Assessing and Scaling Child Needs

Case Management

Workshop Introduction

Context for the Training Training Related to Implementation of Safety Decision Making

Methodology Fidelity of the Ongoing Family Functioning Assessment

◦ Philosophy of practice

◦ Intervention purpose and framework

◦ Conceptual and criteria basis for practice and decision making

◦ Process, practice and outcomes

2

Participant Introductions

3

As a result of this training, participants will be able to: Identify the ongoing family functioning intervention

stages; Define child needs; Recall the purpose of assessing child needs; Identify and demonstrate assessment skills utilized in

assessing child’s needs; Demonstrate assessment skills through case

application.

4

Workshop Training Objectives

Workshop Agenda

5

Inform training and development

Provide feedback to trainer Measure change

Baseline Knowledge Assessment

6

Session 1

Foundational Knowledge: Review of Methodology

Initial Contact: Present Danger

Yes No

Present Danger Plan

Information Collection

Assess for Impending Danger

No Safe

Yes Unsafe

In-Home Safety Analysis

In Home

Out-of- Home/

Removal

Develop Safety Plan

Investigation closed Family may be referred for services in community.

8

From Great Wall of China to the Panama Canal

Child Protection Investigator• Safety

• Danger Threats • Caregiver Protective Capacities• Present and Impending Danger

Safety Plans

Case Management• Safety

• Danger Threats• Caregiver Protective Capacities• Present and Impending Danger

Safety Plans• Safety Management

• Case Plan/Treatment--Change

9

Safety Management and Enhancing Caregivers Protective Capacities

Preparation

Developing Strategy for Engagement

Introduction

Engagement

Exploration

Determine What Must Change Through Information Collection

Caregiver Protective Capacity Assessment

Child Needs

Danger Statement

Family Goal

Motivation for Change

Case Planning

Develop Strategies for Change Case Plan Outcomes

Complete FFA-Ongoing

Case Plan

10

FFA-Ongoing

11

Family Functioning Assessment-Ongoing Decisions

Are danger threats being managed with a sufficient safety plan?

How can existing protective capacities -- STRENGTHS – be built upon to make changes?

What is the relationship between danger threats and the diminished caregiver protective capacities? What must change?

What is the parent’s perspective or awareness of his/her caregiver protective capacities?

What are the child’s needs and how are the parents meeting or not meeting those needs?

12

Family Functioning Assessment-Ongoing Decisions

What are the parents ready and willing to work on in the case plan to change their behavior?

What are the areas of disagreement with the parent(s) as to what needs to change?

What change strategy will be used to address the diminished protective capacities?

13

Philosophy: Family Functioning Assessment-Ongoing

Safety is paramount and the basis for intervention! Case planning process and interventions can be more

clearly defined around the use of safety concepts and behavior change.

Case planning process can be structured in a way to encourage and direct parents’ involvement and establish consistent intervention decisions and objectives.

14

Engagement Teaming Assessment/Understanding Planning

◦ Safety Plan

◦ Case Plan Tracking and Adapting

◦ Safety Plan Sufficiency Evaluation & Update

◦ Case Plan Progress Evaluation & Update

Essential Skills for Case Management

15

Questions?

16

Session 2

Intervention Standards

Preparation Introduction ExplorationCase

Planning

Intervention Standards

Module 9 18

Preparation

Preparation is the act of getting ready, being prepared. In ongoing case management and services this entails key actions and tasks:◦ Review of the Family Functioning Assessment-Investigation

◦ Review and analysis of the Impending Danger Safety Plan

◦ Review of case information and content

◦ Contact with collaterals

◦ Response to any immediate safety management needs

◦ Consultation with the Supervisor to reconcile information and prepare for family contact

19

Introduction is the act of introducing you as the change agent and agency representative, the agency’s role, what case management is and is not, and providing clarification as to the role of the ongoing case manager.

Objectives of Introduction for Case Manager

◦Begin to establish rapport with family; get to know them.

◦Establish a working relationship with the family.

◦Provide clarification and process with family for ongoing case management.

Introduction

20

Exploration is the act of exploring with the family how they are functioning in relationship to the protective capacities, understanding how danger threats or negative family conditions have manifested, exploring motivation for change, resistance or ambivalence, identifying family strengths, creating danger statements, and finding mutuality for continued work.

