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History and Philosophy
Who Qualifies for Services
Overview of Developmental Disabilities
What Types of Services
Role of Regional Center and the Consumer Service Coordinator (CSC)
Service Coordinator
• Prior to legislation, individuals with developmental disabilities lived at home with no supports, were often segregated and hidden from society. More commonly, they were institutionalized in early childhood.
• 1961 – JFK – “Proposed Program for National Action to Combat Mental Retardation”
• 1969 – Lanterman Mental Retardation Services Act signed.
• 1975 – The Developmental Disabilities Assistance and Bill of Rights Act was passed requiring every state to develop a protection and advocacy system. (last amendment was in 2000)
• 1977 - Lanterman Act was amended to include; "people with developmental disabilities to be given the same legal rights and responsibilities as all others under the Constitution"
• A person is eligible for Regional Center Services if they have a “substantial developmental disability,” that originates before the age of 18 and will likely continue indefinitely.
Intellectual Disability
Autism
Epilepsy
Cerebral Palsy
Disabling condition closely related to Intellectual Disability
Early Start 0-3
School Age 3-15
Transition16-22
Adult 23-57
Seniors 57+
Intermediate Care Facilities (ICF)
Intellectual Disability
Autism Spectrum Disorder
Cerebral Palsy
Epilepsy
Payor of Last Resort
About 1/3 of causes are unknown
Genetic conditions - i.e. Down Syn., Fragile X, Williams Syn.
Pregnancy - Substance abuse, illness,
malnutrition, environmental toxins
Birth - Traumatic, oxygen deprivation, LBW
Childhood - Diseases, infections, lead or mercury
exposure, near drowning, shaken baby, poison
IQ of 70 or below
U.S. average IQ is 98
Immunizations - protect against at least 6 diseases which can lead to brain damage.
Injury prevention - helmets, car seats, seat belts, drowning, preventing against abuse
Protection from poisons, lead, mercury, and certain medications
This law dictates how the Regional Center system will be set up and WHO we are able to serve. Additionally, it was a springboard for legislation aimed at improving the treatment of people with developmental disabilities.
Free Service!
ELIGIBILITY
1. Any child 0-36 months old with a 33% delay in one or more areas of development (Cognition, Language, Fine Motor, Gross Motor, Adaptive, Social/Emotional)
2. A child with an Established Risk condition
3. A child with a High Risk for developmental delay:
Transition to School District and Lanterman Services at age 3 pending Lanterman Eligibility
Anyone can refer!
Significant limitations in adaptive behaviors
• CSC is the term the Lanterman act uses to define the Social Worker who works with the consumer
• CSC is assigned to a case load in a specific geographic region
• Advocates on behalf of the consumer with various community agencies.
• Responds to emergencies. Investigates problems, complaints and possible abuse.
• Meets with the consumer as often as necessary to monitor consumer progress on their IPP outcomes and assists with procurement of services
• Inform consumers of cost effective public and community resources and services.
Self-care
Receptive and expressive language
Learning
Mobility
Self-direction
Capacity for independent living
Economic self-sufficiency
Diminished ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly, and learn from experience
85% of the ID population have an IQ score 50-70 (Normal IQ is 90-110)
Profound - IQ <20; 1-2% of ID population. Very limited communication, round the clock care, usually physical impairments
No unusual physical characteristics
Attain reading and math skills up to 3-6th grade level
Severe - IQ 20-34; 3-4% of ID population; limited communication, cannot perform self care independently
Able to live independently and blend in socially
Many have driver's licenses and community employment
Often off the radar
Moderate - IQ 35-49; 10% of ID population fair communication, difficulties with social cues, needs assistance with self care
Not uncommon for these individuals to want to hide their disability
These levels are very noticeable
Easily manipulated
No evidence that immunizations cause ASD!!
1/60 children have ASD
Parents with 1 child with ASD have a 1/5 chance of having another child with ASD
Occurs in all races, ethnic backgrounds, and socio- economic backgrounds
Almost 5 times more likely in boys (1/42) than in girls (1/189)
46% have average to above average intelligence
Individualized Program Plan (IPP)
Takes into account the needs and preferences of the individual…promoting community integration, independent, productive, and normal lives, and stable and healthy environments”
Self Determination - new program
Recent Changes
Our Understanding of ASD is changing constantly
For a diagnosis:
County Mental Health System
Dept. Developmental Disabilities (DDS)
3 Common Threads
Communication
Limited eye contact
Insistence on sameness/routine
Non verbal, limited verbal skills, or completely verbal
Lack shared enjoyment and/or lack of social-emotional reciprocity
Repetitive play/fascination with rotation
Difficulty reading sarcasm, jokes, sub-text
Difficulty transitioning activities
Unable to read social cues/limited boundaries
Abnormal pitch, intonation, rhythm, or stress while talking
Ritualistic/Compulsive behavior patterns (sniffing, licking, rubbing, stemming, humming)
Abnormal social approach and failure of normal back-and-forth conversation
Honest, inappropriate observations
Emotional outbursts and self injurious
May take things literally
Residential Care
Day Programs
Respite
Transportation
Behavior Modification
Infant Stimulation and Therapies
Talks excessively about topics
Extreme phobias for no apparent reason
Facial Expressions/Body Lang.
