Children and Youth Mental Health
Resource Guide
Developed by Parents For Children’s Mental Health of Waterloo Region Revised October 2011
For more information about our Parent Support Groups in Waterloo Region visit our website at www.PCMHwaterloo.com or email us at parent.advocacy@hotmail.com
2011 and 2010 editions and website made possible by SSLI Waterloo Student Support Leadership Initiative
2008 edition and printing made possib le by the KWCF
Copyright 2008 @ Parents for Children’s Mental Health—Waterloo Region. All Rights reserved.
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Table of Contents SECTION 1 (BLUE): GETTING STARTED Disclaimer Translation Services Welcome to Holland Who is this Guide For? What is Parents For Children’s Mental Health (PCMH)? What is Mental Illness? Signs & Symptoms of Children’s Mental Health Problems Psychological Assessments Now You Have A Diagnosis Tips For Self-Care What Is the DSM-IV Manual? The Myth of the Bad Kid
1 1 2 3 3 3 4 5 5 6 7 9
SECTION 2 (YELLOW): WHAT IS: How To Use This Section Addiction/Substance Abuse Anger and Aggression Anxiety Disorder Attention Deficit Hyperactivity Disorder (ADD & ADHD) Autism Spectrum Disorder (ASD) Bipolar Disorder Borderline Personality Disorder Bullying Conduct Disorder Cutting/Self-Harm Depression Dissociative Identity Disorder Dual / Concurrent / Co-morbid Diagnoses Developmental Disability Eating Disorders Fetal Alcohol Spectrum Disorder (FASD) Learning Disabilities (LD) Mood Disorders Obsessive-Compulsive Disorder (OCD) Oppositional Defiant Disorder (ODD) Post Traumatic Stress Disorder – see Anxiety and Trauma Psychosis
Last update: 16-Oct-11
www.PCMHwaterloo.com
11 13 15 17 19 21 23 25 27 29 31 33 35 37 38 39 41 43 47 49 51 53
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Table of Contents SECTION 2 (YELLOW): WHAT IS: (cont’d.) Re-active Attachment Disorder (RAD) Schizophrenia Schizo-affective Disorder Sensory Integration Dysfunction / Sensory Processing Disorder Stress Suicide Tourette Syndrome (TS) Trauma
55 57 58 59 61 63 65 67
SECTION 3 (GREY): CRISIS /EMERGENCY SERVICES Crisis/Emergency Services Other Helpful Phone Numbers Protocol for Crisis or Emergency What to Have Prepared for a Trip to Hospital What to Expect at Hospital Your Child’s Medical History (form) The Updater (resource for people who are in trouble with the law)
69 70 71 72 72 73 Insert
SECTION 4 (GREEN): FINDING SUPPORT Community Resource Listing Front Door - Centralized Access to Children’s Mental Health Services
Insert Insert
Hospitals & Treatment Centres Hospitals Cambridge Memorial Hospital Grand River Hospital St. Mary’s Hospital Treatment Centres KidsLINK Lutherwood and CPRI St. Joseph’s Regional Mental Health Care - London
75 76 77 79 80 81
Counselling Services 83 Insert
Counselling Services Finding a Therapist – MDAO
Support Groups PCMH Waterloo Region Affiliated Parent Support Groups Why Join a Parent Support Group? Local Parent Support Groups
Last update: 18-Oct-11
www.PCMHwaterloo.com
85 86 87
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Children’s Mental Health Resource Guide Parents Supporting Parents, prepared by PCMH – Waterloo Region
Table of Contents SECTION 4 (GREEN): FINDING SUPPORT (cont’d) General Social Skills Training Programs- “Friends” and Tools for Life” and “Aspen” Cognitive Behaviour Skills Training Dialectic Behaviour Therapy Complementary/Alternative Health Care Infant Development Program Access Waterloo Region (formerly Community Connections) Respite Services Recreation & Camps Services
SECTION 5 (ORCHID): FINANCIAL/LEGAL Financial Supports Ontario Disability Tax Credit Certificate Medical Expenses Other Child and Family Benefits Special Services at Home (SSAH) Ontario Disability Support Program (ODSP) (at age 17 start ) Henson or Discretionary Trusts Registered Disability Savings Plan (RDSP) Continuing Power of Attorney for Property (sample form for Ontario) Power of Attorney for Personal Care (sample form for Ontario)
89 91 93 95 Insert
97 99 100
101 102 103 103 103 105 106 107 108
Transition Planning Transitioning to Adult Services Parent’s Guide to Transition: What Happens After High School? Waterloo Region Homes for Mental Health
109 110 111
SECTION 6 (IVORY): ADVOCACY: General Why Advocate for the Mental Health of Ontario’s Children? Invitation to Join PCMH and Annual PCMH Conference Advocacy Resources Quilt of Honor Campaign – Susan Hess Parent to Parent: Mental Health & Our Kids Organize Yourself Creating Your Child’s Profile Sample Assessments Chart Creating a Safety Plan Sample Safety Plans
Last update: 21-Oct-11
www.PCMHwaterloo.com
113 114 115 Insert 117 119 120 121 123 124
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Table of Contents SECTION 6 (IVORY): ADVOCACY (cont’d) School/Government Navigating the School System Creating a Supportive Classroom through Peer Education Parent to Parent: Our Kids and the Schools by Susan Hess Parent to Teacher: Tip Sheet by Susan Hess Communicating with Your School Special Education Advisory Committee (SEAC) The Ontario Ministry of Education – Special Education Resources People for Education – Special Education Tips for Parents
Legal Office of the Provincial Advocate for Children and Youth Child Advocacy Project (CAP) – Legal Assistance What the Human Rights Code Guarantees for Your Child in School (article)
127 129 133 135 Insert 139 141 Insert 143 Insert 145
SECTION 7 (GOLD):RESOURCES 147
Website Resource Listing
SECTION 8 (TAN): GLOSSARY/APPENDIX: Glossary of Terms Glossary of Acronyms How Can You Help? Fundraising/Donation Page Feedback page, address and e-mail
Last update: 19-Oct-11
www.PCMHwaterloo.com
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Disclaimer The material in this Resource Guide is intended to help parents and caregivers, and members of the community to assist children with mental illness. It will hopefully help you to understand mental illness, the support services and resources available for children and their families, and how you can advocate for better support and acceptance from the community and your child’s school. By its nature, this Resource Guide provides information about all of these topics, but is not a complete review of the issues raised or services available for the support and treatment of children’s mental health problems. This Resource Guide is current to August 2011. This Resource Guide is for general reference, and is intended to direct concerned parties to other, more complete sources of information about supports and resources available to them. This Guide is not intended to cover every possible issue that you may encounter when struggling with children’s mental health problems. This Resource Guide should not be relied on as legal advice or a professional opinion. Anyone having specific questions about the contents of this Resource Guide or dealing with children’s mental health issues, including finding support and treatment and accessing resources to assist in this regard, may wish to consult kidsLINK which provides children’s mental health services in the Region, or other children’s mental health agencies, or you may contact Children’s Mental Health Ontario for more information about services in the province, or any of the other services and support groups listed in this Guide. If you have a question about your legal rights, you may wish to consult a lawyer . kidsLINK can be contacted at: 1855 Notre Dame Drive P.O. Box 190 St. Agatha, Ontario Canada N0B 2L0 Phone: (519) 746-KIDS (5437) Website: www.kidslinkcares.com Children’s Mental Health Ontario website - www.kidsmentalhealth.ca Parents for Children’s Mental Health (PCMH) Head Office website – www.pcmh.ca Parents for Children’s Mental Health Waterloo Region – www.PCMHwaterloo.com 2008 PCMH Resource Guide Committee: Barb Ward, Liz Nickason, Laura Coughlin, Tina Blanchette, Carol Parr, Roxanne Warren Copyright© Parents for Children’s Mental Health – Waterloo Region. All rights reserved.
