Single Parenthood and Management of Special Needs Children- Autism and Down Syndrome in Calabar Metropolis, Cross River State, Nigeria.

Introduction

Single parenthood remains a complex phenomenon across tribes, cultures and race constituting major moral issues and making family living incomplete. It refers to a situation where either of the parents, mother or father, takes on the responsibility of raising a child or children without the support of the other biological parent (John & Shimfe, 2020). It is seen as a process or situation in which a single parent raises a child or children without a spouse or live-in partner which are supposed to contribute to positive attitude formation, development of behaviors and other socio-cultural attributes that helps the child or children function and achieve desired and meaningful life (Asiyatu, 2022; John & Shimfe, 2020).

Traditionally and within the African context, parenting involves two gender-linked roles, with the mother being involved in nurturing and providing emotional support to the child or children while the father provides, discipline and offer protection to the child or family as a whole. Supposedly, with the attainment of better education, higher income and gender equality campaign across most part of the world, one would think dual-care parenting will be enhanced but this is no longer the case (United State Census Bureau, 2023; Healy, Malley, & Stewart, 1990).)

According to the United States Census Bureau Press Release Number CB 23-SFS.37 (2023), U.S has the world’s highest rate of children living in single parent household with 12.9 million families headed by a single parent, 80% of which were headed by females (United State Census Bureau, 2023). In Nigeria, the situation is on the rise as available data shows 35% of the population is made up of single parents out of which 75% is attributed to divorce, separation, death of a spouse, single parent adoption, unintended pregnancy or birth to unmarried couples (Ugwuegede, Ngene, & Okoli 2020; John & Shimfe, 2020). However, children raised in such circumstances become less likely to form strong emotional bonds thereby promoting the likelihood for another generation of single parent also called vole family (Asiyatu, (2022).

Consequently, if the above is anything to go by, special needs children which is an umbrella term used to describe people who are handicap, disable, physically challenge, poorly gifted, mentally retarded, impaired etc. and require an additional care and support to carry on daily activities will be at risk of being properly managed by single parents. It is therefore pertinent to determine the relationship between single parenthood and the management of special needs children in Calabar Metropolis, Cross River State, Nigeria. This study therefor specifically seeks to assess the impact of single parenthood in the management of children with down syndrome and determine whether single parenthood affect management of autistic children in Calabar Metropolis.

Literature Review

Single parenthood and management of Autistic children

Autism according to Lagunju, Bella-Awusah, & Omigbodun (2014) has been described as one of the most common lifelong developmental disorders affecting children in their early stage of development. Most research around the globe draw conclusion to the fact that ASD is a medical condition (Al-Beltagi, 2021; Al-Shidhani, & Arora, 2012), however some studies mostly in sub-Saharan Africana and communities with strong puritanical ethos identified that this developmental condition is tagged with a spiritual connotation by some communities (Mthimunye, 2014; Ali, Al-Adwan, & Al-Naimat, 2019 Baffoe, 2013). Thus, Ali et al., 2019 describe it as one of the most confusing disorders for which not only no exact cause has been identified, but also no definitive cure has been found yet. Clinical Science reveals that one out of 125 to 150 Nigerian children is living with this condition amounting to about 600,000 cases with the male children more prone to the condition than female. Though this condition is prevalent in our society, little is known about autism, as myths and superstitions shroud scientific information.

Autism is diagnosed by observing the deficiencies in behavior in three areas that include the social interaction, communicative ability and the range of activity and interests, which is limited. Mthimunye, (2014), in addition to the inability of making friends posits obsessions, fears, a lack of awareness of danger, ritualistic play and behavior, inappropriate eye contact, hypersensitivity to sound, light and spinning objects and hand flapping as signs and symptoms of an autistic child. However, no medication has been found that allows the total cure of any of the autistic spectrum disorders, but there are many therapies that has been developed overtime aimed at improving the quality of life of children with autism according to Ali et al., (2019) which include: Behavioral therapy, TEACCH Method, Picture Exchange Communication System (PECS), Chemical/Drug, Diet without gluten and casein, Vitamins.

Single parenthood and management of children with Down Syndrome

Down syndrome (DS) also referred to as ‘Trisomy 21’ is like all the other disorders with huge medical and social cost according to John, & Shimfe, (2020) Down syndrome is usually associated with a number of phenotypes which include; congenital heart defects, leukemia: Alzhelmer’s disease and a host of others. According to John, & Shimfe, (2020) quoting the National Institute of Child Health and Human Development, Down syndrome occurs in approximately 1 in 800 newborns and thus seen as a genetic disorder caused by the presence of all or part of a third copy of chromosome 21 (47 chromosomes). All affected individuals experience cognitive delays, but the intellectual disability is usually mild to moderate. Carter, (2002) also held this view when he posits that Down Syndrome is a genetic condition that occurs when there is an extra copy of a specific chromosome; that is, chromosome 21.

