Student CH 15 - CONSIDERATIONS IN SERVICE DELIVERY TO SPECIAL POPULATIONS Flashcards
The majority of IAC are 2 years old or younger. What countries do they come from?
Top sending countries:
- China
- Ethiopia
- Russia (no more)
- South Korea
- Ukraine
How much has IAC dropped in the U.S.?
adopted has dropped by almost 2/3
T/F Hwa-Froelich 2012 found that U.S. families adopt CH from abroad 4-16x more than families from other countries
True
Most adopted before 2 yrs
Most studies: South Korean and Romanian
Hwa-Froelich 2012 focuses on S Korea and Romania. What were the outcomes for these countries?
South Korean: positive outcomes
Romanian: negative outcomes
How do IAC become orphans?
Some have parents who are dead
In many cases, however, parents put their children into orphanages cannot afford to feed them
Also, in some cases, parents are not married; great disgrace in some countries, so the child is placed in an orphanage
Who is Kathleen Morris and what did she (Practical strategies for therapists working with SI/SPD Disorders) do?
Volunteered: Russian, Romanian, Bulgarian orphanages
She has also worked for 17 years as the founder and director of two SI clinics
I went to her workshop
What did Kathleen Morris find about how Russian kids become orphans?
Russian cities—mothers abandon CH on streets
Walking along holding hands; mother says “look there!” drops CH’s hand, runs away
Orphanage workers go out PMs to look inside manholes—CH hiding from cold
What did Morris say about the orphanages?
Smell in orphanages is so bad that some visitors throw up when they enter
In some Bulgarian orphanages, schedule:
1. Breakfast
2. Sit on bench
3. Lunch
4. Sit on bench
5. Dinner
6. Go to bed—stay thereFormer student Marilyn Stansfield, (worked in Romanian orphanage) found what about workers and the o?
Orphanage workers stole supplies—diapers, wheelchair parts, bottles, soap, combs, toilet paper
Sometimes Marilyn told not to change a wet diaper or use shampoo during a bath
Workers took orphans’ food
Marilyn also volunteered at a Romanian hospital for abandoned babies…What was it like?
8 beds-room
Only human contact = diaper change
Not held or cuddled
All meals: blanket/pillow propped next to heads, bottle placed on blanket
Marilyn tried to feed a newbie from a bottle and what happened?
Wouldn’t eat—stared at Marilyn
Nurse: baby unfamiliar with being held while fed
Too much sensory input—held and easy simoltaneously
What are some ACCULTURATION ISSUES?
Frequently, IAC are abruptly taken out of their familiar surroundings and placed into totally new environments
This is especially hard on older IAC
They may miss the familiarity of surroundings they have known all their lives
Used to interacting with other children, not adults
What are some general conditions of IAC?
Possible post-traumatic stress syndrome
Consequent need for psychological services, emotional support
Adoptive parents may need these services also–feel overwhelmed
Other potential areas of concern include
Malnourishment—decreased brain development and general health
Decrease dental care
Decrease gross, fine motor skills
Behavioral Issues
Physical abuse, neglect
Decrease emotional bonding opportunities
Potential alcoholism in birth mothers (esp. Eastern European)
Hwa-Froelich 2012—found major parent concerns were…
HIV infection
Latent TB
Immunization status
Short stature
Articulatory-phonological skills may be negatively impacted by what?
low oral muscle tone
Some IAC refuse to even chew, let alone speak
Again, dental/orthodontic needs may have been neglected
define language
A system of symbols that represents concepts formed by exposure and experience
T/F With very limited exposure and experience, some IAC may have very limited conceptual foundations
True
A challenge for many IAC are
Decrease Cognitive-Linguistic stimulation in L1
Rapid L1 loss
Weak conceptual foundation upon which to build L2
IAC may have Post-institutional Autistic Syndrome. Which is ?
experienced such abuse and neglect that they exhibit autistic-like behaviors—e.g., rocking, hair-pulling
Ellesef 2012 (Adoption and pragmatic problems. ADVANCE for SLPs, 12/24/12 issue) found what that some CH (5-10 years post-adoption) tested high on standardized tests. but was else?
But significant pragmatic deficits
Pragmatic deficits interfered with academic performance and social interactions inside and outside of school
So we know from research that The younger IAC are at the age of adoption, the better their chances for what?
developing language normally
Those who show initial delays may still have them later; we always need to test when the children are newly adopted and follow up
SLPs are becoming increasingly involved in providing services to IAC, especially on
multidisciplinary teams
Remember, parents need support too
what is an examples of Anecdotal evidence
pediatricians may tell adoptive parents “wait and see”
Increasingly, this is being viewed as unacceptable; currently, most experts recommend that adoptive parents just assume that children will need additional services and stimulation in all areas of development
When children are evaluated:
Parent report is usually highly reliable and valid
Use prelinguistic measures of joint attention, symbolic play, object permanence, prespeech vocalization
**MacArthur Communicative Development Inventory is popular
In terms of service delivery Maybe CILF-FALF gap—hard for parents. Why?
CILF usually develops fast
Good for parents to read, play games, provide sensory stimulation
Envt—well structured with daily routines—watch over-stimulation
Ideal to videotape parent-ch interaction, give feedback
Again, remember that social-emotional-pragmatics problems needing tx may include
Decrease Theory of Mind
Difficulty regulating emotion
Poor comprehension of abstract and inferential information
Difficulty interpreting body language, facial expressions, gestures
STUDENTS WITH AUGMENTATIVE/ALTERNATIVE COMMUNICATION (AAC) NEEDS..what should we remember?
How comfortable are families with high-tech devices?
If they are not, we might need to introduce low-tech devices or even boards with pictures
Researchers recommend: picture communication systems printed both in L1 and English
T/F ELL students tend to be overidentified
true
Students with DD can still be bilingual!
Be careful about early intervention recommendations, because parents may not believe that early independence is important
T/F CLD CH with HI less likely to be in SPED, restrictive environments than mainstream CH
False they’re more likely
Different countries have different forms of sign language; may or may not be similar to ASL
Some Deaf culturally-linguistically diverse CH—little—no exposure to sign language
Encourage development and use of sign language; don’t force CH to be oral only
With classroom amplification
Studies: if a teacher uses an FM system and students hear her voice more loudly, they may
pay better attention
participate more in discussions
learn new vocab words faster
Stoll, Tolentino, and Roseberry-McKibbin (CSHA, 2008) studied CLD families with ASD children
These families believed in what?
mainstream causes of ASD and also in mainstream treatment (e.g., early intervention, dietary modifications, etc.)
Challenges impacting service delivery include:
If CH no speaking, pediatricians say “bilingualism at home” and tell parents CH will “grow out of it”
Many countries: little-no recognition of phenomenon of ASD. Stigma.
Some families not comfortable with play-based tx, may prefer highly structured tx