Unusual attachments to objects
Overly Trusting
Deficits in non-verbal communication used for social interaction
Difficulty sensing time
DSM IV versus DSM V
Prefer to be alone/minimal acknowledgment of others/difficulty maintaining friendships
Echolalia
- The same rights as any other individual
- Treatment & habilitation services in least the restrictive environment
- Dignity, privacy, and humane care
- Participation in public education regardless of severity of disability
- Prompt medical care and prompt investigation of alleged abuse
- Freedom of religion, recreation, and participation in community activities
- Freedom to make choices in THEIR OWN LIVES
- Essentially, The same rights as any other individual!
Can occur at any time during life
Begins at birth or early childhood
IV
V
PDD
Autistic Disorder
ASD
Aspergers
ASD can also present with sensory issues...
PDD-NOS
Episodic
Permanent
RETT Syndrome
Childhood Disintegrative Disorder
3) Requires very substantial support (Severe)
Extreme sensitivity, OR lack of sensitivity to: touch, sound, smell, taste and sight, and movement
Unusual high or low pain tolerances
Overwhelmed with too much verbal direction
2) Requires substantial support (moderate)
Calmed by external stimulation (sounds, brushing, rocking, pressure, etc)
May need to be left alone to release frustration and/or tension
1) Requires support (mild)
We are dedicated to providing services and supports that increase our consumer’s acceptance into community-based lifestyle.
We believe each individual or their care taker is the primary decision maker and creator of their desired lifestyle.
BRAIN INJURY DURING UTERINE DEVELOPMENT, BIRTHING, OR IN THE FIRST TWO YEARS OF LIFE
Genetic syndromes/chromosomal abnormalities
Intrauterine infection/teratogens
Preterm delivery and related complications
Adverse conditions during labor and delivery
Traumatic brain injury to healthy child
We support and encourage individuals and their families to be the primary decision makers in their lives.
Jaundice
Blood type incompatibility
Multiple births
Artificial reproduction therapy
Schizophrenia
Bi-Polar
Depression/Anxiety
PTSD, OCD, ADD/ADHD
ASD
ID
CP
EP
Dual Diagnosis is possible; conservative statistic - 33%
Epilepsy denotes a predisposition for unprovoked seizures.
A seizure is a simple random event where abnormal brain activity can cause uncontrolled movement and/or varied levels of consciousness.
Two seizures that occur more than 24 hours apart qualify for a diagnosis of epilepsy
Penal code 1001.20-1001.34
“When the court suspects that a defendant may have a cognitive developmental disability, and the defendant consents to the diversion process and to his or her case being evaluated for eligibility for regional center services, and waives his or her right to a speedy trial, the court shall order the prosecutor, the probation department, and the regional center to prepare reports on specified aspects of the defendant’s case. Each report shall be prepared concurrently.” (PC 1001.22.)
Regional Center Consumers
Offense charged at or reduced to a misdemeanor
Cannot be used if diverted within last 2 years
Regional Center provides court with IPP explaining conditions of Diversion; i.e. treatment/habilitation
Jonathan Eckrich, M.A.
Program Manager
jeckrich@inlandrc.org
(909) 382-4693
Useful for consumers who might have been
manipulated into committing a crime, or
who were unaware they were committing a crime
2012 - estimate .9% of the population has ASD, yet 4.4% of prison population may meet criteria for ASD diagnosis
4-10 times more likely to be victims of crime
In judicial system, may be seen as cold and remorseless
<3% of the population has ID, however, they represent 10% of the prison population
Ineffective treatment (continued offenses)
Don't make assumptions!
Try to hide disability
Easily Targeted
Pretend to understand rights
Less likely or able to report
Question of competency
Act upset, attempt to flee/run away
Easily influenced by/ eager to please others
Use concrete rather than abstract language
Don't understand commands/instructions
Think their victimization is normal
Say what they think officers want to hear
Think perpetrator is a friend
Overwhelmed by police presence
Unaware of how serious or dangerous a situation is
Difficulty describing facts/details
Growing # of diagnosis = need for further research
Consider using pictures/visual images
Not considered credible witness*
First to flee and get caught
Few Resources
Confusion leads to false confession
Allow them to speak for themselves
Do not be condescending or patronizing
Use role playing/modeling/rehearsing
Use short, concise instructions
Condense lengthy directions into steps
Use very clear, specific language and adjust speech pace; speak slowly if they get lost
Don't presume they understand; provide clarification
Take your time when communicating; allow more time for action
Listen carefully and let them finish; do not finish their sentence or thought unless they look to you for help
Rephrase using different words or phrases