Meeting the Needs of Children and Families Alexa Callitsis

Introduction to Scenario #13 • This case study deals with Adele, a three year old girl with

acquired brain injury

• Adele developed this injury at 15 months old when her babysitter shook her which resulted in Shaken Baby Syndrome

• Adele has difficulty with gross and fine motor skills and shows some speech and cognitive delays1

• Adele and her mother have moved to Toronto and are looking for services in the Toronto area1 Scenario #13

handout

What is Acquired Brain Injury? • Acquired brain injury (ABI) is damage to the brain which

can be caused by falls, car accidents, assault, and a sport- related injury2

• Shaken Baby Syndrome is one of the causes ABI

2"Definition". Toronto abi Network.17 03 13. <http://abinetwork.ca/definition>

What is Shaken Baby Syndrome? • Shaken baby syndrome (SBS), describes a set of injuries

that happen when a child is violently shaken by an adult. These injuries can include bleeding around the brain, bleeding in the back of the eyes, and, most importantly, injury to the brain itself, both from direct trauma and from a lack of breathing that can occur after a baby is shaken, which leads to poor oxygen flow to the brain3

• The outcome for infants who suffer brain damage from shaking can include a range of impairments seen over the course of the child's life, including cognitive deficits and behavioural problems.3

3 “Dream Online”. Children’s Hospital Boston. 17 03 13. <http://www.childrenshospital.org/dream/summer09/shaken_baby_syndrome_q_a.html>

3 “Joint Statement on Shaken Baby Syndrome”. Paediatrics & Child Health. 11 01. 17 03 13. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805972/>

Adele’s Needs • Since Adele has difficulty with gross and fine motor skills

and shows some speech and cognitive delays, she is going to need some special care

• These are going to include speech and language therapy, rehabilitation and special education

• It is difficult to say if Adele will require care for the rest of her life or if she will recover to look after herself

• Adele will have complex educational and child care needs as well as unique recreational and social needs. In her teen years , she will require specialized education programs and specialized job training4

4 J Milner, C Bungay, D Jellinek, D M B Hall. “Needs of disabled children and their families”. Department of Community Paediatrics, Children’s Hospital , Sheffield. 31 05 96. 17 03 13. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1511770/>

The Mother’s Needs• Raising a child that has disability can have great physical

and emotional demands. There are also time and financial costs. It can increase on stress and take a toll on mental and physical health. Decisions have to be made to find appropriate and affordable child care, work and education/ training5

• In addition Adele’s mother has to worry about chance of going into a relapse of her alcohol and drug abuse

• As Adele’s mother is a full time student at Centennial College, she will need to find resources that will require little money and have full time care5 Nancy E. Reichman, Hope Corman, Kelly Noonan. “Impact of Child Disability in the Family”. Matern Child Health.

2008. 13 03 13. <http://www.medscape.com/viewarticle/581577_print>

Changes to Child Care Setting • Some changes I would make to my child care setting include

training a staff to understand the needs of Adele, specifically with her difficulty with gross and fine motor skills and her speech and cognitive delays

• Schedule meetings with Adele’s mom at times that will be convenient to her on Adele’s progress

• Encourage the other children to accept and respect differences through story telling and posters. I want to ensure that no child is left out

• I will also make sure that the physical environment, equipment and materials are safe to ensure that Adele cannot get injured

Adventure Place6 • Adventure Place has been assisting young children and their

families since 1972. Their services are open to all families living in Toronto, North Quadrant, with children up to 12 years of age who are experiencing difficulties in one or more of the following areas:

•Development •Learning •Communication (Speech and Language) •Behaviour •Social and/or Emotional Functioning •Attention and/or Regulatory Functioning

• These services are funded by the Ministry of Children and Youth Services and you need a referral from a doctor

6 Adventure Place Child and Family Centre. 12 03 13. <http://www.adventureplace.ca/home>

Adventure Place• Their Mission is to provide comprehensive mental health,

social, and developmental services dedicated to the well-being and success of children in their early years and to their families

• Their Goals are • To reduce the impact of difficulties and special needs• To help children achieve their potential by building on

their strengths and self-esteem• To increase parental knowledge, competence, and

confidence• To reduce family stress

Adventure Place• The Day Program provides high quality, individualized education and

treatment programs for children aged four to seven who are experiencing a range of difficulties and challenges. This early child development program offers assessment, diagnosis, treatment and education and operates in a school setting from September through June

• Each year, approximately 40 children take part in the Day Program.

Each classroom accommodates six children with two teachers working intensively with children. Additional support staff includes social workers, psychologists, speech and language pathologists, a music therapist and an occupational therapist consultant

• Adventure Place also offers a series of workshops designed to help parents support the development of children

• http://www.adventureplace.ca/home

Centennial Infant and Child Centre7

• Centennial Infant and Child Centre is committed to the development and education of young children with developmental challenges. They focus on the individual needs of each child and family through early intervention at home, in their integrated preschool and kindergarten programs

• They help children with special needs begin to learn strategies which will help them to develop and function as independently as possible in society. They believe goals are best accomplished through an individualized program. The preschool is enhanced with a one-to-one adult/child ratio and with the inclusion of normally developing children. They work directly with families to lend emotional support

• Children are placed on the Preschool Program’s waitlist by completing an Preschool Application Form

7 Centennial Infant and Child and Centre. 12 03 13. <http://cicc.ca/>

Centennial Infant and Child Centre

• Children entering the preschool program are between the ages of 2 1/2 and 4 years. The program runs weekday mornings from September to June. The preschool currently serves 32 children.

Starting in September 2013, they are expanding Preschool to include an afternoon session

• Each child has an individual program plan developed by their primary teacher and their parents in consultation with a gross motor coordinator, occupational therapist and speech/language pathologist. The program covers the developmental areas of cognition, communication, self help skills, social, and motor skills

Centennial Infant and Child Centre

• Tuition Fees • Preschool Morning Program: Current fee – $550.00 per month, for the

2012-2013 school year

• Preschool Morning Program: $575 per month, for the 2013-2014 school year

• Preschool Afternoon Program: $475 per month, for the 2013-2014 school year

• Subsidies are available through Toronto Children’s Services and Assistance

to children with severe disabilities from the Ontario Government • Transportation service is available for the preschool children since

Centennial is only one of a limited number of specialized preschool programs in the city, and the children come from all over Toronto

• http://cicc.ca/

Conclusion• Adele has special needs - she has difficulty with gross and

fine motor skills and she has some speech and cognitive delays

• Her mother also needs help as she is a single mother going to school full time

• The City of Toronto has numerous agencies that specialize in developing and educating children with special needs

• Many of these agencies are funded through the government and subsidies and funding for low income families are available