Populations

1
(No Transcript)
2
(No Transcript)
3
Learning Objectives

• At the end of this session, you will be able to
• Recognize strengths in families children with
  Developmental challenges
• Identify factors contributing to issues for
  children with complex learning, medical social
  needs
• Learn how to promote coping strategies in families

4
Populations

• Child Development Program
• Cerebral Palsy/Neuromotor
• Neurodevelopmental Disorders (e.g.
  neurofibramatosis)
• Neurogenetic Conditions (e.g. Sotos Syndrome)
• Epilepsy
• Autism
• Children with complex needs

5

• Cleft Lip Palate/Craniofacial Differences
• Spina Bifida
• Neuromuscular (e.g. Duchennes Dystrophy)

6
(No Transcript)
7
Interdisciplinary Team Approach

• Disciplines Available
• Developmental Paediatrician
• Psychology
• Speech Language
• Occupational Therapy
• Social Work
• Others may include
• Physiotherapy
• Dietician
• Nursing

8

• Diagnostic Assessments
• Physical/Medical
• Learning/Developmental
• Psychosocial Interventions
• Parenting groups
• Child groups (Kid Talk CBT)
• Partnering with Other Community Agencies

9
(No Transcript)
10
Risk/Protective Factors

• Risk
• Child characteristics (e.g. difficult
  temperament)
• Parent characteristics (e.g. psychiatric history)
• Violence/trauma/significant loss
• Socioeconomic disadvantage
• Cultural change/ESL/access/advocacy

11

• Protective
• Child characteristics (cognitive ability)
• Parent characteristics (e.g. responsive
  parenting)
• More resources and support (e.g. financial or
  extended family)
• Prosocial media exposure
• Sense of belonging/community

12
(No Transcript)
13
Prevalence/Epidemiology

• 2/1000 Canadian children with CP
• 40 LD in children with CP
• Male-to-female ratio about 6040
• 35 epilepsy in children with CP
• Botox for spasticity (stiff muscles)
• Many other medically complex conditions
• Course of disorders
• Preschool ? School-age ? Adolescence
• Transition to adulthood

14
(No Transcript)
15
Domains

• Social/friendships
• Emotional Regulation
• Self-help/independence
• Self-esteem/confidence/assertiveness
• Behaviour
• Recreation/leisure/participation

16

• Language
• Cognitive
• Attention
• Fine-motor
• Gross-motor
• Physical health

17
(No Transcript)
18
Models

• For social-emotional and behavioural
  competencies
• Behaviour Therapy
• Response-Reinforcement Effects
• Cognitive
• Change Thinking Patterns
• Ecological
• Influence of Environment Factors
• Biological
• Understanding Genetic Medical Condition

19
(No Transcript)
20
Case 1 Presentation

• 7-year-old girl in grade 2
• Premature 32 weeks 2.45kg
• Hospitalized 6 weeks tube feeding
• Low tone hyperbilirubinemia
• Delayed milestones walking and talking
• Mother had 5 miscarriages previously
• Sensory issues (auditory/tactile)
• Attention concerns
• Behavioural (oppositional/aggression)
• Social difficulties (not autism spectrum)

21
Assessment

• Psychoeducational assessment
• Cognitive - visual superior - verbal average
• Weaker processing (speed, memory, and fine-motor)
• Math average word decoding below
• Inattention/parent anxiety/teacher
• Speech language assessment (expressive weak)
• Language-based Learning Disability

22
Services

• Developmental Paediatrician
• Physiotherapy
• Occupational Therapy
• Psychology
• Speech Language
• Social Work
• Feeding Clinic
• Behaviour Management
• Liaison Teacher

23
Issues

• Different perceptions at home and school
• Identification (IPRC) and programming (IEP)
• School visit and support from Bloorview teacher
• Mothers concern re behaviour and
  social-emotional
• Translator at Bloorview and school
• Revisiting findings with mother (e.g. LD)
• Aisling Centre parenting sessions Chinese
• OT for sensory and motor speech language tutor

24
(No Transcript)
25
Case 2 Presentation

• 9-year-old boy in grade 4
• Cardiac surgery for transposition of arteries
• Repaired late at 18 months
• Imaging (MRI) anomalies from cardiac history
• Mild cerebral palsy (spastic triplegia)
• OT for fine and gross motor issues
• Writing skills and computer main focus
• ESL student at school initially
• Family from Pakistan and speak Urdu
• Father and one brother remain in Pakistan

26
Assessment

• Psychoeducational assessment
• Cognitive average to low average nonverbal
• Borderline verbal and working
  memory
• Academic all areas below average
• Strengths in social and adaptive skills
• Some minor inattention at clinic
• Speech and language assessment (receptive weak)
• Language-based Learning Disability

27
Services

• Developmental Paediatrician
• Physiotherapy
• Occupational Therapy
• Psychology
• Speech Language
• Social Work
• Orthotics
• Interim federal health funding

28
Issues

• English Second Language (ESL)
• Medical concerns
• Learning problems
• Family situation
• Bullying
• Attention
• Participation in Kid Talk group

29
(No Transcript)
30
Agencies/Resources

• Integra
• Aisling
• CAMH Child and Family
• Creche Earlscourt (Child Development Institute)
• Books Growing up Resilient
• Keys to Parenting Your Anxious Child
• The Optimistic Child
• Mental, Emotional, Social Health
• Parentbooks Store/Website

31
(No Transcript)
32
VIDEO CLIPS FROM FILM My Different Life

• Illustrates mother of 3 children with learning,
  behaviour, and emotional issues
• Demonstrates how she copes with
  multidimensional family and systems issues

33
(No Transcript)
34
Social Work Role

• Interdisciplinary Team
• Parents
• Child
• Schools
• Parent Education and Support
• Group
• Kid Talk Group

35
Social Work Values

• We value the uniqueness of the individual, the
  power and strength of families, and the
  importance of communities.