Do You Need Translation Services? Mental illness is often stigmatized in any culture. It is important that you obtain information to help you treat your child’s illness. Don’t wait until the situation is urgent. It can be very lonely and scary for the parent raising a child who has special needs even when you have lived in this country from birth. Find someone to talk to and talk to your doctor. Cambridge and Kitchener have Multicultural Centres. The YMCA also has a Cross Cultural and Community Services Department at the Kitchener, Waterloo and Cambridge YMCA. They can refer you to someone who can translate this information for you. Over 40 languages are available for help with translation. There are fees for this service.
Links or Useful Resources for TRANSLATION/MULTICULTURAL SERVICES: Kitchener-Waterloo YMCA Cross Cultural and Immigration Services – 519-579-9622 or www.kwymca.org Cambridge YMCA Cross Cultural and Immigration Services – 519-621-1621 or www.ymcacambridge.com Kitchener-Waterloo Multicultural Center – 519-745-2531 or www.kwmc.on.ca American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org Centre for Addictions and Mental Health – www.camh.ca – fact sheets in 16 languages - www.camh.ca/About_Addiction_Mental_Health/Multilingual_Resources/index.html Centre for Community Based Research – 519-741-1318 Cultural Profiles Project – www.cp-pc.ca Yellow Pages – www.yellowpages.ca/ or check your local listings under “Translation”
Last update: 14-Oct-11
www.PCMHwaterloo.com
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
WELCOME TO HOLLAND ©1987 by Emily Perl Kingsley. All rights reserved
I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...... When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland." "Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy." But there's been a change in the flight plan. They've landed in Holland and there you must stay. The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place. So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts. But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned." And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very, very significant loss. But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.
Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Who Is This Guide For? As parents supporting parents, Parents for Children’s Mental Health (PCMH - see below) recognizes that Children’s Mental Health is one of the least talked about and most common childhood problems today. In our vastly varied experiences we have found that one of the most common problems families face raising a child with a mental disorder is the lack of information available for those seeking services and resources in the community. Another common issue is the lack of support in the Health Ontario) community whether it is due to ignorance, intolerance or disbelief. It is our sincere hope that parents, educators and caregivers will benefit from this combined collection of Children’s Mental Health information, services and supports available to you and your family in the Waterloo Region. It is the goal of this guide to share with parents some information to enable them to find the answers and assistance they so desperately need. Who is this guide for? Almost 1 in 5 children in Ontario between the ages of 3 and 17 have a diagnosable mental health disorder. Of these approximately 500,000 children, 3/5 or about 300,000 of them have more than one disorder. (Source: Children’s Mental
Parents/caregivers who are struggling with their child’s behaviour at home or school Parents/caregivers seeking emotional and/or financial support Parents seeking advice regarding school concerns Parents who suspect something is the matter, but don’t know where to start Parents/caregivers not sure what mental illness means, or how to go about getting help Parents/caregivers seeking to support or advocate for their special needs child
What Is Parents For Children’s Mental Health (PCMH)? Parents for Children's Mental Health or PCMH (as it will be referred to in this book) is a voluntary group of parents who have used, or are currently using, the mental health services of Ontario. Members are dedicated to helping families and improving mental health services in the province. Since 2005, kidsLINK has supported parents operating a local chapter of Parents for Children's Mental Health. For more information about PCMH, please visit the national website at www.pcmh.ca. In the Waterloo region, please contact the PCMH representative at (519) 746-5437. You can also reach the local parent support group by e-mail at parent.advocacy@hotmail.com.
What Is Mental Illness? Mental illness and mental disorder are not easy to define. Misunderstandings lead to misuse and abuse of the terms, reinforce myths, and even prevent people from getting help when it is really needed. In general, mental illness refers to clinically significant patterns of behavioural or emotional functioning that are associated with some level of distress, suffering (pain, death), or impairment in one or more areas of functioning (such as school, work, or social and family interactions). The basis of this impairment is a behavioural, psychological, or biological dysfunction, or a combination of these.
Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Signs and Symptoms of Children’s Mental Health Issues The way a child thinks, feels and behaves may be a sign that he or she needs help with a mental health problem. It can sometimes be difficult to decide if a child is acting “appropriately” for his or her age or if the child does, in fact, have a mental health need. Although many children and youth will show some of the following characteristics and behaviours at various times during normal childhood development, it is the degree and frequency to which these characteristics affect their day-to-day living. This list serves as a guide and is by no means complete.
Signs & Symptoms • getting poorer marks in school, suspension/expulsion • persistent nightmares • avoiding friends and family • outbursts of anger and rage • hyperactivity or low energy • loss of appetite • difficulty sleeping • rebelling against authority • abusing alcohol or drugs • stop doing things used to enjoy • damaging others' property
• • • • • • • • • •
many physical complaints (headaches, stomach aches) severe worry and anxiety stop caring about appearance obsession with weight lost energy and motivation hitting or bullying other children trying to injure self mood swings personality change threatening to run away
Links or Useful Resources for SIGNS AND SYMPTOMS: Children’s Mental Health Ontario - www.kidsmentalhealth.ca/parents/resources_parents.php American Academy of Child & Adolescent Psychiatry - www.aacap.org kidsLINK - www.kidslinkcares.com Parents For Children’s Mental Health - www.PCMHwaterloo.com
Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Psychological Assessments If you are asked to have an assessment performed on your child, we feel you should be aware of the benefits of having one done. It is a tool to help you decide the best course of action for the best interests of your child. It can be a relief to know the true nature of the difficulty you are presented with or to have a diagnosis for a variety of reasons: • • • • •
you can do your own research on the subject you can join a local support group of parents experiencing similar issues you may benefit from proven strategies at home and school you can help educate other friends, family members about the subject you may be eligible for special services or funding
Your child’s school may suggest and pay for a psycho-educational* or psychological assessment to be done and refer you to their team. It has been recommended that assessments be done every four years during elementary school.The other option is to have your own assessment done privately, which your benefits or Employee Assistance Program (EAP) through your workplace might cover. You can expect to pay anywhere from $800 - $4,000 to have this assessment completed privately. See box below for links to “Finding a Therapist.” The Ontario Psychological Association can direct you to local therapists as should your family doctor or pediatrician. * the term psycho-educational assessment is commonly used by school personnel to describe an assessment of academic accomplishment, which may or may not include intellectual testing. These tests can be administered by anyone trained to administer these tests. Conversely, a psychological assessment is usually administered by a practitioner trained in psychology and psychometrics and includes IQ, cognitive, memory, language processing, etc., as well as personality tests and questionnaires.
Now You Have a Diagnosis If your child has just been diagnosed, don’t panic! There are other people who understand what you are going through. There are also sources of information which can help you handle problems now and in the future. “Even though we received this A first step would be to find and join a local support group. news about our child, this child is (see Local Parent Support Groups in Finding Support). the very same one we loved Talking to other families experiencing similar difficulties yesterday, a diagnosis has not can help you get perspective. They will often have resources such as books and videos that will help to changed that. We love the gifts answer your burning questions. They can be a wonderful that are also a part of his source of possible new friends for your child, and for disability.” parents/caregivers also. It is comforting to be around other people who “get it”. Other sources of information are local libraries and the internet. Links or Useful Resources: “Finding A Therapist” page under Finding Support Canadian Academy of Psychologists in Disability Assessment – www.capda.ca Finding a Therapist - www.mooddisorders.ca – 1-888-486-8236 Ontario Psychological Association – www.psych.on.ca - click on referral service or 1-800-268-0069 “What You Can Expect from a Mental Health Professional – www.cymhin.ca/downloads/What%20to%expect.pdf – Child and Youth Mental Health Information Network (CYMHIN) The Association of Chief Psychologists with Ontario School Boards – www.acposb.on.ca Last update: 14-Oct-11
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Children and Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Tips For Self-Care
MOST OF ALL, to be an effective advocate, parent, and partner you must keep your own life going! DON’T create a bubble around you and your child’s illness.
