Transcript No Slide Title

Characteristics of High Quality Early
Childhood Services
1. Comprehensive
11. Individualized
2. Coordinated
12. Team-based
3. Interdisciplinary
13. Strength-based
4. Family-guided
14. Seamless
5. Culturally appropriate
6. Ecological
7. Based on research & recommended practices
8. Community-based (natural environments)
9. Developmentally-based (DAP)
10. Evaluated/outcome-based
Characteristics Activity
What did you learn from this activity?
What Is the Physical Rationale for
Early Intervention?
• Discussion of Working
Paper #5, Center on the
Developing Child,
Harvard University
Reflect & Write – 15 Minutes
• What are the main messages you will
take home?
• How you will use this information in your
work or family life?
Why Should We do This Intervention?
-- Research
• Center on the Developing Child – Harvard
University
1. Child development is a foundation for
community development & economic
development
2. Creating the right conditions for EC
development is likely to be more
effective and less costly than
addressing problems at a later age
Why Should We do This Intervention?
-- Research
• Jean Brooks Gunn (2004)
1. Enhance school readiness
2. Benefits strongest for children in
poverty & with parents with little
education
3. Positive benefits continue into the high
school years & beyond
4. Programs with intensity & continuity
have the most effect
Convince Others about These 9 Reasons for
Early Intervention – Group Presentations
1. A legislator who cares much about children
2. A legislator not known to favor spending for children
3. A wealthy business person who might donate
money for an Early Intervention Center
4. Parents who are eager to get help for their child with a
disability
5. Parents who are ashamed or fearful about their
child’s disability & do not seek Early Intervention
Convince Others about These 9 Reasons for
Early Intervention – Group Presentations
• Form into 5 groups
• Work with your group to decide what key points from the
lecture are most important for your assigned audience to
hear
• How will you convince them to act?
• Plan to demonstrate your argument to the class by
convincing me (I’m the person!)
• You will have 3-5 minutes to be convincing
Form 5 teams
Build your case
Show us how you will try to convince this person
ACTIVITY
What do you observe about this activity?
Culturally Appropriate Services
• Listen before speaking
• When people honor their own
culture, then they can begin
to honor others’
• Respect crosses boundaries
• Services can be bicultural –
honoring science as well as
tradition
What else would you add?
Video: Christopher’s Story
1. Self awareness
2. Awareness of other culture
3. Services in that culture
What observations do you have about this?
Relationships Are the Keystone of Child
Development – Working Paper #1
• Relationships are what makes learning happen and self
concept flourish
• Work with 1-3 classmates. Pull out the main ideas from
what the research says about Relationships and
children’s development. Write them in bullet form
• Be sure to say what kinds of
relationships help and which hurt
• Turn in one paper with the names
of all the writers
What is the most important idea in this article?
Emotional Development Is Built into the
Architecture of the Brain– Working Paper #2
• Emotional development begins early in life
• It is critical to the development of overall brain
•
•
•
•
architecture
Social competence is initiated during the first 5 years
Emotions are highly related to learning in school, to
forming friendships, and to success in life
Emotional development is as important
as cognitive development
Ignoring emotional development
hurts the society
Next Time: Supporting Children’s
Social-Emotional Development
• Shauna Tominey will share social
learning games
• Meanwhile check out
CSFEL
http://www.vanderbilt.edu/csefel/
CEBP
http://challengingbehavior.fmhi.usf.edu/
Three Cases for Early Intervention
Substance Affected Children -a special case of toxic
impacts on the brain
Motor Impairments
Autism Spectrum Disorders
Video: Fetal Abuse
The Drug Affected Infant
(Drugs Here Includes Alcohol & Tobacco)
• Facts
– Up to 221,000 babies (5.2%) born each year in the U.S. to
mothers (5-11%) using illegal drugs. 48,000 newborns are
affected by these drugs. The increase rate exceeds 400%
per decade.
– Up to 75% of babies placed in foster care have been
affected by drugs.
– Exposure impacts neurological & milestones development
– Risk for premature birth increases, with associated problems
– Care is complicated by withdrawal symptoms
– 1:10 drug addicted pregnant women receive drug treatment.
Source: Dicker & Leighton, Trends in the US prevalence of drug-using parturient women and drugaffected newborns, 1979 through 1990 Am J Public Health. 1994 Sep;84(9):1433-8.
In Focus: Acts of Omission: An Overview of Child Neglect
Author(s): National Clearinghouse on Child Abuse and Neglect Information (HHS) (2001)
http://www.nida.nih.gov/EconomicCosts/Chapter4b.html
How Many Mothers in Oregon are Using
Illegal Drugs
• 2,140+ women a year are using illegal
drugs during their pregnancy in Oregon
• 50% are using amphetamines and heroin
• Only 18% of treatment slots are designed
for mothers. This is sufficient for 13% of
current users
• 78% of mothers using illegal drugs
received prenatal care.
Source: Shaster, Smith, Higginson & Fleming. (1993). Recognizing illicit drug use by pregnant women:
Reports from Oregon birth attendents. American Journal of Public Health, 83(1), 61-64.