36
Explore Parent and Child Strengths
The strengths model of Social Work practice
allows the practitioner to respect the clients
abilities, beliefs, values, support systems, and
goals. It acknowledges societal barriers, family
dynamics and intrapsychic challenges . The
framework suggests the worker and client
collaborate in all phases of the therapeutic
alliance. (Saleeby, et al)
37
The model emphasizes consumer resiliency, choice,
self-determination and shared decision-making
38
What Are Strengths?

• What people have learned about themselves
• How they have coped with their lives so far
• People learn from their difficulties as well as
  their successes
• Personal qualities, traits and virtues we
  possess e.g. sense of humour, caring,
  creativity, loyalty, insight, independence,
  patience, etc.

39
Strengths contd

• How one has managed grief, illness or other
  life challenges in the past
• Hidden Talents Such as musicality, cooking,
  creativity, being a good friend
• Sources of meaning /inspiration From cultural
  and spiritual life in times of difficulty

40
Inner Strengths and Community Support
It is the ability to have survived in
circumstances that may have been detrimental to
them in the past. It is who they connect with
within their community. E.g. the local shop, the
pub, the church, etc.
41
Common Concerns

• Access to testing
• Implementation and recommendations
• Lack of funding/resources
• Poor social skills
• Unpredictable behaviour
• Sensory issues
• Lack of friends
• Teasing/Bullying

42
Bullying in this population

• My daughter has been bullied for the past 5
  years
• My son is an easy target
• She doesnt know what a friend is
• A 2003 Canadian council on Social Development
  study noted that 11 of children with special
  needs aged 10 and 11 reported they were bullied
  all or most of the time vs. 5 of peers without
  disabilities.

43
Cultural
The cultural style of a family may be influences
by ethnic, racial or religious factors or by
socio-economic status. Cultural beliefs can
effect the manner in which familys adapt to a
member with a disability The Family Journal,
2005
44
In a Comparative Profile Citizen and
Immigration Canada (April 2005)
Nearly one in 3 families in Toronto is a recent
immigrant family. In Canada as a whole, one in
nine families is a recent immigrant family.
45
Bloorview Kids Rehab 2007
46
Impact on Family System When the family system
includes a child with a disability, member
functions and roles may be modified, priorities
change, and the family financial stability may be
effected. Recreational and social activities may
need to be modified, career choices and career
ladder may be restricted and the time required to
carry out routine functions may be increased.
(Turnball Turnball, 1986)
47
Klaus Kennell have suggested that the quality
and character of parent-infant bonding is a
determining factor in the nature of the childs
relationships with other individuals in the
future. Although a child may be able to live
with a disability, the quality of his or her life
may depend to a large degree on the parents
ability to love the child completely. Parents
who are aware of the childs limitations but able
to offer love helps the child believe he or she
is worthy of being loved.
(Bristor, 1991)
48
Theoretical Models

• Family Systems
• Attachment Theory
• Lifecycle Model
• Strengths Resiliency

49
Multidimensional Approach
When the school cooperated in even a small way,
it made a big difference in the life of our child
and family
It is important to have a multidimensional
assessment understanding of the family. We can
then focus on building strengths skills and
capacity. In some cases this can be more
complex. Some families need more support in
different areas.
50
Types of Interventions

• Family Counseling
• Advocacy
• Parenting Skills -Individual Group
• Self-esteem/Social Skills Individual Group
• Respite Support

51
Parent Education Support Group
52
The ABCs of Communicating with your childs
school

• Learn about school placement process and the
  supports available for your child with special
  needs
• Explore methods of building cooperative strong
  effectively with your child school

53
Bullying and Friendships How Parents Can Help
54
Positive Parenting Program5-Part Series

• Social Workers are certified in Triple-P Stepping
  Stones Parenting Program
• What is Positive Parenting?
• Understanding Causes of Behaviour
• Promoting Positive Behaviour
• Managing Misbehaviour
• Learn Strategies and How to Design Implement
  Activities

55
Kid Talk Peer Support Group
Criteria Participants must be client of
Bloorview Kids Rehab in the Child Development
Program. They are between the ages of 9-13
years old who have a diagnosis of Cerebral
Palsy. Purpose Kid Talk Peer Support Group
provides children with disabilities an
opportunity to meet and share common interests
and challenges. Members must have some ability
and willingness to communicate ideas and
participate in problem solving with peers.
56

• Activities
• Through guided group activities the children work
  on positive problem solving strategies, building
  self-awareness and enhancing self-esteem.
• Developing Mission Statement and Group
  Guidelines
• Role Play Activities
• Therapeutic Games
• Therapeutic Art Activities
• Videos and Group Discussion
• Ability Awareness and Education
• Strengths Focused

57

• Purpose
• Kid Talk Peer Support Group provides children
  with disabilities an opportunity to meet and
  share common interests and challenges.
• Some themes include
• Understanding Myself
• Making and Keeping Friends
• Coping with Bullying and Teasing
• Recognizing and Handling Feelings
• Communication and Listening Skills
• Talking to and Education others about My
  Abilities and Uniqueness
• Celebrating Differences and Strengths