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Dr. Hock Slides

David Diana
April 23, 2014
150

Dr. Hock Slides

David Diana

April 23, 2014
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Transcript

  1. Best  Practices  For  Engaging  and   Supporting  Families  Of  Children

     With  ASD   Robert  Hock,  PhD,  LISW-­‐CP   Pine  Grove  Au;sm  Conference   April  4th,  2014  
  2. Introduction     •  Diagnos;c  Evalua;ons   •  Behavioral  Interven;ons

      •  Social  Skills  Groups   •  Consulta;on  to  Schools   •  School  Social  Work   •  Research  on  families  of  children  with  ASD:  Challenges,   benefits,  and  strategies  for  support  
  3. After  this  talk,  I  hope  you  will…   •  Be

     able  to  ar;culate  the  central  role  of  the   family  in  health  and  adjustment  of  individuals   with  ASD.   •  Iden;fy  specific  family  factors  that  contribute  to   ASD  outcomes  and  service  delivery  success.   •  Learn  specific  prac;ces  and  skills  to  successfully   deliver  family-­‐centered  ASD  services  .      
  4. From  Family  to  ASD  Outcomes     • Early  Iden;fica;on  

    • Timely  Dx   Help  Seeking   ASD  Knowledge   • Consistency   • ATunement   • Warmth   Coparen;ng   parent  mental   health   • Treatment  Ini;a;on   • Treatment  adherence   Treatment   AUtudes   Working  alliance     Child  Outcomes  
  5. Exploring  ASD  Awareness  Among  Parents   Objec;ves   •  To

     examine  whether  parent  characteris;cs  contribute  to  ASD   awareness  among  parents  of  young  children  in  the  general   public.   Methods   •  An  online  survey  was  distributed  through  Amazon’s   Mechanical  Turk  (MTurk)  to  parents  (N=497)  who  have  a  child   2-­‐years  or  younger  (and  who  do  not  have  a  child  with  ASD).    
  6. ASD   Awareness   Age   Length  of   Parenthood

      Personal   Involvement   Educa;on   Status   Race  
  7. ASD   Awareness   Age   Length  of   Parenthood

      Personal   Involvement   Educa;on   Status   Race   (Asian)   +   +   -­‐  
  8. Examining  Treatment  Adherence   Sample   •  274  Parents  of

     children  with  ASD  currently   receiving  treatment  for  ASD  symptoms   •  226  Mothers;  34  Fathers;  13  Close  rela;ves   •  70%  Caucasian,  23.1%  African-­‐American,  6.2%   Other  background   Method     •  Mail  and  Online  Ques;onnaires     •  Paired  t-­‐tests  and  mul;ple  linear  regression    
  9. Coparen;ng   Quality   Perceived   Family   Burden  

    Parent   Demographics   Greater   ASD   Severity   Types  of  Treatment   Medica;on   Developmental   Behavioral   Alterna;ve  
  10. Coparen;ng   Quality   Perceived   Family   Burden  

    Parent   Demographics   Greater   ASD   Severity   Types  of  Treatment   Medica;on   Developmental   Behavioral   Alterna;ve  
  11. Coparen;ng   Quality   Perceived   Family   Burden  

    Single   Parent   Greater   ASD   Severity   Types  of  Treatment   Medica;on   Developmental   Behavioral   Alterna;ve  
  12. Coparen;ng   Quality   Perceived   Family   Burden  

    Single   Parent   Greater   ASD   Severity   Types  of  Treatment   Medica;on   Developmental   Behavioral   Alterna;ve  
  13. Evaluation  of  a  Statewide   Behavioral  Intervention  Program   Objec:ves:

      •  Examine  factors  that  interfere  with  families’   ability  to  use  the  PDD  program  treatment  hours   alloTed  to  their  child.   •  Elicit  parent  perspec;ves  on  factors  that  would   make  it  easier  for  families  to  u;lize  treatment   hours.   •  Explore  parents’  level  of  knowledge  about  the   PDD  program  while  they  were  on  the  wai;ng  list.  
  14. Pervasive  Developmental  Disorder     (PDD)  Program   •  Treats

     children  ages  3-­‐11  with  Pervasive   Developmental  Disorders   •  Provides  ABA  through  private  providers  throughout   the  state.   •  Three  years  of  intensive  in-­‐home  and  clinic-­‐based   interven;on   •  Outcomes  measured  by  provider  at  baseline,  ager   year1,  and  ager  year2  
  15. Percentage  of  Parents  Endorsing   Barriers  to  Treatment  Hours  