And the Problem Is Growing…
• Methamphetamine use by parents has grown
from 10% of referrals to child welfare services in
2001 to 59% of referrals in 2003
Of Mothers Using Drugs During Pregnancy…
• Tobacco: 74%
• Alcohol: 22%
• Amphetamines and opiates together (heroin,
meth, crack, crank & cocaine): 59%
• Meth alone: 23%
• Cocaine alone: 23%
• Poly use: 23%
Maternal Risk for Fetal Alcohol Syndrome
Typical user
• Age of mother: >25
• Number of children: >3
• Pattern of drinking: Binging & regular use
• Family use
• Unstable marriage
• Accepts culture of over drinking
• Other children in foster care
Maternal Risk Factors for
Methamphetamine -- Meth
Typical user
• Smoker
• Uses alcohol
• Unmarried
• No or limited prenatal care
• Uses public assistance
• Less than a high school education
• Less than 25 years old
• Minority ethnic group
• Lives in a city, BUT rural users
increasing faster
The Babies
• 1 to 2: 1000 will have Fetal Alcohol Syndrome
(FAS)
• 5:1000 will have Fetal Alcohol Effects (FAE)
• 4% of those exposed to amphetamines will
need to be medically treated for withdrawal
http://www.nida.nih.gov/EconomicCosts/Chapter4b.html
Studies on Outcomes of Drug
(Including Alcohol) Abuse
• Outcomes derived from three areas
– Animal studies
– Human studies
– Comparison to studies from similar drugs
(i.e., cocaine and crack)
Results…
• Animal Studies
– Increased fetal deaths
– Visual defects
– Cleft palate
– Bone abnormalities
– Delayed development.
• Human studies
– Delayed or altered
development
– Poor intrauterine growth
• Comparison studies
– Increased irritability
– Decreased attention
– Abnormal motor
development
– Increased incidence of:
• Co-occurring medical
conditions
• HIV
• Hepatitis
• SIDS
The Biggest Risk of Abuse….
• The environment the abuser enters
– Poverty, chaos, mental health disorders, domestic
violence, & sexual assault
– Drug addicted parents struggle to choose parenting
over addiction
Source: Wouldes, T. (2004). Exposure to methamphetamine in the womb causes adverse
developmental effects. Medical Study News, 2004.
Exposure to Drug Labs
• High exposure to
– Hydrochloric acid
– Iodine
– Volatile compounds
– Methamphetamine powder even days after
“cooking”
• The biggest risk is for the crawling child
• Result: respiratory problems, irritation, &
neurological toxicity
Facial Features May Be Present with Fetal
Alcohol Syndrome
• Flat midface
• Short nose
• Flat philtrum
• Thin upper lip
• Epicanthal
folds
• Low nasal
bridge
• Small head
size
Why Do Drug Affected Babies Have Problems?
• Neurological development affected from first
•
•
•
•
month of gestation
Cardiac development starts at week 4 of
pregnancy. Premature birth impacts cardiac
transition
Prematurity impacts lung development and
function
Drugs can decrease oxygen to baby at any time
from pregnancy to birth to early infancy
Drug use can increase mother’s risk for poor
nutrition, pregnancy complications (i.e.,
toxemia) and infections
Common Outcomes for Infants
• Infant characteristics
– Congenital defects
– Drug withdrawal
– Prematurity
– Difficult delivery
• Hypoxia
• Injury
–
–
–
–
–
Infection: HIV and Hepatitis
Poor feeding
Neurological irritability
Neurological damage
SIDS
Symptoms that Affect Parenting
• Neurological irritability
– Increased crying or lack of crying and excessive
fatigue
– Difficulty organizing states
• Sleep- wake states
• Eating patterns
– High sensitivity to stimulation
• Touch
• Noise
• Movement
– Prolonged or abnormal newborn reflexes
– Difficulty establishing midline
Other Common Effects
• Digestive immaturity or hypersensitivity
– Gas
– Diarrhea
– Reflex or “spitting”
– Poor growth
Infections
• Immature immune
system
• HIV
• Hepatitis
Drug Withdrawal
• Tremors
• Neurological irritability
• Seizures
• Excessive sleeping or inability
to sleep
• High pitched cry
Child Abuse & Neglect
• Most at risk
– Premature infants
– Disabled infants
– Difficult temperament of infant and/or
parent
– Stress in the home
– Violence in the home
– Unplanned & unwanted pregnancy
– Immature personality of parent
Shaken Baby Syndrome
• Cranial bleeding
• Visual damage:
Vision center of the
brain & retinal
damage
• Seizures
• Long term: learning
disabilities, even
death
Common Long-Term Outcomes
Attachment disorders
Learning disabilities
Communication difficulties
Behavioral disorders
Attention and impulsivity disorders
Difficulty developing social skills (i.e., play, interaction,
affection)
• Poor growth
•
•
•
•
•
•
Outcomes of Early Intervention?
• Parents become more knowledgeable about
development
• Getting help early
– Decreased excessive crying
– Improved feeding and/or growth
– Decreased health problems (rashes,
respiratory infections, etc.)
– Decreased parental excessive fatigue
– Identification of tremors- seizures
– Developmental intervention
•
•
•
•
Language and communication
Motor
Social
Cognitive
– Social support
Summary of Common Challenges
• Feeding problems
• Neurological irritability
• Abnormal growth
• Respiratory: asthma
• Cardiac/respiratory: apnea
•
•
•
•
and cardiac defects
Attachment disorders
Neurological disorders
Developmental delay
SIDS
Remember…
• Drug & alcohol related disabilities are 100%
preventable!
• We don’t always know
when a child is drug
exposed
• Knowing common risk
factors and symptoms can
assist in providing help
early
• Knowing how to support
parents supports their
children
• Children can’t wait!
Summary of Common Interventions
• Feeding techniques
• Sensory & developmental
stimulation & modulation
• Infant massage
• Medications
• Monitors & record keeping
Knowledge
• Support
•
Where To Get Help
• Case worker
• Pediatrician/ pediatric nurse
• Colleagues
• Support groups
• Parenting education
• Relief nurseries
• Child development centers
• Diagnostic teams
• Disability services
Take Time Now…
Reflect on what you knew when you
came today
Reflect on what you learned and will
take with you today
Reflect on what you still want to know
Because I Want To Send
Us Off Hopeful…
Let’s SOAR with some very special children!
Video: The Sky’s the Limit
See you next week