Identifying children/people with DS is no difficult task. The head, face and neck features of children with DS according to John, & Shimfe, (2020) include brachycephaly (disproportionately shorter or small head or skull shape), usually round face, short neck, low-set, small ears, flat nasal bridge, microgenia (an abnormally small chin), macroglossia (protruding or oversized tongue) due to small oral cavity, small chin, almond shape to the eyes caused by an epicanthic fold of the eyelid and oblique palpebral fissures. These observable features clearly tell you if a child is suffering from down syndrome.

According to Amorha, Echeta & Ogochukwu (2017), DS prevalence in sub-Saharan Africa remains a largely unrecognized problem due to limited awareness of the problem in communities and those that are affected are usually isolated from others, even in schools. In Nigeria, studies of DS covering a period of 9 years revealed an incidence of 1 in 865 live births in a Nigerian hospital (Amorha, et al., 2017). Its causes could be linked to the genetic origin of an individual Ugwuegede, Ngene, & Okoli (2020). Therefore, children with Down Syndrome suffer from intellectual disability (Low IQ), heart problem at birth, thyroid abnormalities, hearing and vision problems, Gastrointestinal problems, gastro esophageal reflux, autism with challenges with social skills, communication and repetitive behavior, Lagunju et al., (2014)

John, & Shimfe, (2020) advance timely surgical treatment of cardiac defects during the first 6 months of life which may prevent other serious complication, balance diet, regular exercise and regular checkup to help manage Down syndrome. Ugwuegede, et al., (2020) agree totally to Shilfa’s management strategies and added the deployment of various therapies, the use and deployment of assistive technology such as seat cushions, making aids, pen grips, large button mobile phones and touch screen tablets etc.

Theoretical framework

The theoretical framework for this study rest on the social learning theory and the structural functionalism theory. The social learning theory propounded by a psychologist Albert Bandura (1901-1994) in the year 1977 in his book Social Learning Theory, attempt to explain how people (children) learn from others through interaction, how social context affects behavior of individual both at home and in the society where they live. This theory is seen as the most influential theory of learning and development and its proponent Albert Bandura (1952) is seen as the father of Cognitive theory. According to the theory, people learn by observing the behavior of others and as such, develop similar behavior and learning is achieved by assimilating and imitating others’ behavior especially if their observational experiences are positive or include rewards related to the observed behavior. Thus, imitation involves the actual reproduction of observed motor activities according to Banduras & Walters, (1977).

Applying the Bandura’s theory to this work, it can be said that children with autism and down syndrome experience difficult in learning process due to altered cognition and physiological wellbeing. Because learning also involves interaction assimilation and subsequent imitation of other people behaviours, children with these conditions finds it difficult to learn because these conditions disrupt their ability to interact and be interacted with thereby making learning process a difficult task

The structural functionalism theory by A. R. RadCliffe-Brown (1881-1955) in his book “Structure and Function in Primitive Society (1952) in the other hand seeks to explain the interrelationship between the various components in the society which have indispensable functions for one another; the continued existence of the one component is dependent on that of the other and for society as a whole which is seen as an integrated organic entity. Applying the structural functionalism theory to this work, social structure in this sense could be acceptable patterns, normal social relations or activities that conform to acceptable social rules or norms working towards enhancing the management of special needs children by single parents. It can also be seen as organizational structures put in place by the government of society to help in the training and support, rehabilitation, care as well as management of special need children.

Methodology

The research adopts a cross-sectional survey design and uses primary data generated from the field through interview and questionnaire for analysis on the relationship between single parenthood and management of special needs children (down syndrome and autism) in Calabar metropolis, Cross River State Nigeria. Two (2) schools namely Special Education School, Calabar and Hillcrest Special Needs Model School Calabar were identified as the site for this study as they specialize in the educational training and management of special needs children in Calabar metropolis. With support of the school management, a sample size or total of 36 respondents (19 children/single parents with autistic children and 17 children/ single parents having children with down syndrome) were identified and drown from the two schools using the cross-sectional survey design with simple random techniques in choosing the respondents to participate in the survey. Data collected were subjected to statistical treatment using descriptive statistical and presented in simple percentage. Data was analyzed using SPSS version 21.

Result

Result from the current study shows that 39% of single parents disagreed they have adequate knowledge about the causes and characteristics of autism and Down syndrome. 48% also refute that they were able to recognize the signs and symptoms of autism/Down syndrome early enough in my child. Whether they understand the basic management, care and support needs of children with autism and Down syndrome, 53% says no while another 58% acknowledge children with autism and Down syndrome required special medical, educational and therapeutic/intervention. Finally, majority (44%) admitted not knowing where to access reliable information and professional support regarding autism and Down syndrome for their children.

Data generated from the respondents on single parenthood and management of autistic children indicates that 47% of the respondents strongly agreed that their parents get stressed while taking care of them, 63% of the respondents agreed that they only have few friends due to their health challenge, 68% of the respondents agreed that they and their parents suffer stigmatization and neglect from members of the society. However, there is no clear agreement from the respondents when asked if people insult them and their parents because of their condition. 37% of the respondents agreed to being insulted while 37% of the respondents also disagreed to this. Furthermore, 53% of the respondents strongly agreed that their condition and challenges have improved since they started schooling.