Take time to enjoy yourself and do things to take your mind away from the illness of your child. Structure your day and stick to a schedule. Pace yourself. Don’t be afraid to not always be there. Remain positive and optimistic – keep that sense of hope. Grieve your loss and dream new dreams. If it is indeed a mental illness accept the fact that your child is not choosing to be “bad” and that they may not have control due to the illness. Acknowledge that those around you may react negatively to the words “mental illness”. Develop a thick skin. You did not cause the illness and you can not cure it. Get counselling if you cannot deal with how you are feeling about the illness of your child – feelings of guilt, shame and grief are normal. Sometimes you may need to give up some authority. Let events take place as they unfold. Be ready to compromise. Understand that it may take time to make a diagnosis. Take time for just you and/or you and your significant other. Join a support group and find out as much information as possible. Eat healthy foods and drink lots of water throughout the day to maintain your energy. Try to exercise or do something active on a regular basis. Practice meditation, yoga or other relaxation techniques. Get a good night’s sleep even if it means taking the phone off the hook for the evening. Try distraction: spending time with pets, going for a walk, watching television, HOUSEWORK! Look for humour in unexpected places and laugh out loud! Practice self-compassion and NOT self-pity.
Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region
What is the DSM-IV? Now that you have an assessment, you should have a diagnosis. For your information, the DSMIV is the basis of that diagnosis, so we have attempted to help you understand its importance. Psychiatric Diagnoses are categorized by the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition. Better known as the DSM-IV, the manual is published by the American Psychiatric Association and is the standard classification of mental health issues (disorders) for both children and adults. It also lists known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches. Mental health professionals use this manual when working with patients in order to better understand their illness and potential treatment and to help 3rd parties (e.g., insurance) understand the needs of the patient. The book is typically considered the ‘bible’ for any professional who makes psychiatric diagnoses in Canada, the United States and many other countries. The DSM uses a multiaxial or multidimensional approach to diagnosing because rarely do other factors in a person's life not impact their mental health. It assesses five dimensions as described below: Axis I: Clinical Disorders This is what we typically think of as the diagnosis (e.g., depression, schizophrenia, social phobia). These are conditions that need clinical attention. Axis II: Personality Disorders and Mental Retardation Mental retardation and developmental disorders (e.g. autism) which are typically first evident in childhood. Personality disorders are clinical syndromes which have more long lasting symptoms and encompass the individual's way of interacting with the world (e.g. Paranoid, Antisocial, and Borderline Personality Disorders). Axis III: General Medical Conditions which play a role in the development, continuance, or exacerbation of Axis I and II Disorders. Physical conditions such as brain injury or HIV/AIDS that can result in symptoms of mental illness are included here. Axis IV: Psychosocial and Environmental Problems Events in a person’s life, such as death of a loved one, starting a new job, college, unemployment, and even marriage can impact the disorders listed in Axis I and II. These events are both listed and rated for this axis. Axis V: Global Assessment of Functioning Scale On the final axis, the clinician rates the person's level of functioning both at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected.
Last update: 14-Oct-11
www.PCMHwaterloo.com
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
What Is the DSM-IV? (continued) The DSM-IV has been designed for use across settings-- inpatient, outpatient, private practice and with community populations and by psychiatrists, psychologists, social workers, nurses, occupational and rehabilitation therapists, counsellors, and other health and mental health professionals. The DSM consists of three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text. The diagnostic classification is the list of the mental disorders that are officially part of the DSM system. "Making a DSM diagnosis" consists of selecting those disorders from the classification that best reflect the signs and symptoms that are afflicting the individual being evaluated. Associated with each diagnostic label is a diagnostic code, which is typically used by institutions and agencies for data collection and billing purposes. These diagnostic codes are derived from the coding system used by all health care professionals. For each disorder included in the DSM, a set of diagnostic criteria indicates what symptoms must be present (and for how long) in order to qualify for a diagnosis (called inclusion criteria). It also includes those symptoms that must not be present (called exclusion criteria) in order for an individual to qualify for a particular diagnosis. The use of these criteria has been shown to increase diagnostic reliability (i.e., likelihood that different users will assign the same diagnosis). Finally, the third component of the DSM is the descriptive text that accompanies each disorder. The text of DSM-IV describes each disorder under the following headings: "Diagnostic Features"; "Subtypes and/or Specifiers"; "Recording Procedures"; "Associated Features and Disorders"; "Specific Culture, Age, and Gender Features"; "Prevalence"; "Course"; "Familial Pattern"; and "Differential Diagnosis." The last major revision was published in 1994, although a "text revision" was produced in 2000 (the DSM-IV-TR). Changes were made to a handful of criteria sets in order to correct errors identified in DSM-IV. The DSM-V is currently in consultation, planning and preparation, due for publication in May 2012.
Links or Useful Resources for DSM-IV: American Psychiatric Association - www.psych.org Psychiatry Online - www.psychiatryonline.com All Psych Online – www.allpsych.com
Last update: 14-Oct-11
www.PCMHwaterloo.com
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
The Myth of the Bad Kid We all remember at least one “bad kid” in our class or in our lives. The child was thought to be spoiled, abused, or “just trying to get attention”. Sound familiar? Many of these children suffer from illnesses that are not their fault or their caregivers’ fault. Mental health myths make it easy to blame instead of trying to help. These kids are often written off. However, with appropriate mental health services many of these children can be successful and grow up to lead productive lives. Here are some of the myths that lead to misconceptions that contribute to stigma about mental illness and need to be overcome.
Myth: Depression and other illnesses, such as anxiety disorders, do not affect children or adolescents. Any problems they have are just a part of growing up.
Fact: Children and adolescents can develop severe mental illnesses. Almost 1 in 5 children in Ontario between the ages of 3 and 17 have a diagnosable mental health disorder. Of these approximately 500,000 children, about 300,000 of them have more than one disorder (source: Ontario Child Health Study, Children’s Mental Health Ontario). Left untreated, these problems can get worse.
Myth: Mental illness is fatal or terminal and people never get better. Fact: With the right help, many children with a mental illness do learn to cope and go on to lead healthy, productive, and satisfying lives.
Myth: Children misbehave or fail in school just to get attention. Fact: No child chooses to be bad. Mental illness has a physical cause, and is not the result of bad parenting. Most experts agree that a genetic susceptibility, combined with other risk factors, leads to a psychiatric disorder.
Myth: People with a mental illness are psycho, mad and dangerous, and have to be locked away.
Fact: Many individuals with a mental illness can have difficulty coping with dayto-day living. These individuals are at greater risk of harming themselves than others when in great distress.
Myth: You can tell if someone has a mental illness by looking in their eyes . Fact: Although there are many signs and symptoms for when someone may be developing a mental illness (see Signs and Symptoms of Children’s Mental Health Issues under Tab 1: Getting Started), quick judgements and stereotypes DO NOT make for comprehensive assessments by professionals.
Myth: Only crazy people see “shrinks.” Fact: People of all ages and all walks of life seek help from a variety of mental health professionals, including psychiatrists. Seeking and accepting help early are critical and are signs of coping and of preventing situations from getting worse. Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
The Myth of the Bad Kid (continued) Myth: If you talk about suicide, you won't attempt it. Fact: Suicidal comments have to be taken seriously as they often lead to plans, attempts, or completions.
Myth: Psychiatric disorders are not true medical illnesses like heart disease and diabetes. People who have a mental illness are just "crazy." Fact: Brain disorders, like heart disease and diabetes, are legitimate medical illnesses. Research shows there are genetic and biological causes for mental illness, and that they can be treated effectively.
Myth: Depression is a character flaw and people should just snap out of it. Fact: Research shows that depression has nothing to do with being lazy or weak. It results from changes in brain chemistry or brain function, and medication and/or psychotherapy often help people to recover.
Myth: Schizophrenia means split personality, and there is no way to control it. Fact: Schizophrenia is often confused with multiple personality disorder. However, it is a brain disorder that at times causes people to be unable to think clearly and logically. Symptoms range from social withdrawal to hallucinations and delusions. Medication helps many of these individuals to lead fulfilling, productive lives.
Myth: If you have a mental illness, you can will it away. Fact: Being treated for a mental illness means an individual or his family has decided to seek professional help. You can't just make a mental illness go away because you want it to. Ignoring it doesn't make it go away either. All mental illnesses require professional help, which could include medication, psychotherapy, or a combination of the two.
