considerations in service delivery to special populations

CONSIDERATIONS IN SERVICE DELIVERY TO SPECIAL POPULATIONS

Is international adoption like Brangelina say it is…?

Some information taken from:

Hwa-Froelich, D. (2012). Supporting development in internationally adopted children. Baltimore: Paul H. Brookes Publishing.

I. INTRODUCTION**The majority of IAC are 2 years old or younger

Top sending countries:1.1. China2.2. Ethiopia3.3. Russia (no more)4.4. South Korea5.5. Ukraine

Decreasing numbers of IAC in the U.S.

Hwa-Froelich 2012:

Youtube video clip

John Upton Discovers The Need of Romanian Orphans

II. BECOMING AN “ORPHAN”**In home countries of IAC, usually found in orphanages

Some have parents who are dead

In many cases, however, parents put their children into orphanages cannot afford to feed them

Also, in some cases, parents are not married; great disgrace in some countries, so the child is placed in an orphanage

Kathleen Morris (Practical strategies for therapists working with SI/SPD Disorders)**

Volunteered: Russian, Romanian, Bulgarian orphanages

She has also worked for 17 years as the founder and director of two SI clinics

I went to her workshop

According to Kathleen Morris:

(Morris)

Former student Marilyn Stansfield, (worked in Romanian orphanage)

Marilyn also volunteered at a Romanian hospital for abandoned babies…

Marilyn tried to feed a newbie from a bottle…

III. ACCULTURATION ISSUES**Frequently, IAC are abruptly taken out of their familiar surroundings and placed into totally new environments

This is especially hard on older IAC

They may miss the familiarity of surroundings they have known all their lives

Used to interacting with other children, not adults

IV. GENERAL CONSIDERATIONS**

Possible post-traumatic stress syndrome

Consequent need for psychological services, emotional support

Adoptive parents may need these services also--feel overwhelmed

Other potential areas of concern include:

Hwa-Froelich 2012—major parent concerns:

V. SPEECH AND LANGUAGE CONSIDERATIONS**Articulatory-phonological skills may be negatively impacted by low oral muscle tone

Some IAC refuse to even chew, let alone speak

Again, dental/orthodontic needs may have been neglected

We will remember the definition of “language”**

A system of symbols that represents concepts formed by exposure and experience

With very limited exposure and experience, some IAC may have very limited conceptual foundations

A challenge for many IAC…

IAC may have…**

Post-institutional Autistic Syndrome

—experienced such abuse and neglect that they exhibit autistic-like behaviors—e.g., rocking, hair-pulling

Ellesef (Adoption and pragmatic problems. ADVANCE for SLPs, December issue)

So we know from research that…**The younger IAC are at the age of adoption, the better their chances for developing language normally

Those who show initial delays may still have them later; we always need to test when the children are newly adopted and follow up

VII. CONCLUSION**SLPs are becoming increasingly involved in providing services to IAC, especially on multidisciplinary teams

Remember, parents need support too!

Anecdotal evidence: pediatricians may tell adoptive parents “wait and see”

Increasingly, this is being viewed as unacceptable; currently, most experts recommend that adoptive parents just assume that children will need additional services and stimulation in all areas of development

When children are evaluated:

In terms of service delivery:

Again, remember that social-emotional-pragmatics problems needing tx may include:

VIII. STUDENTS WITH AUGMENTATIVE/ALTERNATIVE COMMUNICATION (AAC) NEEDS**How comfortable are families with high-

tech devices?

If they are not, we might need to introduce low-tech devices or even boards with pictures

Researchers recommend: picture communication systems printed both in L1 and English

IX. STUDENTS WITH DEVELOPMENTAL DELAYS**We have to be careful, because ELL students tend to be overidentified

Students with DD can still be bilingual!

Be careful about early intervention recommendations, because parents may not believe that early independence is important

X. SERVICE DELIVERY TO CLD DEAF STUDENTS

Research has found great success…**

With classroom amplification

Studies: if a teacher uses an FM system and students hear her voice more loudly, they may

• pay better attention• participate more in

discussions• learn new vocab words

faster

XI. STUDENTS WITH AUTISM SPECTRUM DISORDER**

Stoll, Tolentino, and Roseberry-McKibbin (CSHA, 2008) studied CLD families with ASD children

These families believed in mainstream causes of ASD and also in mainstream treatment (e.g., early intervention, dietary modifications, etc.)

Challenges impacting service delivery include: