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Supporting Young Homeless Children with Developmental Delays: A Successful Cross-System Model

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Supporting Young Homeless Children with Developmental Delays: A Successful Cross-System Model July 10, 2007 The Partners Infant/Toddler Early Intervention Federal ... – PowerPoint PPT presentation

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Title: Supporting Young Homeless Children with Developmental Delays: A Successful Cross-System Model


1
Supporting Young Homeless Children with
Developmental Delays A Successful Cross-System
Model
  • July 10, 2007

2
The Partners
Philadelphia Department of Behavioral
Health/ Mental Retardation Services
Infant/Toddler Early Intervention
Philadelphia Office of Supportive Housing (OSH)
Philadelphia Infant/Toddler Early
Intervention Providers
Philadelphia Health Management
Corporation (PHMC) Homeless Programs
Travelers Aid Kirkbride Family Shelter
RHD Woodstock Family Shelter
3
Infant/Toddler Early Intervention
  • Federal Program
  • Entitlement for Eligible Children
  • Eligibility guidelines may vary from state to
    state
  • Family Centered Approach to Service Delivery
  • Services Delivered in the Natural Environment
  • Services embedded in familys typical routines
    and activities and delivered in the home and
    community
  • Child Find activities are federally mandated
  • Preschool Early Intervention

4
Homelessness in Philadelphia
  • Citys Office of Supportive Housing (OSH) is
    central point of entry for shelter system
  • Over 10,000 homeless children birth 18 years of
    age
  • 50 shelters/transitional housing facilities with
    women and children (40 of the population)
  • 10 of those in shelters were aged 0 5 in FY
    2005.

5
Planning Process
  • Meetings with OSH
  • Meetings with EI service providers
  • Meetings with shelter directors
  • Meetings with shelter case managers
  • All partner meeting at each shelter
  • Resident community meetings
  • Regular review meetings
  • The Foundation of Good Collaboration is Great
    Communication (start-up and ongoing)
  • Meetings, Meetings, Meetings, Meetings, Meetings!

6
Program Overview
  • Shelter/EI Childrens Specialist administers the
    ASQ (Ages and Stages Questionnaire)
  • Findings are shared with the families and all
    families are offered a multi-disciplinary
    evaluation for their child
  • Those who give approval for an evaluation are
    scheduled for a MDE
  • Those who prefer not to be referred are added to
    the at-risk tracking and monitoring program

7
Program Overview (contd)
  • The shelter service coordinator arranges a MDE
    appointment to occur in the shelters bright
    space.
  • MDE slots are set aside for the shelter program
  • IF the child is eligible, the Individual Family
    Service Plan (IFSP) is written at the MDE
  • Family is offered a choice of service providers,
    if no preference, Child services are picked up by
    the agency serving the families in that shelter.
  • Services are delivered in the shelter and are
    continued if the family leaves the shelter.

8
Child FindChildren at Risk for Delay
  • State identifies vulnerable and underserved
    populations at risk for developmental delay
  • Children who are Homeless
  • These children are vulnerable and underserved
    because
  • Limited resources
  • Poorly educated parents
  • Changing caregivers and changing homes and
    environments
  • Developmental concerns low priority until child
    is school age
  • Other vulnerable (at-risk) populations for
    Early Intervention are children who were
    premature or had a stay in the NICU, children
    with prenatal drug exposure, low birth weight
    babies and children with high lead levels.

9
Risk Factors Identified
  • Of 62 children assessed, these are the risk
    factors identified
  • Exposure to Violence
  • 4 children
  • Prenatal D/A Exposure
  • 4 children
  • No Prenatal Care
  • 2 children
  • Loss of Caregiver
  • 2 children

10
Role of EI Service Coordinator
  • Every Family referred to early intervention is
    assigned a service coordinator
  • Schedules an initial visit with family within 48
    hours of receiving referral completes a child and
    family assessment questionnaire
  • Completes intake and registration, obtains
    information and schedules Multidisciplinary
    Evaluation (MDE)
  • Obtains necessary consents
  • Arranges services for children who are eligible
  • Supports EI providers to connect/re-connect with
    families who miss services

11
Role of the EI Providers
  • Accept Referrals of children in Shelter and
    assign staff to provide services to children
    found eligible
  • Work with families to learn interventions to
    support their childs development
  • Interface with shelter staff to establish a
    presence and familiarity with shelter staff and
    families
  • Develop and conduct other developmentally
    appropriate activities in the shelter to help
    families learn more about EI and child
    development
  • Re-establish contact with family of eligible
    child if they leave the shelter while the child
    is receiving early intervention.

12
Role of Shelter Staff
  • To identify all children birth 2.10 months
    entering the shelter
  • To ensure that all children birth to 2.10 months
    sees PHMCs Childrens Specialist no later than
    30 days after entering shelter
  • To provide copies of daily census to PHMCs
    Childrens Specialist
  • To develop and update service plan to include
    early intervention services
  • To monitor,support and reinforce familys
    participation in the early intervention process
  • To coordinate discharge and transition of early
    intervention services

13
Role of Shelter/EI Childrens Specialist
  • Attend Shelter Community Meetings and Shelter
    Case management meetings
  • Check in with shelter staff to determine any
    changes in census (new families or families that
    have left the shelter)
  • Assess Talk with each family and complete a
    Child Find demographic form
  • Conduct a developmental assessment using the Ages
    and Stages Questionnaire for each child 0 2.10
    months of age entering the shelter

14
Role of Shelter/EI Childrens Specialist
(continued)
  • Share findings of ASQ with family, identifying
    children with concerns
  • Offer all parents the option of having their
    child evaluated. (MDEMultidisciplinary
    Evaluation)
  • Interface with shelter staff to establish a
    presence and familiarity with shelter staff and
    families
  • Develop and conduct other developmentally
    appropriate activities in the shelter to help
    families learn more about EI and child
    development

15
Issues Identified During Assessment
  • Behavior
  • 4 children
  • Communication/Speech
  • 9 children
  • Gross Motor
  • 2 children
  • Learning Disability
  • 2 children
  • Parents concern
  • (child above ASQ cut-off)
  • 12 children

16
Duration of Homelessness
17
Dedicated Staff Needed
  • Solutions
  • CS receives daily census
  • CS meets with each parent in person to complete
    ASQ and demographic form
  • EI family centered system
  • CS schedules apps. for parents
  • CS schedules Bright Spaces for Med's and ongoing
    EI services
  • Barriers
  • Shelter crisis driven, population in
    transition
  • One phone for residents use
  • Adult focused system
  • Difficulty making, rescheduling appointments
  • Space is limited

18
Benefits to the model
  • Vulnerable children are identified and served
  • Cross systems collaborations closes the gaps in
    service delivery
  • Provides an opportunity to teach parents about
    importance of child development ( thru the MDE,
    the provision of early intervention services and
    EI sponsored parenting groups)
  • Relationships/Services with early intervention
    established while in the shelter (designated
    service coordinator, designated service
    providers-challenges)
  • Services established in the shelter more likely
    to follow the child

19
Funding
  • Foundation Grants aimed at homeless families with
    young children
  • Local Office of Shelter Services
  • Early Intervention Child Find Money
  • Screening vs. Evaluation
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