Myth: Addiction is a lifestyle choice and shows a lack of willpower. People with a substance abuse problem are morally weak or "bad". Fact: Addiction is a disease that generally results from changes in brain chemistry. It has nothing to do with being a "bad" person or lacking willpower.
Last update: 14-Oct-11
www.PCMHwaterloo.com
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
How to use this section: We have attempted to describe, in simple language, the definition of each of the following terms in an easy to understand manner. Words appearing in boxes within this and other sections are defined in the glossary at the back of the book.
WHAT IS...? Addictions/Substance Abuse Anger/Aggression - NEW Anxiety Disorder Attention Deficit/Hyperactivity Disorder (ADHD) Autism Spectrum Disorder (ASD) Bipolar Disorder Borderline Personality Disorder - NEW Bullying - NEW Conduct Disorder Cutting/Self Harm Depression Dissociative Identity Disorder – NEW Dual/Concurrent/Co-morbid Diagnoses Developmental Disability Eating Disorders Fetal Alcohol Spectrum Disorder (FASD) Learning Disabilities (LD) Mood Disorders Obsessive-Compulsive Disorder (OCD) Oppositional Defiant Disorder (ODD) Post Traumatic Stress Disorder (PTSD) – see Anxiety and Trauma Psychosis Re-active Attachment Disorder (RAD) Schizophrenia Schizoaffective Disorder Sensory Integration Dysfunction / Sensory Processing Disorder Stress Suicide Tourette Syndrome (TS) Trauma - NEW
Last update: 18-Oct-11
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NOTES
Last update: 14-Oct-11
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Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Addiction/Substance Abuse Children and in particular teenagers may be involved with a variety of drugs, both legal and illegal. Experimenting with a variety of drugs is common. Using alcohol and tobacco at a young age increases the chances of using other drugs later. Some will try them, some will use occasionally but unfortunately others will develop a dependency and cause harm to themselves. Twelve is now the age when children begin to try alcohol and marijuana. Teens use drugs for a variety of reasons: curiosity; because it feels good; to reduce stress; to feel grown up; to fit in. Drug use includes* alcohol; tobacco; prescribed medications; inhalants; overthe-counter cough, cold and sleep medications; stimulants; marijuana; club drugs; depressants; heroin and steroids. * Drug identification information can be found on the Waterloo Regional Police Service website, www.wrps.on.ca/community-safety/drug-identification.htm
Who is at risk? Teenagers that are at risk of developing serious alcohol and drug problems include those: With a family history of substance abuse Who are depressed Who have low self-esteem Who feel like they don’t fit in
Warning Signs of Substance Abuse Physical – health complaints, red and glazed eyes, lasting cough, fatigue Emotional – personality change, mood swings, irritable, irresponsible behaviour, poor judgement, low self-esteem, depression, general lack of interest Family – starts arguments, negative attitude, breaks rules, withdrawal from family, secretive School – decreased interest, negative attitude, drop in grades, many absences, truancy, discipline problems Social – new friends who are not interested in school or family and make poor decisions, problems with police, changes in clothing and music
Treatment Early education is critical and is often received at school. Professional consultation with a mental health professional is also crucial. No one treatment is the answer. All the individual’s needs must be met, not just the substance abuse, since the substance abuse is usually a symptom of a more serious issue, such as depression. Cont’d on reverse…
Last update: 14-Oct-11
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Addiction/Substance Abuse (continued) Links or Useful Resources for ADDICTIONS/SUBSTANCE ABUSE: Al-Anon and Adult Children of Alcoholics and Alateen Kitchener-Waterloo – 519-896-5678 Al-Anon and Alateen, Cambridge - 519-658-8222 Alcoholics Anonymous, Cambridge – 519-658-8222 American Academy of Child & Adolescent Psychiatry (AACAP) – www.aacap.org Canadian Centre of Substance Abuse – www.ccsa.ca Canadian Mental Health Association – www.cmha.ca Centre for Addiction and Mental Health (CAMH) – www.camh.net Children’s Mental Health Ontario – www.kidsmentalhealth.ca Drug and Alcohol Registry of Treatment (DART) – 1-800-565-8603 – www.dart.on.ca Golden Triangle Area Narcotics Anonymous – www.gtascna.on.ca or 519-651-1121 Grand River Hospital Withdrawal Management – www.grhosp.on.ca or 519-749-4318 Kitchener-Waterloo Alcoholics Anonymous – www.kwaa.ca or 519-742-6183 Mayo Clinic – www.mayoclinic.com National Institute on Drug Abuse – www.nida.nih.gov Narcotics Anonymous – 1-800-573-0920 or www.glana.ca Science and Management of Addictions - www.samafoundation.org St. Mary’s Hospital Counselling Services - - www.smgh.ca or 519-745-2585 Waterloo Regional Police Service – 519-653-7700 or 519-570-3000 or www.wrps.on.ca - Drug identification information - www.wrps.on.ca/community-safety/drug-identification.htm
NOTES
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Anger and Aggression Anger is a natural response to perceived threats. It inspires powerful, often aggressive feelings and behaviours, which can trigger the “fight or flight” response to allow us to defend ourselves when we are attacked. A certain amount of anger is therefore necessary to our survival. It is a common and unavoidable emotion and can be a healthy emotion when it is not harmful to others. For some children, however, anger escalates quickly out of control and they are not able to regulate this emotion.
Children that are affected by a range of mental health problems can be more significantly predisposed to angry outbursts than the average population due to many factors.
Anger manifests in increased heart rate and blood pressure rise, increasing adrenaline and stress hormones (can look like: red in face, clenched fists, clenched jaw, sweating, scowling, swearing). Aggression refers to a range of behaviours that can result in both physical and psychological harm to oneself, other or objects in the environment. The expression of aggression can occur in a number of ways, including verbally, mentally and physically. We can not, however, physically lash out at every person or object that irritates or annoys us. Laws, social and societal rules, and common sense place limits on how far our anger should take us. Children that are affected by a range of mental health problems can be more significantly predisposed to angry outbursts than the average population due to many factors, including: Difficulty reading social cues Poor social skills Emotional disregulation Learning disabilities Rigid thinking Suppressed or in-expressed anger Bullying and discrimination Trauma It is important to note that kids dealing with such difficulties seem to have a lower tolerance for frustration. However, they are actually more likely chronically frustrated, and therefore more prone to anger. Triggers Needs are not being met Memories of traumatic or enraging events Worrying about personal problems Bullying, discrimination, mistreatment Physical environment: too hot, too cold Fatigue Injury Not feeling well Trauma Last update: 14-Oct-11
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Anger and Aggression (continued) Anger can be a “substitute emotion”. People can change their feelings of pain into anger, instead of feeling the pain. This is because anger feels better than pain. It is easier to feel angry than to live with painful feelings of vulnerability. However, anger cannot resolve what made a person vulnerable in the first place, and it can actually cause new problems, i.e. health and social issues. Taking the time to understand how you deal with your or your child’s anger and learning to constructively deal with it can save you considerable frustration and heartache. There are many ways of working with anger – the strategies vary depending on the age of the child and their abilities. For a template to work through anger issues, see the Kids Help Phone link below for a helpful exercise. Your doctor or a mental health professional can also be of great help with seeking treatment.
Links or Useful Resources on ANGER AND AGGRESSION: Alberta Children’s Hospital – An article to help with “Dealing with Anger”: http://www.calgaryhealthregion.ca/clin/child/paed/parents/pdf/winter2001.pdf Anger Management Tips.com – www.angermanagementtips.com/children.htm and angermanagementtips.com/teens.htm To Speak to a Counsellor: Kids Help Phone – 1-800-668-6868 For a Helpful Exercise: http://kidshelpphone.ca/Teens/InfoBooth/Emotional-Health/Feeling-Angry.aspx Offord Centre for Child Studies - www.knowledge.offordcentre.com/index.php?...id
Last update: 14-Oct-11
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Anxiety Disorder Parents may notice that their child is fearful or nervous. This can be associated with a stressful event, such as public speaking or writing a test. It is normal for a child to worry or feel nervous about these single events. Anxiety disorders are treatable. Both anti-anxiety medications and cognitive behavioural therapy (CBT) have been shown to be effective and are sometimes used in combination. Early intervention is important.