Achieve agreement with parent(s) as to: What must change for

children to be safe. How to achieve change. Parent’s role in achieving

change. Role of others in helping

parent(s) achieve change. How progress will be

measured.

Exploration

21

Case planning with the family is the act of establishing outcomes and motivation for change.

Case Planning

22

Questions?

23

Session 3

Child Development: Assessing Child Needs

The Concept of Child Development

Heredity

Environme

nt

Factors: Child Development

26

Statistical concept Typical or expected for the

majority of members of a group

Identified traits and processes displayed by most children within timeframes

Normal?

27

Developmental Domains: Child Functioning

Physical Emotional

Cognitive Social

Body structures Sensory development Motor development Sensation and movement

Developmental Domain: Physical

29

Intellectual/Mental Thinking Memory Reasoning Language Concept Development Problem Solving Ability Abstract Thinking

Developmental Domain: Cognitive

30

Personal traits and characteristics

Self-Esteem Reciprocal Emotional

Relations Mood and Affect-

Appropriate for Age and Situation

Developmental Domain: Emotional

31

Interactions with others Development of

relationships Social roles and norms Group involvement

Developmental Domain: Social

32

Questions?

33

Birth to 3

Pre-School (3-5)

School Age (6-12)

Adolescence (13-21)

Child: Ages and Stages

34

Practice: Identifying Indicators Ages and Stages

Small Group Activity Working in small groups:

◦Complete Worksheet: Identifying Indicators of Ages and Stages

◦ Large Group Report Out

Newborn-6 Months: 6-12 Months: 12-18 Months: 18-24 Months: 2-3 Years:

Child: Birth to Three

36

Language Development Time and Order of Events Social Development Emotional Development Self-Control Self-Esteem Conscience

Child: Pre-School (3-5)

37

Cognitive Development Physical Development Memory Social Development Emotional Development

Child: School Age (6-12)

38

Transition Physical Development Cognitive Development Social Development Moral Development Emotional Development

Child: Adolescence (13-21)

39

Questions?

40

Session 4

Factors Affecting Child Development

Factors Affecting Child Development

42

Child

Environmental Factors

Biological FactorsInterpersonal

Relationships

Housing Income Employments Education

Environmental Factors

43

Gender General Health Mental Health Health Practices Hereditary Factors

Biological Factors

44

Family and Friends Social Interaction Sibling Interaction

Interpersonal Relationships

45

Questions?

46

Abuse and Neglect

InterpersonalFactors

Environmental FactorsBiological

Factors

What About Child Abuse and Neglect?

47

Child: Birth to Three

48

Growth retardation Poor muscle tone and

motor control Language and speech

delays Immobility Listless demeanor Lack of separation anxiety Unresponsiveness Lack of play skills

Child: Pre-School (3-5)

49

Small in stature High incidences of “sickness” Poor muscle tone, motor

coordination Delayed speech Poor articulation/pronunciation Short attention span Insecurity Detachment Social immaturity

Child: School Age (6-12)

50

Suspicious of adult figures Overly solicitous Agreeable Manipulative Unrealistic view of parents Assuming adult

responsibilities Inability to focus:

educational Lack of coping skills

Child: Adolescence (13-21)

51

Varying Degree Based Upon:◦ Age of maltreatment

◦ Frequency of maltreatment

◦ Severity of maltreatment

◦ Relationship with maltreating parents/caregivers

Questions?

52

Take Away from today:◦ What did you find helpful?

◦ Questions that still need to be answered?

◦ More time spent on…?

Day 1: Take Away from the Day

53

Case Management

Day 2: Assessing and Scaling Child Needs

Overnight Thoughts?◦ Questions from

yesterday?

◦ Feedback from yesterday?

◦ Reflections from yesterday?

Day 2: Welcome Back

55

Child Needs and Scaling Assessing Core Skills and

Practice Small Group Exercise:

◦ Case Application

Agenda: Day 2

56

Session 5

Child Needs: Defining the Needs

Child Needs

58

Child

Environmental Factors

Biological Factors

Interpersonal Relationships

Abuse and Neglect

Small Group Activity Using Worksheet, and

based upon what we have learned about child development, identify:◦ Examples of each child

need.

