspects.
Meetings held with Martina showed a lack of self-esteem and non-acceptance of her body. Our therapy focussed on the strengthening of her self-esteem and the integrations of her limits and strengths. This psychologic support needs to be continued in view of a deeper awareness of her potentialities and limits.
Jacopo, aged 15, is diagnosed with a Light Cognitive Retardation and motor, memory and space and time difficulties due to a neurologic deficit of unknown origin. He also has continuous epileptic crises. His parents are divorced and Jacopo lives with her mother and an elder brother; his father presently shows great difficulties in meeting his son on a regular basis. Jacopo goes to year 2 of the Vocational School for Opticians.
Cognitive Occupational Activities
In the last year, thanks to an improvement in his health conditions and epileptic crises, he seems calmer, more available and collaborative; he has improved his tolerance of frustrations and diminished his use of seductiveness in his relations. When assigned a task, Jacopo shows interest and involvement, thanks also to a more constant attention. His emotive and cognitive aspects seem to be better harmonised and his critical skills have increased, and therefore he can make choices that are more in tune with his needs. In the light of what above, we suggest the continuation of this therapy.
Occupational and Expressive Music Activities
Jacopo seems to have perfectly understood the aims of proposed tasks, which consist in the integration of music stimuli and manual work on associated materials and forms. His attention and mnemonic skills have increased, whereas the seductiveness he has always used in his relations with the reference adult is decreased.
Jacopo is more motivated towards this therapy and more collaborative in its activities. Conflict and sometimes provocative behaviours have decreased. He can keep focussed and attentive on someting for a longer time, though this increased capacity is always connected to his health conditions. He dark listens to other group members and intervenes in the discussions, at times also in with a critical mind. His memory in remembering events has improved, though his long term memory is still showing deficits. In problem solving, if helped by the therapist leading the processing of problems to be solved, he is more and more able to frame the initial situation and undestand its goal. We suggest to continue this therapy so to increase his cognitive capabilities and attempt to minimize his obivious deficits.
During this year Jacopo significantly modified his attitute in the activities; he is more motivate and has a greater proposal-making attitude, whereas his "istrionic" behaviour has greatly diminished. Attention and participation have increased, and now in carrying out the assigned tasks he tries to find possible problem-solving strategies even without the help of the therapist. His manual skills and knowledge of tools have improved. His relation with the therapist and other group members is good. We suggest to continue this therapy so to strengthen acquired skills.
Meetings of psychologic support were held once a week. In the first meetings Jacopo used his seductiveness to avoid the establishment of a significant relation with the therapist; he also had to conquer her confidence and establish a relation that could really provide psychologic support. His relation with the therapist is presently established and it has been possible to begin to work on identity and family-related problems as well as on his relations with other children of his same age. This therapy must be continued to help Jacopo face his problems. His parents received psychologic support. His mother, in particular, needed such support to strengthen her parental functions.
Mario, aged 17, suffers from Average Mental Retardation and behavioural disorders as well as general immature behaviour and development. He lives with his uncle and aunt to whom he has been entrusted; his family situation seems to be very complex. Mario is in year 1 of a Vocational School
Manual activities (woodwork)
Thanks to a constant presence, Mario has been able to profit of such experience in a meaningful way; in fact both his ability to interact with other group members and his increased knowledge of the activity contents, the application techniques and tools seem to have been modified, with consequent greater confidence in planning the work to be carried out. What most, Mario Mario also modified his ability of acquiring abstract concepts and tranferring them in an adequate way to new work to be developed. His relation with the therapist and group members has improved, since he now has a better knowledge of social rules. The satisfactory results achieved hint at the possible succesful acquisition of further objectives to be pursued, as for example an improved knowledge of social and behavioral rules and a greater orientation towards reality.
Occupational, Expressive and Music Activities
In his progress, Mario showed a great ability to understand the proposed tasks and perform them; his creative coupling of sound and emotions and relevant forms was extremely significative, also because the forms were always consistent with the contest. In this activity he has also shown a series of manual skills well coupled with cognitive abilities, and therefore we suggest to continue this activity in both individual and group settings.
In this therapy Mario had to use a personal computer as support in carrying out basic writing and reading tasks and overcoming some spelling difficulties. Durino this year, his strong destre to improve his writing and reading competences made it possible a great commitment in overcoming his literacy limits. We plan to continue this important experience, also to the benefit of his classroom activities, and work with him in a small group or in individual settings.