Children or adolescents may have a problem, however, if they are frequently nervous or worried and find it hard to cope with any new situation or challenge. If they are trying to avoid any situation that causes anxiety, it may mean the child has an anxiety disorder. Anxiety is defined as a feeling of unease. When the level of anxiety is great enough and persistent enough to interfere with everyday activities, it is considered an Anxiety Disorder.
Types and Symptoms of Anxiety Agoraphobia
•
• •
Generalized Anxiety Disorder (GAD)
Panic Disorder
Phobia Post-Traumatic Stress Disorder (PTSD)
• •
persistent avoidance of places or situations in which one feels trapped or fears having a panic attack and/or being unable to escape the situation can be so debilitating that some people become house bound can include avoiding elevators, crowds, busy streets, traveling, using public transportation, driving or being alone many worries and fears
•
tense muscles, a restless feeling, becoming tired easily, having problems concentrating, trouble sleeping a need for approval
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sudden onset of intense apprehension, fearfulness or terror
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may include shortness of breath, dizziness, unsteady feelings, heart
•
palpitations, trembling or shaking, sweating, chest pain, choking, feelings of unreality, fear of dying or going crazy each occurrence usually lasts only a few minutes
•
extreme fear of a specific thing or situation (e.g. dogs, insects)
•
fears cause significant distress and interfere with usual activities
•
fairly rare in children
•
begins after one or many episodes of serious emotional upset
• •
may include jumpiness, muscle tension, being overly aware of one’s surroundings nightmares and sleep problems
•
sometimes flashbacks when events are triggered Cont’d on next page…
Last update: 14-Oct-11
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Anxiety Disorder (continued) Cont’d from previous page
Separation Anxiety
Social Anxiety
• •
constant thoughts and intense fears about the safety of parents and caretakers refusing to go to school
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frequent stomach aches and other physical complaints
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extreme worries about sleeping away from home
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being overly clingy
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panic or tantrums at times of separation from parents
•
significant anxiety in certain types of social or performance situations fear the evaluation or judgment of others
• • •
avoidance of public washrooms, eating in restaurants, writing in public may cause panic or anxiety attacks
•
few friends outside the family
Links or Useful Resources for ANXIETY: Anxiety Disorders Association of Ontario – www.anxietyontario.com Anxiety BC – www.anxietybc.com American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org Canadian Mental Health Association – www.cmha.ca Children’s Mental Health Ontario – www.kidsmentalhealth.ca Hamilton Health Sciences - www.macanxiety.com kidsLINK - www.kidslinkcares.com or via Front Door - 519-749-2932 London Health Sciences – Paediatric Outpatient Department -519-685-8500 x77553 Mind Your Mind – www.mindyourmind.ca Mood Disorders Parent Support Group of Waterloo Region –email: kidsmood@gmail.com Offord Centre for Child Studies – www.knowledge.offordcentre.com Parents for Children’s Mental Health parent support group – 519-746-5437, www.PCMHwaterloo.com or e-mail: parent.advocacy@hotmail.com University of Waterloo Psychology Department, Centre for Mental Health Research - 519-888-4567, Ext.33842; www.cmhr@waterloo.ca
Last update: 14-Oct-11
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Attention Deficit/Hyperactivity Disorder Children can seem inattentive, because they are daydreaming or are easily distracted by something going on in their life. They may run around because they simply have energy to burn. Some children may not appear to have attention problems until they get to school and are required to pay attention during activities they have no interest in. In some school-aged children, however, there are kids for whom paying attention and sitting still is very difficult. Their behaviour frequently gets them into trouble at home, school and in the neighbourhood. It can affect their social skills and make it difficult for them to make and keep friends. As a result, they can experience sadness and low self-esteem or feelings of rejection. Their impulsive behaviour and lack of judgement may also bring them into conflict with the law. These children would benefit from seeing a health professional to find out whether they have Attention Deficit Hyperactivity Disorder (AD/HD).
Symptoms of AD/HD Inattention
Hyperactivity/Impulsivity
1.
1.
2. 3. 4.
5. 6.
7.
8. 9.
Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities. Often has difficulty sustaining attention in tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to complete schoolwork, chores or duties (not due to oppositional behaviour or failure to understand instructions). Often has difficulty organizing tasks and activities. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework). Often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books or tools). Is often easily distracted by extraneous stimuli. Is often forgetful in daily activities.
Last update: 14-Oct-11
2.
3.
4. 5. 6. 7. 8.
Often fidgets with hands or feet or squirms in seat. Often leaves seat in classroom or in other situations in which remaining seated is expected. Often runs about or climbs excessively in situations in which it is inappropriate; (in adolescents or adults, may be limited to subjective feelings of restlessness). Often has difficulty playing or engaging in leisure activities quietly. Is often “on the go” or often acts as if “driven by a motor.” Often talks excessively. Often blurts out answers before questions have been completed. Often has difficulty waiting for turn. Often interrupts or intrudes on others (e.g. butts into games or conversations).
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Attention Deficit/Hyperactivity Disorder (continued) Sub-Types of AD/HD Predominantly Inattentive Type -When a person displays 6 or more symptoms of inattention, but fewer than 6 symptoms of hyperactivity-impulsivity, and the symptoms have persisted for at least 6 months. Predominantly Hyperactive-Impulsive Type - When a person displays 6 or more symptoms of hyperactivity-impulsivity, but fewer than 6 symptoms of inattention, and the symptoms have persisted for at least 6 months.
Combined Type - When a person displays 6 or more symptoms of inattention and 6 or more symptoms of hyperactivity-impulsivity, and the symptoms have persisted for at least 6 months. Most children and adolescents with AD/HD have the combined type. Children with undiagnosed AD/HD are at risk for school failure. Many also have other common related problems such as anxiety, mood problems, and oppositional behaviour or conduct disorder. (see definition of Conduct Disorder in this section). If their emotional and behavioural problems are not addressed and treated they could have higher rates of alcohol, nicotine and other drug abuse in adolescence due to self-medication. AD/HD can be safely and successfully treated with a combination of medication and behavioural therapy. More than 150 quality studies have shown that medications are the best treatment for AD/HD symptoms. When the child is treated with medication, it allows for the second approach of behaviour therapy to be more effective. Parent training may also be helpful in managing some of the social problems associated with AD/HD. (Also see Social Skills Training information under Finding Support). th
Adapted from the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4 edition
Links or Useful Resources for ATTENTION DEFICIT/HYPERACTIVITY DISORDER: Attention Deficit Disorder Association (ADDA) – www.add.org ADHD Parent Support Group Kitchener Waterloo - www.adhdparentsupportgroupkw.com -519-648-2942 Cambridge AD/HD Support Group – 519-624-7312 or e-mail: canadiankruger@rogers.com Canadian Mental Health Association – www.cmha.ca Centre for ADD/ADHD Advocacy, Canada - www.caddac.ca Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) – www.chadd.org Child and Parent Resource Institute www.cpri.ca or 1-519-858-2774 Children’s Mental Health Ontario – www.kidsmentalhealth.ca Dr. Daniel G. Amen’s Clinic – www.amenclinics.com McMaster University’s Canchild Centre for Childhood Disability Research - www.canchild.ca Offord Centre for Child Studies www.knowledge.offordcentre.com Tourette Syndrome Foundation of Canada - www.tourette.ca Tourette Syndrome Plus - www.tourettesyndrome.net
Last update: 14-Oct-11
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Autism Spectrum Disorder (ASD) Autism is a complex developmental disability that often appears during the first three years of life and is the result of a neurological disorder. Autism Spectrum Disorder or ASD affects over 70,000 individuals in Ontario or an incidence of 1 in 165. Autism affects the typical development of the brain in the areas of social interaction and communication skills. Children and adults with autism often have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. They find it hard to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behaviour may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in sight, hearing, touch, smell and taste. Autism is treatable. Early intervention is critical. Parents should ask their child’s family doctor for referral to a developmental paediatrician for assessment if there are concerns.