From the above, 59% of the respondents disagreed that as a single parent their child receives adequate emotional support to promote their psychological well-being, 47% of the respondents disagreed to the question that their child receives sufficient time, attention and personalized care. However, 65% claim they are able to adequately meet the healthcare and educational needs of their child with Down syndrome independently without support. Notwithstanding, another 65% of single parents of children with Down syndrome admitted that a child with Down syndrome raised by two parents show healthy social interaction and communication skills compared to those raised by single parent and 41% of the respondents disagreed to the question “the overall quality of life of children with Down syndrome is positively influenced when raised by single parent.

Discussion, Conclusion and Recommendations

Effective single parenthood has remained a serious delusion with children at the negative receiving end. This can be further compounded by reduced care and affection especially in medical conditions like autism and Down syndrome. Although couple living together do not guarantee and accelerate relieve in these medical situations; it however, improve the psychological well-being of the child, reduce pressure from either parent and enhance health seeking behaviors that may culminate to the effective management and support for the child.

Findings from the current study indicate that 39% of respondent (single parents of children living with autism and Down syndrome in Calabar metropolis disagreed they have adequate knowledge about the causes and characteristics of autism and Down syndrome. 48% also refute that they were able to recognize the signs and symptoms of autism/Down syndrome early enough in my child. Additionally, 53% and 44% respectively do not understand the basic management or care needs and where to access reliable professional information and support for their child with autism and Down syndrome. This result is in line with the findings of Amorha et al., (2017) which assert that the problem remains largely unrecognized in Africa due to limited awareness to information and isolated from others. Although the causes of autism and down syndrome persist as genetical, the variability in the manifestation of the symptoms are wide Ashraf, & Majeed, (2011).

Furthermore, findings from the analyzed data on single parenthood and management of autistic children indicates that 47% of the respondents strongly agreed that their parents get stressed while taking care of them. However, there is no clear agreement from the respondents when asked if people insult them and their parents because of their condition. Notwithstanding, 53% of the respondents strongly agreed that their condition and challenges have improved since they started schooling. But 63% of the respondents agreed that they only have few friends due to their health challenge. These findings are again consistent with Mthimunye (2014) and report of Iyabo (2018), which posits the inability of making friends among children suffering from autism and down syndrome. According to Al-Shidhani, & Arora (2012), Karkera (2021), the conditions affect the individual’s experience and cognitive delays. This obviously makes most children not to identify with them as they may not appear smart or intelligent in class or social activities.

Stress according to the findings of the most difficult experience single parents faced while managing their children with special needs. Most respondent agreed that they have gone through several stages of stress including financial stress, emotional stress in the cause of managing their children. This finding and conclusion is in agreement with the report of Iyabo (2018) and findings of Mthimunye, (2014) and Anderson, (2014) who posit that “parents of children with a disability tend to experience higher level of stress than a parent of a typical developing child.

Therefore, working alone as a sole parent have may not minimizing the challenges in managing children with special needs because they assume the responsibility of the home alone. Government and non-governmental organization including social workers have not done much in providing support to single parents to help manage children with special needs according to the findings. The view of the single parents was validated by the responses from the children who also echoed this point that government presence and that of non-governmental organizations or social workers is poor and, in some cases, non-existence since they can access reliable information from professionals.

Finance from the study plays a vital role in the management of special needs children. This is evident to the fact that all respondent agreed that finance constitute one of the major challenges they face in managing their children with special needs properly. This ascertain is in agreement with Anderson, (2014); Healy, Malley, & Stewart, (1990) and Iyabo (2018) who among other things point at the cost of treatment and therapy as the most challenging factor in the management of a child with autism and other special needs children alike.

Conclusion

Drawing from the analyzed data, the following conclusion was made;

1. Single parenthood has not foster better or improve management of children with special needs rather it has a negative impact on the parents and their children alike.

2. Though the children are termed special and often stereotyped negatively, it is evident from the study that they have potentials and abilities that could benefits them and the society if they are properly harnessed, utilized and managed.

3. With proper sensitization, information, and early medical intervention, most of the severity of the cases associated with special needs children will be curtailed and brought to the barest minimum thereby allowing and giving them better opportunities to participate adequately in the society with less stress.

Recommendations

Based on the research findings, the following recommendations are made;

1. All stakeholders should intensify efforts in educating the public on the peculiarities of this life-long health challenges faced by special needs children so that actions are taken early enough in their managements.

2. Funds should be made available through the National Health Insurance Scheme or interest free loans or grants to single parents with special needs children to enable them carry on the responsibilities of managing their children.

3. Social workers should also advocate for these categories of persons for a better living by attracting donor agencies to them.

4. Care homes, dormitories, professionals and skilled manpower should be made available to help cater for the needs of special needs children thereby giving their parents leverage to pursue their life goals.