Apart from improved relations with therapist and group member, this activity showed a significant change since Mario gave up some TV stereotypes he used (he watches TV for many hours) and began to express emotional contents more in tune with his personal reality. Besides an adeguate use of music instruments, Mario expressed and performed some emotions, such as anger, for instance. Moreover, he has acquired a new ability: he can now enjoy psychic and physical relaxation at the end of activities since he now allows himself to reflect and even metacomunicate the events just experienced. This activity is so important and significative that we suggest to continue with it. Psycologic support was provided to his parents with the aim of easening family conflicts and strengthening parental functions.
Giorgio is aged 11 and suffers from Light Cognitive and Language Retardation associated with attention deficit and poor behavioural control. He lives with his parents and a 16-year-old sister. Family atmosphere is serene. He is in year 5 of primary school and his school relations are good.
Thanks to his liking and affection, Giorgio has been able to get involved in the activities without great problems and he has not taken much time to acquire the stimuli provided by the therapist;he has succeeded in fact without particular difficulties in translating such information into actions, performing some tasks composed of simple passages and getting satisfactory results. Giorgio knows how to make proposals, with simple ideas and fit to his possibilities; he succeeds in brightly overcoming all those possible difficulties that may arise during the performance of his tasks by using simple but functional strategies.With the passing of time, his learning and attention abilities improved so much that often Giorgio did not show any sign of frustration or tiredness for the whole duration of the activity. However, Giorgio shows difficulty in putting his actions into words, since he has a poor vocabulary and a difficulty in the correct use of words and verbs. In the light of a strengthening his cognitive and practical abilities, we suggest to continue this therapy.
In this second year of activity, Giorgio maintained unchanged his motivation and desire to perform the proposed tasks, characterised by a playful use of personal computer as well as its merely technical use (microsoft word and Internet applications). For what above, the continuation of this therapy is very important.
This therapy has been characterised by a significative consolidation of his relation with the therapist and by an active participation in the activities. Giorgio increased his self-esteem and thus could express greater confidence in performing some musical ideas or in inventing a story or expressing some emotions. During our meetings Giorgio expressed curiosity, desire to share his experience, joy, wish to know and explore things, though often coupled with anxiety and restlessness, also motor restlessness, which demanded control strategies. However, his attention and ability to fix his mind on a thought remain very poor. It is therefore necessary to continue with this therapy.
Michele, aged 12, suffers from Attention Deficit, Hyperactivity and Impulsiveness, but his cognitive development is almost normal. He lives with his parents and an elder brother; his parents show great difficulties in the management of the complex education and relational situations of their children. He is in year 2 of middle school.
Manual activities (woodwork)
The progress achieved by Michele in these activities continues in a satisfactory way, though huge behavioural problems still remain. Michele shows great interest in this work, diligently performs the assigned tasks and shows good manual skills. Michele is greatly satisfied when he can plan and perform small woodwork tasks and shares their practical content with his group members in a suitable way. He has a good interaction with other group members, though he shows perhaps too much "exuberance" in it. It must be noted that the way in which Michele uses his logic reasoning has improved the implementation of problem solving strategies, and in this way Michele was often able to cope extremely well with obstacles arisen during working phases. His behavioural problems as well as his attention deficits make it necessari to continue this activity in the light of the child's strong motivation towards it.
His behavioural problems and his strong desire of independence make it difficult to carry out social and rehabilitation activities. Conflict behaviours have increased, although his relation with the therapist is basically good. However, it must be said that the results achieved in word processing are quite good. Family therapy is underway to improve relations and communications in the family and strengthen parental functions.
Sara D. M.
Sara, aged 14, shows a fair-light Cognitive Retardation with lack of attention, dysarthria and dyslexia. She lives with her parents and an elder brother. She goes to year 2 of the Middle School and has joined our Camelot project this year. She apparently enjoys a serene family atmosphere.
Occupational and Expressive Activities
In this setting Sara showed great difficulties of interaction with the other group members, as well as anxiety and psychosomatic discomfort. In fact, due to her problems, she seems to experience any relation in a very anxious way, and therefore she avoids to establish relations. In a more individual settino, Sara showed greater attention ability and good manual skills and therefore participated more in the activities. In the light of what above, we suggest individual therapy.
After some initial difficulties due to high levels of anxiety that forced Sara to look for strategies to avoid the assigned tasks, she has recently expressed less problems in being involved in the setting, she seems to pay more attention to what goes on and to show more confidence in her relations. In fact, since she wants to be independent, Sara tries to establish relations with those stronger group members who inevitably overcome her in her abilities and personality. Sara's most important achievement was an increased ability in establishing and carrying out relations. This is the priority that makes us suggest the continuation of theatre therapy.