Warning Signs of Autism in Early Childhood Communication Red Flags
Behavioural Red Flags
Social Red Flags
- No babbling by 11 months - No simple gestures by 12 mos. (e.g., waving bye-bye) - No single words by 16 mos. - No 2-word phrases by 24 mos. (noun + verb; e.g., “baby sleeping”) - No response when name is called, causing concern about hearing - Loss of any language or social skills at any age
- Odd or repetitive ways of moving fingers or hands - Oversensitive to certain textures, sounds or lights - Lack of interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole) - Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted) - Preoccupation with unusual interests, such as light switches, doors, fans, wheels - Unusual fears
- Rarely makes eye contact when interacting with people - Does not play peek-a-boo - Doesn’t point to show things he/she is interested in - Rarely smiles socially - More interested in looking at objects than at people’s faces - Prefers to play alone - Doesn’t make attempts to get parent’s attention; doesn't follow/look when someone is pointing at something - Seems to be “in his/her own world” - Doesn’t respond to parent’s attempts to play, even if relaxed - Avoids or ignores other children when they approach
Autism is a spectrum disorder. The symptoms and characteristics of autism can present themselves in a wide range from mild to severe. Autism is defined by a certain set of behaviours; children and adults can exhibit any combination of the behaviours in any degree of severity. Two Last update: 14-Oct-11
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Autism Spectrum Disorder (continued) children, both with the same diagnosis, can act very differently from one another and have varying skills. There is no "typical" person with autism. Parents may hear different terms used to describe children such as autistic tendencies, autism spectrum, high-functioning or low-functioning autism, Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). Whatever the diagnosis, children can learn and function productively and show gains from appropriate education and treatment. Autism Spectrum Disorder (ASD) is the general category of disorders, which are characterized by severe and pervasive impairment in several areas of development. Children who fall under the ASD category show similarities in lack of communication and social skills, but are different in terms of severity, number of symptoms or age of onset. Some differences are listed below.
Types of Autism Autistic Disorder Asperger's Disorder Pervasive Developmental Disorder - Not Otherwise Specified Rett's Disorder
Childhood Disintegrative Disorder
Impairments in social interaction, communication, and imaginative play prior to age 3 years. Stereotyped behaviours, interests and activities Impairments in social skills and restricted interests and activities, with no significant delay in language, and in the range of average to above average intelligence A diagnosis of PDD may be made when a child does not meet the criteria for a specific diagnosis, but there is a severe impairment in specified behaviours. A progressive disorder which, to date, has occurred only in girls. They have a period of normal development and then lose previously acquired skills, as well as normal use of the hands and repetitive hand movements beginning at the age of 1-4 years Characterized by normal development for at least the first 2 years, followed by significant loss of previously acquired skills.
Links or Useful Resources for AUTISM: Autism Ontario – www.autismontario.com, search to find your local chapter
Autism Web – www.autismweb.com Autism Society of America – www.autism-society.org Child and Parent Resource Institute (CPRI) – www.cpri.ca or 1-519-858-2774 Developmental Services Access Centre (DSAC) – www.dsac-wr.com or call 519-741-1121 Geneva Centre for Autism – www.autism.net KidsAbility Centre For Child Development – www.kidsability.ca – 519-886-8886 Erinoak – www.erinoak.org Interesting Article: “The Truth About Autism: Scientists Reconsider What They Think They Know” http://www.wired.com/medtech/health/magazine/16-03/ff_autism?currentPage=1 Autism Spectrum Connection – www.autismspectrumconnection.com
Last update: 14-Oct-11
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Bipolar Disorder Bipolar disorder (also known as manic-depression) is a serious but treatable medical illness. It is thought to be a chemical imbalance in the brain marked by extreme changes in mood, energy, thinking and behaviour. Symptoms may be present since infancy or early childhood, or may suddenly emerge in adolescence or adulthood. Until recently, a diagnosis of the disorder was rarely made in childhood. Doctors can now recognize and treat bipolar disorder in young children. Early intervention and treatment offer the best chance for children with emerging bipolar disorder to achieve stability, gain the best possible level of wellness, and grow up to enjoy their gifts and build upon their strengths. Proper treatment can minimize the adverse effects of the illness on their lives and the lives of those who love them. Everyone has ups and downs in mood. Feeling happy, sad and angry is normal. Bipolar disorder, or manic-depressive illness, is a serious medical condition that causes people to have extreme mood swings that affect their entire outlook in all areas of life. These swings affect how people think, behave and function.
How to Recognize Bipolar Disorder Symptoms of a Depressive Episode
Symptoms of a Manic Episode Enjoyable Symptoms Negative Symptoms
- preoccupation with failure - loss of self esteem - feelings of uselessness and hopelessness - excessive guilt - crying easily - slowed thinking - loss of interest in activities - sleep problems - loss of appetite - suicidal thoughts - loss of energy and motivation - decreased sexual drive
- feelings of happiness and excitement - inflated self-esteem - heightening of the senses - excessive energy - increased sexual drive
- irritability and impatience - speaking loudly and quickly - rapid, unpredictable emotional changes - racing thoughts - overreaction to stimuli - poor judgement - overspending - decreased sleep - alienating friends and family members - hallucinations or delusions - sexually inappropriate behaviour
Links or Useful Resources for BIPOLAR DISORDER: Centre for Addiction and Mental Health – www.camh.ca American Academy of Child and Adolescent Psychiatry – www.aacap.org Child and Parent Resource Institute (CPRI) –1-519-858-2774 - www.cpri. ca Children’s Mental Health Ontario – www.kidsmentalhealth.ca Canadian Mental Health Association – www.cmha.ca Juvenile Bipolar Research Foundation – www.bpchildresearch.org Child and Adolescent Bipolar Foundation – www.bpkids.org Mood Disorder Parent Support Group of Waterloo Region –email: kidsmood@gmail.com Mood Disorder Association of Ontario (MDAO)-www.mdao.ca or 1-888-486-8236
Last update: 14-Oct-11
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NOTES
Last update: 3-Aug-11
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Borderline Personality Disorder A problem with emotion regulation is a defining characteristic of this disorder.
Borderline Personality Disorder (BPD) is a serious mental illness recognized by some professionals and discounted by others. Parents for Children’s Mental Health Waterloo Region feel that they cannot summarize this mental illness effectively.
Below we have simply listed some of the things we are aware of as characteristics associated with this diagnosis. There are often additional diagnosis that can fit or can be co-occurring which makes a diagnosis more difficult. A number of different criteria have been developed to suggest possible Borderline Personality Disorder in children. A problem with emotion regulation is a defining characteristic of this disorder. If the symptoms listed below are apparent it is important to get a complete evaluation by a professional. A diagnosis of borderline personality disorder is usually made in adults, not children or adolescents. Signs and symptoms may go away with maturity.
Some Signs and Symptoms Explosive and impulsive behavior Unstable self-image Mood swings Intense rages, hostility, oversensitivity, overreaction Self-injurious behaviours like cutting, burning, substance abuse Misinterpreting conversations in a negative way Aggressive towards themselves or others and poor impulse control Significant issues with thinking and reasoning Makes friends who turn into enemies suddenly – unstable relationships Treatment is possible. Early intervention is critical. There is evidence that children with BPD do improve with appropriate treatment. This could be a combination of medication and psychotherapy and Dialectic Behaviour Therapy (see Section 4: Finding Support).
Links or Useful Resources for BORDERLINE PERSONALITY DISORDER: About.com - http://bpd.about.com/od/forfamilyandfriends/a/bpdchild.htm American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org BPD Demystified – www.bpddemystified.com Keeping Kids Healthy – www.keepingkidshealthy.org
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Bullying Bullying is a way of being repeatedly cruel to another person whether physically, verbally, socially or emotionally. A child with disabilities can be either the aggressor or the victim, most often the victim due to the imbalance of power.
