Northern Health Assessment Network (NHAN) Autism, Fetal Alcohol Spectrum Disorder, and Complex Children and Youth.

Transcription

1 Northern Health Assessment Network (NHAN) Autism, Fetal Alcohol Spectrum Disorder, and Complex Children and Youth. Enhancing Communication in the North April 8 th 2011

2 Overview NHAN: The regional team for two provincial networks for the diagnosis and assessment of children 0-19 who are: 1. Suspected of having Autism (ASD Autism Spectrum Disorder), or 2. Suspected of having FASD or other complex developmental behavioural condition (CCY complex children and youth) The assessment process begins with recognition of the need for diagnosis and ends with implementation of appropriate recommendations (FASD: Canadian guidelines for diagnosis, 2005)

3 Network leadership Provincial Program manager Autism and CDBC Networks: Karen Kalynchuk Overall planning, development, implementation Provincial committee representation from all health authorities Autism Clinical lead: Dr. Steve Wellington Ongoing clinical consultation and mentoring to the NHAN Autism clinical team FASD/CCY Clinical lead: Dr. Nancy Lanphear: recent appointment, working to provide more training, mentoring, leadership Regional Manager hosts monthly teleconferences with all Intake/Key Workers: administration, sharing, support

4 Tiers of Service Tier 4 Specialized Provincial Service Providers Tier 3 Regional Service Providers Assessment Teams Tier 2 Community Service Providers e.g. schools, mental health centres, child development centres

5 NHAN resources Provincial funding Based primarily on number of assessments Autism: for 89 assessments FASD/CCY: for 110 assessments Staffing Senior Management Support: Sharon Davalovsky Program Manager (1.0 FTE): Chantelle Wilson Program Coordinator (1.0 FTE): Natalie Abrahamson Clinical Psychologist ( FTE VACANT)* Speech Language Pathologist (1.0 FTE) Carol Oosthuizen Intake Worker (.6 FTE) Crystal Martin Administrative Assistant 3 (.8 FTE) Sandi Wittmeier Contracted clinical services Psychologists, Pediatricians, Speech & Language Pathologists, Occupational Therapists, Intake & Key Workers

6 NHAN Multi-disciplinary Assessment Model Autism Mandatory: Under age 6: What is wrong? Pediatrician Psychologist Speech Language Pathologist Age 6-19: Does this child/youth have an ASD? Pediatrician Psychologist As required - all children Speech & Language Pathologist, Occupational Therapist, Psychiatrist, other specialists (may require Tier 4 referral) FASD/CCY All children 0-19 Psychosocial and family assessment (Intake/Key Worker) Pediatrician Psychologist As required Speech Language Pathologist Occupational Therapist, Psychiatrist, other specialists (may require Tier 4 referral) For both Autism & FASD/CCY, results of previous assessments (past 2 yrs) may be used if meet criteria

7 Who is NHAN? Pediatricians Dr. Hay Dr. Earl Dr. Abelson Dr. Hales Dr. Moisey Dr. Adlam Dr. du Plessis Dr. Simons Dr. Wingerin Psychologists Dr. Rocha Dr. Wagner Dr. Eaves Dr. Gibbins Dr. Phillips-Hing Dr. Wiebe Dr. Batstone Dr. Papsdorf Dr. Desroches Dr. Conry Dr. Miranda Dr. Bowman Occupational Therapists Sherry Mitchell Ami-Jo Dunn Graham Lees Sandy Haskett Pat Lehaux Josh Butotte Psychiatrist Dr. Diane Fast Speech Language Pathologists Dr. Carol Oosthuizen Lynne Dunn Charlene Bradbury Chantal Phillips Karen Rabbiosi Audrey McKinnon Jill Weeres Maureen O Connell Barb Kuhl Yvette Thompson Intake/Keyworkers Elle Ambrosi Crystal Martin Janna Christensen Shannon Ferguson Cathy Juric Wanda Giesbrecht Lori den Engelsen Leah Macknak Angela Genaille Donna Pierce Sandi Ash Susan Cross

8 ASD Assessment Teams

9 Service Delivery (1): Autism assessments Assessment clinics coordinated from PG office: 89 assessments North east 2 x year North west 2x year Prince George 1x mo (10/year)