This activity focussed mainly on relational purposes. After burdens initial difficulties two to her relational problems, anxiety, fear and lack of self-esteem, Sarah could partly change her relational behaviour thanks also to the help of the therapist and could get involved in the setting and positive perform behaviours, such as bringing the music tapes to be used to listen and dance together. In the light of what above, we can notice a partial achievement of proposed goals and terefore propose to continue this therapy also in individual settings.
Valeria, aged 17, shows learning difficulties and retardation in symbolic, graphic and practical performances. She lives with her parents and dropped out school due to problems with her schoolmates. This is her first year in the Camelot Project.
Valeria got involved in this activity with great enthusiasm, and showed good manual and cognitive skills in taking care of herself. She suitably processes the proposed therapeutic inputs and plays an active role in enriching the activity by bringing ad hoc materials. She succeeded in translating these therapeutic attainments in her family and private life. Behavioural difficulties still remain in her relation with group members, also due to some "restlessness" she lately showed in her behaviour. We suggest to continue this therapy in order to strengthen her identity.
Occupational and Expressive Activities
These activities (realisation of dressmaking linked to woman identity) has greatly troubled Valeria's inner world so that she had to drop out this therapy. This input was perhaps too strong for her, due to some problems she has in acknolwedging her body features.
Valeria showed great interest in computer experiences, and worked in tune with the proposed goals; in fact she is getting very good results in the use of word processing programmes. Pur manifestando alcuni comportamenti oppositivi, di natura prevalentemente emotiva, Valeria showed to possess the necessari qualifications to acuire further computer skills. To this end we suggest her involvement in this activity also next year.
Valeria participated in music activities with interest and pleasure, and enthusiastically accepted all proposed inputs. She showed to possess abilities both in spontaneous production and in the use of her voice. Ambivalent and divergent behaviours were noted in her involvement: she made proposals, smiled, was happy, self-confident, friendly and attentive to exchanges with other participants, she showed curiosity towards the new inputs, but all this was counterbalanced by moments or days in which she was angry, she had the sulks, showed conflict behaviours or depreciation for her work and for what the group was doing. In so doing, she showed great anxiety, that she expressed in pacing back and fro with anger and nervousness, and sometimes she also put these emotions into words, thus showing a good awareness of her emotions. Sometimes Valeria showed to be strong, determined and self-confident, whereas other times she expressed great fragility, lack of self-confidence, frustration, which denoted some depression and experiences of refusal. The continuation of this activity will therefore be focussed on a greater control of her ambivalence and on a greater harmonisation of her strongly conflictual aspects. This assessment is also shared by the therapist of this activity.
Gianluca, aged 13, suffers from Down Syndrome with fair retardation. He lives with his parents, an elder sister and his maternal grandparents.He goes to year 2 of Middle School. He joined the Camelot Project this year
Gianluca is motivated and interestest in the use of the computer as an IT means and a working tool (use of word processing and Internet), and a play tool. He has established a good relation with the therapist, though at the beginning he seemed to make the therapist the object of a morbid behaviour and this made it difficult to work with other group members. Now Gianluca shows greater tolerance towards frustration that may arise when facing difficulties in achieving his tasks. Due to his interest and motivation and also due to the partial achievement of proposed goals, we suggest to continue this therapy.
Motivated and interested in this activity, Gianluca showed good skills, abilities and appropriate actions in performing the assigned tasks and in using tools; his manual skills have improved. His aggressive use of words and "jocose" behaviours that troubled the work of other group members have decreased. His relation with the therapist and other members is good. It is therefore desirable to pursue this activity.
Elena M. G.
Elena, aged 17, is of Rumanian origin and has come to Italy in 1995; she lives with her foster parents and two foster brothers. She shows a mental retardation not yet officially diagnosed as well as serious genital and urinary problems and terminal renal insufficiency treated with haemodialysis. She is repeating year 3 of Middle School. Her neuropsychologic screening is still underway.
Elena's serious and complex relational problems made us give priority to the establishment of positive relations with the therapist and other group members. In fact Elena did not show great problems in understandin the proposed setting and inputs. Her difficulty was the sharing of learning and of "emotional" spaces with the other group members. It must be noticed, however, that the proposed goals were partially reached; for this reason, Elena's involvement in future activities is desirable, also in the light of her strong motivation.
Supported by her positive trasnfer with the therapist, Elena could experience this setting with quite positive results. The activities were mainly focussed on the use of her voice abilities, which will be soon recorded on a CD that Elena wants to give to her parents. Her communication and relational behaviours with other group members and therapists remain difficult. For the next year, our goals will aim at facilitating communication and relational patterns.