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Purpose
Purpose
This module will review early intervention concepts and ideas and will be able to identify values and touch on the research. The module will explore a situation where a child would benefit from tier 2 services and early intervention.
Retrieved from : TOT 2: Early Intervention (2019)
General Discussion Post:
General Discussion Post:
After reading the article and viewing the Appleton, Wisconsin website go to the general discussion board and find the discussion called Food for Thought. Post your thoughts on the readings and on the benefits and challenges to starting with diet as an intervention. Would a discussion about food be appropriate for a school mental health team? Would OT have a role in implementing any of these interventions?
After reading the article “A Different Kind of Lunch”, I found the tier I concept of food and healthy eat affecting behavior to be a very interesting thought. I am a terrible eater and I am usually lethargic and moody and sometimes irritable when I am fighting for every last bit of energy to keep a smile on my face throughout the day. I recently have started to change my diet by incorporating more fruits and vegetables into my diet and decreasing my carb and sugar intakes. I have noticed some serious effects to my mood and irritability and energy levels. I sleep better at night and I feel good. I feel like my mental health has improved as well. I catch myself having more positive thoughts and attitudes towards things I don’t want to do. I think changing the diets of children is a spectacular idea. Schools have the opportunities to educate children on the importance of healthy eating and proper nutrition. Most parents want their children to eat healthy and understand that fast and processed foods are not good frothier children, but they feed it to them anyways due to convenience, money, or just people the kids like the taste better (as in my case). The more children start to eat these foods that are high in sugars and processed substances, the more likely they will continue to eat that way the rest of their lives leading to poor nutrition and in most cases (myself included) a lack of energy to exercise and move because they are weighed down by the negative effects these food put on our bodies. By taking the time to properly educated children, it can help them understand how their bodies function and hopefully increase their behaviors not only in school, but at home and throughout their lives. Healthy eating is also good not only for physical health, but it is also brain food and helps mental health as well. The foods we put into our bodies can help us learn and ultimately succeed. By providing our bodies the right fuels to keep us going, we can accomplish more and begin to educate others by our actions and prove to them how important nutrition is for behavior and learning within the schools.
As an OT, I believe our role is to encourage and educate kids on proper nutrition. Eating is an occupation and poor eating, or meal prep can cause all sorts of issues within the classroom and at home. I had a cousin who was struggling in school, having random outbursts, crying, and becoming aggressive with other students. It wasn’t until an OT observed her and she realized that her outbursts really only happened after lunch. The OT suggested that she cut Gluten from her diet and my cousin Sarah has been a wonderful, polite, and well-behave child ever since. Sarah changed her diet in first grade and now, as an eighth grader, she is excelling in school, playing basketball and soccer, and maintaining a lovely relationship with her parents. Although these are anecdotal stories, it is important to see how nutrition and proper diet can seriously affect a child’s ability to sit in class and learn without disrupting others. I think a discussion and intervention with a change in diet is a very easy and relatively inexpensive way to change the way a child might behave. Healthy foods can be grown in gardens at home or purchased in a store. It takes more time to cook healthy foods, but in the end it can save yourself a lot of time and energy fighting a kid who doesn't have the motivation or energy to complete the tasks you are asking them to do.
Appleton, Wisconsin is absolutely on to something. Changing the school’s food sources can improve so many different aspects within children, as well as educated children from the horse’s mouth. Most children listen to their parents when it comes to things like food choices, because their parents are the ones that feed them the majority of their meals. So to see and understand food from a new perspective where is constantly ingrained into their minds is beneficial for not only the students, but also the faculty within the school. Appleton, WI should give themselves a pat on the back for the great work they are doing to improve mental and physical health within their schools. I hope to promote and learn from a program similar to this when I begin working in a school.
The research that resulted in the Recovery Model approach highlighted a very important point. One of the strongest predictors of long term disability from psychotic disorders was the length of time between the person first episode of psychosis and treatment (Davidson and McGlashan, 1997). As a result more and more programs are developing to catch and intervene as soon as a person experiences their first signs of psychosis.
Take a few moments and go to the Early Assessment and Support Alliance website and take a look at what they have developed to help children who are experiencing early signs of psychosis. This program is in Portland, Oregon and is considered an exemplary program. It is referenced in the Downing chapter in Bazyk. There are OT’s actively involved in this program. http://www.easacommunity.org/ Trilogy services in Chicago is in the process of developing an early intervention program for both adults and adolescents. There is an OT actively involved in helping Trilogy develop that program.