10 CDBC Teams

11 Service Delivery (2): CDBC assessments

12 Who can make a referral? Autism assessments: Pediatrician Child psychiatrist Family Physician Clinical Nurse Practitioner **Speech & Language Pathologist CDBC assessments: Pediatrician Child psychiatrist Family Physician (where Pediatrician is not available) Clinical Nurse Practitioner

13 Referral Criteria For CDBC Children to be functioning significantly below average in 3 of: 1. Development and learning 2. Mental health and behavior 3. Adaptive and social skills 4. Biomarkers a. Substance Exposure b. Dysmorphic Features c. Growth Retardation

14 Autism Referrals Per Year

15 Autism Referrals

16 Where do our Autism referrals come from?

17 How are we doing?

18 CDBC Referrals Per Year

19 CDBC Referrals

20 Where do our CDBC referrals come from?

21 How are we doing?

22 Benefits of a Diagnosis Increased awareness of individual needs. Discovery of individual strengths and abilities. Access to appropriate supports and resources. Shared understanding among family members and community. Prevention of FASD through increased awareness and education. Promoting a better future for children with CDBC and their families. Increased self-acceptance and self-confidence for children with CDBC. Providing tools to empower children and families across the lifespan.

23 Working with Schools

24 Confidentiality & Privacy Ethical codes binding health professionals emphasize confidentiality and informed consent. We ask for consent to release information after families have heard the diagnosis. Ideally, professionals talk to families about the benefits of releasing information to schools. Most families are comfortable releasing diagnostic information to schools. However, a few are not, and we feel that decision should be respected.

25 Communicating with Schools We encourage assessment professionals to understand financial realities and the regulations that schools must work within e.g. aides, Chronic Health Designation. Our teams try not to be prescriptive in their recommendations for school services but keep to generalities

26 Communicating with Schools We recognize that schools have the legal responsibility to make designation and service decisions. We recognize that resource decisions may depend on school factors such as other students with special needs We recognize that school staff may have more expertise than we do in writing IEPs, choosing curricula, etc Key workers do a wonderful job of connecting with local schools with guardian consent.

27 Diagnosis Designation

28 Chronic Health Designation Given Little Johnny s diagnosis of FASD/CDBC and its impact on his education in the areas of (socialemotional functioning, communication, physical functioning, selfdetermination/independence, academic/intellectual functioning), the school district is encouraged to review Little Johnny s file to determine whether he meets criteria for a Chronic Health Impairment.

29 NHAN Program Evaluation Purpose Evaluate how and if the assessments done by NHAN benefit the children and families it serves Perspectives from: Parents of children assessed by NHAN Service providers working with children assessed by NHAN External contractors who perform assessments for NHAN

30 What Parents Said 55% said the wait time for their child to be assessed was reasonable 78% said the clinical team was knowledgeable 96% said their family was treated with respect during the assessment process 75% said the recommendations that were made were helpful 85% said overall they were satisfied with the services provided by NHAN 29% said their CDBC key worker was their biggest source of support 51% said to improve the service NHAN should expand services to help families who did not have an autism diagnosis to find help getting further assessments and services

31 What Service Providers said 55% said getting a referral to NHAN is clear and easy to understand 84% said the information provided in the reports is easy and clear to understand 67% said the recommendations were easy to follow through on 78% said after receiving assessments, they are better able to understand and respond to the needs of the children The service has been essential in providing an integrated service plan for the youth. Even if a diagnosis does not generate more funding, the knowledge we have around the student is invaluable

32 What External Contractors said 96% said NHAN has been beneficial to Northern BC families 99% said the diagnostic team works effectively during the synthesis meetings 92% said the meetings with families are effective for results, diagnosis's, and providing recommendations 81% said the key workers play a useful role in supporting families during and after assessments 68% feel satisfied with the NHAN service I have seen an increased recognition of the value of assessment and diagnosis in families and schools, including children outside the mandate of NHAN

33 Recommendations Sources of Support Local Services Funding

34 Recommendations Increased Collaboration Extend Network Increased Partnership with Schools Improve Wait Times Increased Community Awareness

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