    0   10   20   30   40   50   60   70   Provider  ;mes   were   inconvenient   Provider  did   not  offer   enough  hours   overall   Other  child   treatment   demands   Parent  work   schedule   Loca;on  of   services   Family   disagreement   Child's  school   schedule   Addi;onal   caregiver   demands   Child  is   overburdened  
  16. From  Family  to  ASD  Outcomes     • Early  Iden;fica;on  

    • Timely  Dx   Help  Seeking   ASD  Knowledge   • Consistency   • ATunement   • Warmth   Coparen;ng   parent  mental   health   • Treatment  Ini;a;on   • Treatment  adherence   Treatment   AUtudes   Working  alliance     Child  Outcomes  
  17. Family  Centered  Care   Principles:   •  Listen  to  and

     respect  each  child  and  his  or  her  family.   •  Tailor  services  to  the  needs,  beliefs,  and  cultural  values  of  each   child  and  family   •  Share  complete,  honest,  and  unbiased  informa;on  with  pa;ents   and  their  families   •  Provide  and  ensure  formal  and  informal  support   •  Collaborate  with  pa;ents  and  families  at  all  levels  of  service   delivery   •  Recognize  and  build  on  the  strengths  of  children  and  families   •  Ensure  coordinated  services  
  18. Implications  for  Engaging  Families-­‐ Professional  Behaviors   •  Elicit  expecta;ons:

      “What  do  you  hope  to  get  out  of  this  process?  How  do   you  imagine  you  will  use  the  informa9on  from  this   assessment?”     •  Defining  Family:   “What  other  important  people  in  your  child's  life  would   you  like  to  be  involved  in  this  process?  Are  there  people   who  disagree  with  your  decision  to  bring  Johnny  here?   Who  else  provides  care  for  Johnny?”      
  19. Implications  for  Engaging  Families-­‐ Professional  Behaviors   •  Elici;ng  treatment

     aUtudes  including  the  percep;on  of   effec;veness  and  the  percep;on  of  burden.         "I  know  that  this  would  be  a  lot  for  anyone  to  add  into   their  lives.  How  are  you  doing  with  all  of  this?  Are  there   challenges  that  you  and  your  family  are  facing  that  we   haven't  talked  about  yet?“   "What's  your  sense  of  how  things  are  going  so  far?  Are   things  changing  for  the  beDer?  Is  this  going  the  way  that   you  had  hoped?"       •  REGULARLY  SEEK  FEEDBACK  FROM  FAMILY  MEMBERS    
  20. Suggestions  for  Engaging  Families-­‐ Structural   •  Include  all  important

     adults  in  assessment  feedback   and  treatment  planning   •  Deliver  services  at  more  flexible  ;mes  and  loca;ons   •  Augment  child  treatments  with  brief  family   interven;ons  targe;ng  beliefs   •  Group-­‐based  parent  Interven;ons   •  Parent-­‐to-­‐parent  support  interven;ons  
  21. Suggestions  for  Engaging  Families-­‐   Service  System     • 

    Increase  communica;on  between  agencies-­‐develop   shorthand  communica;on  strategies   •  Develop  rela;onships  with  community  support   organiza;ons  (churches,  YMCA,  etc.)   •  Pa;ent  Naviga;on  Models   •  Devo;ng  resources  to  raising  public  awareness   about  the  signs  and  symptoms  of  ASD  and  the   effec;veness  of  treatment-­‐strategic  and  informed   messaging   •  Shared  or  braided  funding  across  agencies  to  serve   families  more  responsively  (PalmeTo  Coordinated   System  of  Care)  
  22. Next  Steps     •  Family  Founda;ons  for  Au;sm  Spectrum

     Disorders   •  Tes;ng  models  of  pa;ent  naviga;on   •  Bringing  behaviorists,  family  scholars,  and  others   together  to  develop  integra;ve  models  of  how   children  and  parents  influence  each  other   •  Develop  more  precise  and  adap;ve  models  of  family   interven;on