Bullying can mean different things to different ages and stages of child development. More boys than girls are bullied. One-third of students experience bullying at school, and almost one-third report having bullied someone else (Centre for Addiction and Mental Health, 2005). Bullying seldom happens without bystanders. Bullying, whether the victim or the bully, has life-long consequences if not dealt with in an appropriate manner. Unfortunately, those with disabilities, be they learning or mental health are more often victimized due to the imbalance of power.
A young child may only know that someone is being mean or hurting her or making her feel sad. A teenager on the other hand won’t necessarily tell anyone there is a problem. They will try to handle it on their own as they may think they will hurt you by telling you. They may also be embarrassed by the situation. Bullying can be verbal, physical, social or electronic (cyber-bullying). The best thing to do is to watch for signs that your child may be a victim or a bully.
You must also keep in mind that the neurology of those with any type of mental illness (OCD, ADHD, etc.) can contribute, influence or impact a child’s bullying behaviours. These issues then need to be worked on (medication, professional help, etc). Signs and symptoms that your child may be being bullied: Coming home with torn clothes or damaged or missing belongings Not having any good friends Unexplained bruises, scratches, etc. Refusal to go out – school, social activities, playground Shyness, stomach aches, headaches, panic attacks Not being able to sleep/sleeping too much, exhaustion Who is the Bully? Children with mental health issues that want to belong Children with neurology that affects every aspect of their health Insecure children needing to make themselves feel good by making others feel bad School and social failures Can be learned behaviour from television, movies, other children or parents/adults Bigger and stronger than their victims Intolerant towards differences Initally they may show no empathy, compassion or shame but they can be extremely remorseful, even though it may be delayed Children that have undergone trauma in their lives What you can do if your child is the bully: Teach moral responsibilities Social skills training Appropriate role modeling Last update: 14-Oct-11
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Bullying (continued) Positive reinforcement for good behaviours Seek professional help if needed How to Deal with a Bully: Children should not have to deal with a bully without adult intervention. Research shows that telling your child to deal with the bully results in increasing the bullies power. If the situation occurs at school involve your child’s teacher; principal or school/community behaviour consultant. Use humour if possible to defuse the situation Intervene immediately with discipline Create opportunities to “do good” Teach friendship skills – see Social Skills Training in the Finding Support Section Agreeing with the bully may defuse the situation Know when to seek professional help – if you are out of ideas or you need additional support this may be the time. There are a number of good books on dealing with bullies including but not limited to: Keys to Dealing with Bullies by Barry E. McNamara and The Bully, The Bullied and the Bystander by Barbara Coloroso. These books are available for loan at various libraries. How to Deal with the Victim: Listen, listen, listen – be clear on what your child is telling you Help the child come up with strategies to reframe the situation so that they are less sensitive to others comments/actions Use strategies to help your child be positive and successful Teach him how to introduce himself into a group Strengthen his sense of self Help your child to fit in – look at how other children are dressing, etc. Social skills training can help with comebacks, reading social cues and other strategies Seek professional help if needed Don’t hesitate to involve police if serious and ongoing Cyber-bullying: Most children use the internet to play games, connect with friends and more. Unfortunately, there are dangers in the internet world. Cyber-bullying is simply defined as the use of technology to hurt or intimidate others, their relationships and their reputation. Social networking sites, email, You Tube, cell phones are all tools at a bully’s disposal. Many teens think it is simply fun but there have been suicides as a result of this type of incident. Kids Help Phone.ca has an amazing site with lots of strategies to prevent cyber-bullying and ways to block the cyber-bully. They also can talk directly to the child or teen and help them deal with cyber-bullying. ( www.kidshelpphone.ca).
Links or Useful Resources for BULLYING: Safe Schools Strategy – www.ontario.ca/safeschools Kids Help Phone Line – www.kidshelpphone.ca or 1-800-668-6868 “Notice of Harassment Kit for School Bullying” – www.documatica_forms.com/bullying Ministry of Education link to 12-pg. Bullying Guide - www.edu.gov.on.ca/eng/parents/bullying.pdf Last update: 16-Oct-11
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Conduct Disorder Conduct disorder is a repetitive and persistent pattern of behaviour in children and adolescents in which the rights of others are violated (or they are behaving in a socially unacceptable way). The child or adolescent usually exhibits these behaviour patterns in a variety of settings — at home, at school, and in social situations — and they cause significant impairment in his or her social, academic, and family functioning. Many youth with this disorder have trouble feeling and expressing empathy or remorse and reading social cues. Some may have been rejected by peers as young children. They often misinterpret the actions of others as being hostile and respond by escalating the situation into conflict.
Early intervention is key. Family therapy, Psychotherapy and Cognitive Behavioural Therapy are usually necessary to help the child appropriately express and control anger.
The disorder is more common among boys than girls. It can have early onset, before the age of 10, or in adolescence.
Many factors can contribute to a child developing conduct disorder. Although it is more common in the children of parents who themselves exhibited conduct problems when they were young, other factors such as brain damage, child abuse, school failure, and traumatic life experiences are also believed to contribute to development of the disorder.
Identifying the Signs of Conduct Disorder • Aggressive behavior that threatens harm to other people or animals (bullying, intimidating, physical fighting, cruelty to animals, use of weapons, steals from a victim in a confrontational manner) • Non-aggressive conduct such as fire-setting or deliberate destruction of property • Theft; breaking in to someone else’s building, car or house, or shoplifting • Deceitfulness; “conning” or lying to obtain goods or favours or to avoid obligations • Serious rule violations, such as staying out at night, running away from home, truant from school. Children that exhibit these behaviours should receive a comprehensive evaluation. Many children with a conduct disorder may have co-existing conditions such as mood disorders, ADHD, anxiety, Post Traumatic Stress Disorder, substance abuse, learning disorders or thought disorders. Intervention is crucial, as without help, these youth are at risk to not adapt into adulthood and will continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner. Treatment of children with conduct disorder can be complex and challenging. Treatment can be provided in a variety of different settings depending on the severity of the behaviours. Adding to the challenge of treatment are the child's uncooperative attitude and fear and distrust of adults. In developing a comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers, and other medical specialties to understand the causes of the disorder. Last update: 14-Oct-11
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Conduct Disorder (continued) The key is early intervention. Family therapy, psychotherapy and Cognitive Behavioural Therapy are usually necessary to help the child appropriately express and control anger. Focus needs to be on building skills like anger management. Drug therapy alone is not sufficient for the treatment of conduct disorder. Special education may be needed for youngsters with learning disabilities. Parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Treatment may also include medication in some youngsters, such as those with difficulty paying attention, impulse problems, or those with depression. Treatment is rarely brief as establishing new behaviour patterns takes time. However, early treatment offers a child a better chance for considerable improvement and hope for a more successful future.
Links or Useful Resources for CONDUCT DISORDER: American Academy of Child and Adolescent Psychiatry - www.aacap.org Child and Parent Resource Institute (CPRI) – 1-519-858-2774 or www.cpri.ca Mental Health America - www.nmha.org Mood Disorders Parent Support Group of Waterloo Region – email: kidsmood@gmail.com Parents for Children’s Mental Health parent support group – 519-746-5437, www.PCMHwaterloo.com or e-mail: parent.advocacy@hotmail.com
Last update: 14-Oct-11
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Cutting/Self Harm Cutting is when a person intentionally makes cuts on his or her body with a sharp object. The cuts may be small or large, shallow or deep. They may cause a little bleeding or a lot of bleeding and require stitches. The person cuts to try to feel better. This is not a suicide attempt. Some people use other methods to hurt themselves – burning, scratching, head banging, pulling out hair, biting or hitting Cutting can become an addiction themselves, etc. At schools in Waterloo Region they are over time. Like other addictions known as “EMO’s” (“emotional”) and sometimes they only the addict can have the hang around in groups. The EMO subculture is associated with emo music (emotional rock or indie power to make change, seek help music) but also extends into appearance, behaviour, and and support. perspectives on life. Both sexes may cut themselves, but more females do this. They may cut at any age but most people start as teens or young adults. It could be short term or go on for years. Background, race and income level does not appear to have any influence.
