Systems Of Care Flashcards
What are the 5 red flags that alert parents that something may not be right with their child?
- Delayed milestones
- Not interested in play
- Unusual behaviour
- No gestures
- Loss of language
When was the word Autism first used?
1943
Why was the word Autism chosen?
It means auto and self
Lack of interest in other people
What were the first symptoms noted for Autism in 1943?
Lack of interest in other people
‘Sameness ‘ routines and if that changes it causes distress
Childhood psychosis
What were the views on Autism in 1970?
Intellectual impairment
Rejection of psychiatric illness
What were the views on Autism in the 1980s?
Autism first entered the DSM-3
What has changed for Autism in the DSM-5 2013
Called Autism spectrum disorder asd
- Deficit in social communication and interactions
- Behavioural patterns interests
What is the prevalence of autism?
10/16:10,000 Children aged 8years have been diagnosed
164,000 Australians
Rates increasing
What information was gathered from Jacobs first interview at the children’s clinic? List 8 points
- Screams at people/no interest in other children
- Temper tantrums
- Speech regression
- Delayed walking/no crawling
- Difficultly sleeping/sensitivities to light and noise
- Uneventful pregnancy and birth
- Family history of autism
- Cared for at home/ recently moved house
What information do you want to know more about in a child’s first interview at a clinic?
- History taking (development, medical social family psychological goals)
- Semi structured interview using the DSM-5 as criteria to guide questioning
What are the criteria in the DSM-5 for Autism? List 5
- Deficits in social communication and social interaction Must be in ALL of the following:
Social-Emotional reciprocity
non verbals
relationships/play - Restricted, repetitive patterns of behaviour, interests or activities, manifested by at least TWO of the following:
Repetitive movement /objects/speech
Sameness/routine
Fixated interests
Hyper/hypo reactivity to sensory environment - Symptoms present early
- Clinically significant impairment of functioning
- Not better explained by intellectual disabilities
What is the Eyesburg child behaviour inventory? What is in it? What does it ask?
Validated Questionnaire Adds to interview
36 items, 2 subscales
Asks: how often certain behaviours occur?
Parents rate on scale of never to always
Parents also asked if this behaviour is a problem for them
What is the Parenting Scale? What does it ask? How is it used?
30 items, 3 subscales
Looks at different styles of parenting
Subscales : parenting styles
- Laxness
- Hostility
- Over reactivity
What is the relationship quality index? Why would parents need to complete it and what does it ask?
Measures relationship quality as having a challenging child can cause stress in the relationship
6 item measure
How satisfied with relationship
Degree of happiness
Completed by both parents
What is the DASS? Why would parents complete it? What does it ask?
DASS= depression anxiety stress scales
42/21 items 3 subscales
Information on whether parents are having depression/anxiety/stress symptoms
How do observations contribute to a child’s clinical interview?
Psychologists observe child’s behaviour during interviews
What does he do?
How does he relate to family/psychologists
Can take patients out to natural settings for observation (daycare/school)
What does ADOS stand for?
Autism
Observation
Diagnostic
Schedule
How is ADOS administered ?
A standardised Test
Done in social situations that are standardised
Ask patient to engage in play/social interactions
Observe and score
What are the disadvantages of ADOS?
Takes hours to do and resource intensive
When is ADOS used?
When there is a grey area case for autism / not sure if child meets criteria
What are the 6 different types of diagnostic assessment used for autism?
- Semi-structured interview
- Child observation
- ADOS
- Parent Questionnaires
- Medical exam
- OT speech physio Assessments
What is the gold standard diagnostic assessment for autism?
MDT case conference
What is the MTD case conference for autism?
Multidisciplinary case conference
Gold standard Diagnostic assessment for autism
All health professionals involved come together and talk about evidence that might meet criteria and evidence against
The group work towards recommending if child meets autism criteria
What question do psychologists ask and seek to answer when assessing a child for autism?
But why is THIS child having THIS type of problem NOW?
What is a Formulation?
Involves developing hypotheses about causes and maintaining factors
Treatment planning
What is the 5 Ps model of formulation?
- What is the Problem?
- Predisposing - what made this child vulnerable?
- Precipitants- triggers- why now?
- Perpetuating- what keeps the problem going?
- Positives - what strengths does the child have?
What are 4 child focused early interventions for autism?
- Medication/nutrition
- Applied Behavioural Analysis
- Social skills training
- Psychology/speech/physio/occupational therapy
What is Stepping Stones Triple P?
Parenting Intervention Developed for parents and children with developmental disabilities
Support parents to foster positive relationships with child
encouragement positive behaviours
Manage negative behaviours
What is the evidence for Stepping Stones?
Meta-analysis (12 studies)
For child problems, parenting style, program satisfaction, parental relationships-large to moderate effect styles
What are the 6 courses in Stepping Stones?
- Positive Parenting
- Promoting children’s development
- Teaching new skills and behaviours
- Managing misbehaviour
- Planning ahead
- Implementing parenting routines
What is the cognitive triangle?
- Thoughts
- Feeling
- Behaviours
What is the circle of security?
Evidence based intervention
Parents attending to children’s needs
Focus on positive relationships
Parents need to be bigger stronger wiser and kind
Follow child’s needs and take charge
Secure base and safe haven
What are 4 things to consider as a practitioner when doing an intervention for a child?
- Consider parents goals
- Timing of interventions
- Therapeutic relationship
- Perpetuating factors
What therapy’s work for Children with anxiety and autism?
Muscle relaxation
What are 3 obstacles when translating research into practice in health services?
- Limited access to psychologists
- Long waiting lists
- Population increases
What is involved in designing a System of Care?
Ensure families get:
Right care
Right time
Right place
What are 5 things Perceived injustice is associated with?
- Pain
- Depression
- Anger
- Catastrophic thinking
- Disability
4 ways Clinical psychologists are good at identifying gaps in services and research
- Ask questions
- Reason
- Integrate theory and research
- Research training
Caldwell et al (2011) Research and evidence model views health professionals as what 3 things?
- Research consumers
- Research participants
- Research generators