Most of these programs developed around early intervention for psychosis are geared toward late adolescents or early adulthood as that is the typical age of onset for schizophrenia. Fortunately there are a few programs attempting to address the needs of children who appear to experience prodromal signs of psychotic disorders. Read the Algon, et. al., article on evaluation and treatment of children and adolescents with psychotic symptoms and Chapter 7 in the Bazyk test. Although the bulk of research shows that early intervention does not necessarily prevent future episodes of symptoms it can impact how a child learns to live with periodic psychosis and avoid long term disability. In your readings and resources folder you will find a copy of the EASA OT manual. This was put together by the OTs at EASA and written about in OT Practice last year. I like the manual but would argue it could be more occupation based than it is. Reading it isn’t a requirement but you might find it interesting to skim through and see what they did.
Another program to look at is the PIER program. This is referred to as the Portland Identification and Early Referral Institute. This program also identifies OT though as a requirement of the core team, though I don’t see any indication that the role is defined the way the EASA program does. Here is the fact sheet on the PIER website for comparison should you be interested: http://www.piertraining.com/resources/frequently-asked-questions/
Retrieved from : TOT 2: Early Intervention (2019)
Group Discussion Post
Group Discussion Post
In your group discussion board find the TOT2 week 2 post on Early Intervention. Use the readings to discuss the unique contribution that OT might bring to a team dedicated to identifying prodromal signs and intervening with children to avoid long term disability.
The contribution that OT can bring to a team working to find prodromal signs and intervene with children to avoid long term disability is that OTs can bring a new lens and perspective onto the team. The OTs abilities to recognize and observe behaviors that are not characteristic of a child may help identify the first signs that something might be wrong. As the OT, understanding the characteristics of a child or adolescent with a psychotic or subthreshold psychotic symptom, Algon et al. defines the main characteristic to question when identifying the symptoms as:
Do the unusual beliefs or perceptions exceed a psychotic threshold?
When was the onset and what is the frequency?
Do they affect behavior?
Are there known or suspected medical or substance contributors?
If other psychiatric conditions are present, what is the temporal relationship between the onset of psychotic symptoms and the other psychiatric symptoms?
When looking at these different questions to consider, I believe the two most important questions for OTs to focus on when identifying symptoms is to look for how the symptoms affect behavior, and if other psychiatric conditions are present, what is the temporal relationship between the onset of psychotic symptoms and the other psychiatric symptoms. I think the OTs can help the team by better defining and identifying these symptoms through a very different lens. These two questions as an OT can be important to answer, because if the psychotic symptoms are causing issues with behavior, it can also potentially be affecting other aspects of the child’s life, such as school, home life, friendships, etc. Poor behavior in a child can be a major red flag for a lot of children. Typically, there are other things happening to the child that are causing the behavioral issues. As the OT on the team, I would be aware of the behavior, but also how the behavior is affecting the child’s occupations and activities throughout their day. The second question looks at the child’s symptoms and any underlying issues when another condition triggers at a similar time as the original symptoms. This is another place where OTs can look at a child and better understand what occupations might be affected. It is important for the OT to be observant and recognize these characteristics in the child so the multiple symptoms that are being triggered do not completely isolate kids and adolescence from their daily lives.
By having an OT on a team that helps prevent and identify psychotic symptoms, I think the benefits can be tremendous. By targeting and recognizing when something is wrong early, it can provide a huge leg up for treatment and recovery. The OT’s perspective should be accounted because the OT can notice problems with routines, roles, and occupations that are not typical of an age group or of a specific child. The OTs can provide a holistic approach to the child that other medical professionals may not observe. With the training OT’s have, having them on the team can only provide benefits to the outcome of the child once the symptoms develop. Having OTs on teams that can provide the skills to help treat children with symptoms can only benefit the child and the team.
Steven Case:
Steven Case:
About Steven is a case that was developed by the University of Minnesota’s Children, Youth, and Family Consortium. This case was selected for you to review because it spans Steven’s life from early development through high school. I have prepaid for you to use the case.
You must follow the following instructions in order to access the case correctly at no cost to you.
About Steven: A Children’s Mental Health Case Study About Depression, hosted by the University of Minnesota Extension’s Children, Youth & Family Consortium.
Assignment
Once you have gone through the case, answered the questions and explored some of the options, please complete the Steven Worksheet. The Steven worksheet.docx is located in the readings and resources folder for this module.
The worksheet is focused on exploring how OT might be used to support Steven.
This will take you some time to do - in the past scholars have spent nearly 6 hours on this. I believe when I completed it, I took nearly 4 hours, though I was editing and making sure it was ready to send out to you. I really think it has been a valuable exercise so rather than take it out I will give you a couple weeks to complete it. I would highly recommend that you work on it a little bit at a time. No need for full sentences or perfect grammar.
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