◦ Specific examples as experienced in the field or through case review.

Activity: What are Child Needs?

Management of emotions Self-regulation Response to stress Coping skills and techniques Physical symptoms of

trauma

Emotion/Trauma

60

Empathy Right from wrong Impact of behavior on self

and others Actions towards others Societal

expectations/norms

Behavior

61

Cognitive abilities:◦ Language development

Physical skills:◦ Riding a bike

◦ Dressing

Development and Early Learning (0-6)

62

Academic advancement:◦ Reading

◦ Math

◦ Language

◦ Advancement to next grade level

Academic Status (6-17)

63

Positive Peer/Adult Relationships

64

Interactions with others Demonstrated social skills Peer pressure: life choices

Parent/child relationship Sibling relationships Dynamic family

relationships Support and guidance from

family Sense of family identity

Family Relationships

65

Provision of basic and appropriate health care

Physical symptoms of health concerns

Dental and visual needs Medical and dental

established providers/provision for care

Physical Health

66

Race Class Ethnicity Religion LGBTQ Identified cultural identity Sense of cultural identity Desire for cultural identity

Cultural Identity

67

Self Others Treatment Awareness of effects Recovery

Substance Awareness

68

Life skill development:◦ Housing

◦ Employment

◦ Financial

◦ Educational

◦ Support

◦ Planning

Preparation for Adult Living (13-17)

69

Questions?

70

Session 6

Child Needs: The Assessment and Scaling

Information Collection: Drives Decision Making

72

Information Collection

Family: Parents and Children

ObservationsReview of

Information

Family and Friends

CPI-Family Functioning Assessment◦ Based on six domains of

information

◦ Limited information known at the time in relation to what can be known

◦ Focused on the assessment of safety

CM-Ongoing Family Functioning Assessment and Evaluation ◦ Based on four domains of

information

◦ Extensive information to be known

◦ Determination of degree of need from a limited to extensive perspective

◦ Knowledge of the child and the parents

Assessing: Child Needs

73

Engagement

Critical Thinking

Observation

Skills and Competencies: Case Manager

74

◦Probing◦Going beyond what is

said◦Seeking clarification◦Reflecting content◦Reflecting feeling and

meaning◦Active Listening◦Self-awareness

Engagement: Utilization of Skills

75

◦Observation is getting information about objects, events, moves, attitudes and phenomena using one or more senses.

Observation: Utilization of Skills

76

Critical Thinking: Utilization of Skills

77

Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication.

A statement by Michael Scriven & Richard Paul presented at the 8th Annual International Conference on Critical Thinking and Education Reform, Summer 1987

Large Group Activity Observation:

◦ Group of three six-year-old children who do not know they are being filmed.

What do we see happening between the three?

Consider the Ages and Stages we have discussed.

Practice: Observation As Assessing

Activity Report Out

Scaling of Child Needs: Purpose

80

Child Needs

Well-BeingPermanency

Safety

Scaling Child Needs: Child Needs Met

81

A: Demonstration of exceptional ability in this area OR that the need is being addressed by the parent.

B: Demonstration of average ability in this area OR that the parent is attempting, or has made attempts to meet the need.

Scaling Child Needs: Child Needs Not Met

82

C: Demonstration of need for increased support or attention in this area; could be for both child and parent response.

D: Demonstration of need for intensive support in this area; could be for both child and parent response.

Questions?

83

Small Groups of 4 Croft Family:

◦ Review FFA.

◦ Identify the child needs.

◦ Scale the needs based upon your analysis of the information.

Practice: Assessing and Scaling Child Needs

Activity Report Out

Session 6

Case Application Practice

Using the OFFA that you brought to training:

Review Child Functioning and Parenting General Information.

Consider information known about the Family: Review and revise, if necessary,

and/or complete the Child Functioning and Child Needs Scaling.

Identify the missing information, and develop strategies for obtaining the information (interview with collateral, observation, etc.).

Practice: Applying Concepts to Our Practice

Activity Report Out

Used to:o Inform training and

development;o Provide feedback to

trainer;o Measure change.

Post Training Knowledge Assessment

89

Used for:o Professional growth and

development;oUpdating/refining training

material content and exercises;

oMeasuring change

Training Evaluation

90

Thank you for your time and attention!

91