Why do people cut? Cutting is a response to deep and painful feelings. People cut for different reasons: Some feel numb. The pain of cutting makes them feel alive. Some feel ashamed or guilty about something. It is a way to punish themselves. Some believe it is a method of control. Choosing when and where to feel physical pain makes them feel more in control of their emotional pain. Some want to communicate. Cutting is a way to express pain the person can’t say in words.
Signs of Cutting It may be difficult to spot signs of self-injury as people often try to keep this behaviour secret.
Signs & Risks of Cutting Signs - Scars, such as from burns or cuts - Always wearing long sleeved shirts and long pants - Cuts, scratches or other wounds - Bruises - Broken bones - Keeping sharp objects on hand - Spending a lot of time alone - Frequent accidents or mishaps
Last update: 14-Oct-11
Risks - Infection - Scars - Unintended life-threatening injuries - Losing (or not learning) other ways to cope - Feeling guilty, ashamed or angry about the cutting - Having painful feelings continue and get worse - Isolation from friends and family - Avoiding usual activities as the cutting becomes more addictive
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Cutting/Self-Harm (continued) Signs of Cutting (cont’d) Cutting can become an addiction over time. Here are some suggestions from people who stopped cutting: Be honest. Admit how serious the behaviour is. Know what you can do. Like other addictions only the addict can have the power to make change, seek help and support. Notice triggers. What events, situations and memories can lead to cutting? Avoid these triggers. Build a support system – Find people who can help you to make healthier choices. Try therapy – If the person has been cutting for some time, therapy may be a way to get support.
If your child or youth is cutting: In an emergency, GET HELP. Call 911 if you need to. Ask about it. Listen if he or she wants to talk. Avoid judging. Don’t dismiss the cutting as a way to get attention. Let them know you care. Understand that they are feeling pain. Help them find resources that can help. Contact your paediatrician or family doctor Get a referral to a mental health specialist-preferably with expertise in self-injury
Links or Useful Resources for CUTTING/SELF HARM: Mayo Clinic – www.mayoclinic.com Canadian Mental Health Association – www.cmha.ca Kids Help Phone – 1-800-668-6868 – www.kidshelpphone.ca The Helpline USA – www.helpguide.org/mental/self_injury A Complete Guide to Self Injury – http://www.mentaline.com/articles/self-injury-information.aspx
Last update: 14-Oct-11
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Depression Parents may notice that their child is sometimes sad or blue. Sadness is part of living. It helps us understand our inner world and gives meaning to events. Depression is treatable. Early identification, diagnosis and treatment will help the child reach full potential.
Children or adolescents may have a problem, however, if they are frequently sad and it begins to interfere with a child’s ability to function in daily life. Depression is not a weakness or character flaw and you cannot just “snap out of it”.
Depression is treatable. Early identification, diagnosis and treatment will help the child or adolescent reach full potential. Any child, youth or adult who abuses substances should also be evaluated for depression. Dysthymia is a mood disorder that falls within the depression spectrum. It is considered a chronic depression, but with less severity than a major depression. This disorder tends to be a chronic, long-lasting illness.
Symptoms of Depression - Sad mood or cries a lot and it doesn’t go away - Don’t feel like doing a lot of things they used to - Loss of self-esteem, feeling useless, hopeless, excessively guilty - Life seems meaningless - Withdrawal from friends and activities - Slowed thinking, forgetfulness - Difficulty concentrating and making decisions - Lethargy, low energy - Sleep pattern changes; sleeping more or having trouble falling asleep - Frequent physical complaints such as headaches and stomachaches - Agitation - Changes in appetite or weight – eating too little or too much - Suicidal thoughts or talk of death or self-destructive behaviour A combination of these symptoms for more than two weeks should be discussed with a mental health professional or doctor.
Links or Useful Resources for DEPRESSION: American Academy of Child and Adolescent Psychiatry – www.aacap.org BC Partners For Mental Health & Addiction Information - www.heretohelp.bc.ca Canadian Mental Health Association – www.cmha.ca Children’s Mental Health Ontario – www.kidsmentalhealth.ca Depression Hurts – www.depressionhurts.ca Families for Depression Awareness – www.familyaware.org Mood Disorders Association of Ontario (MDAO) – www.mdao.ca or 1-888-486-8236 See also “The Facts About Teen Depression” sheet at http://www.mooddisorders.ca/faq/teen-depression
Last update: 14-Oct-11
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NOTES
Last update: 14-Oct-11
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Dissociative Identity Disorder (DID) Dissociative identity disorder (herein known as DID) is often a misunderstood mental illness. DID was formerly known as Multiple Personality Disorder and in recent years has become better understood as a Dissociative Identity Disorder is complex and chronic post traumatic mental health issue. found more commonly in females It has been attributed to severe trauma from extremely than in males and is often frightening or life threatening experiences like child abuse, sexual abuse, war, and accidents. This is a difficult to diagnose. condition in which a person displays at least two or more recurring distinct personalities or identities. These are known as alter egos or alters), each with its own pattern of perceiving and interacting with the environment. Each alternate personality has a unique set of memories, behaviours, thoughts and emotions related to each specific personality.
Signs and symptoms of DID include: Lapses in memory (dissociation), particularly of important life events like birthdays Experiencing blackouts in time, resulting in finding oneself in places but not recalling how one traveled there Being frequently accused of lying when they do not believe they are lying (for example, being told of things they did but cannot recall) Finding items in one’s possession but not recalling how those things were acquired Encountering people with whom one is unfamiliar but who seem to know them sometimes as someone else Being called names that are completely unlike their own name or nickname Hearing voices inside their head that are not their own Not recognizing themselves in the mirror Feeling unreal Feeling like they are watching themselves move through life rather than living their own life Feeling like more than one person
What DID is not: Not due to alcohol or drug intoxication Not due to imaginary playmates or fantasy play Not due to a medical condition
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Dissociative Identity Disorder (DID) cont’d Links or Useful Resources for DISSOCIATIVE IDENTITY DISORDER: CMHA (Canadian Mental Health Association) – www.chma.ca Regional Mental Health Care St. Thomas - http://www.sjhc.london.on.ca/mhst/programs/openingpagestthomas2.htm Children’s Mental Health Ontario – www.kidsmentalhealth.ca Discussing Dissociation – http://discussingdissociation.wordpress.com/2008/12/09/50-treatment-issues-fordissociative-identity-disorder/ Dissociative Identity Disorder Discussion – www.reddit.com/r/DID Dissociative Identity Disorder on emental Health http://www.ementalhealth.ca/elgin/en/_Dissociative_Identity_Disorder_DID_a12_b8906.html International Society for the Study of Trauma and Dissociation - http://www.isst-d.org/ Kids Help Phone – 1800-668-6868 or www.kidshelpphone.ca Medicine Net.com - http://www.medicinenet.com/dissociative_identity_disorder/article.html Mind Disorders.com - http://www.minddisorders.com/Del-Fi/Dissociative-identity-disorder.html Mind Your Mind – www.mindyourmind.ca Ontario Centre of Excellence for Child and Youth Mental Health – www.excellenceforchildandyouth.ca Youth Net/Reseau Ado – www.youthnet.on.ca
Last update: 18-Oct-11
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Dual / Concurrent / Co-morbid Diagnoses “Dual Diagnosis” has been used to refer to the occurrence of both a mental illness and a developmental disability (see the reverse for a definition) in the same person. Some examples of developmental challenges are: intellectual disability, (also known as mental retardation); learning disability; Downs Syndrome; Prader-Willi Syndrome and Autism Spectrum Disorder. Concurrent diagnosis refers to the presence of an addiction as well as a mental illness. However, in the United States, they use the term dual diagnosis to refer to this condition. Co-morbid, or cooccurring disorders means they are commonly found together in the same person, i.e. AD/HD + Obsessive-Compulsive Disorder). Often, a dual diagnosis is not given right away. Usually, either the developmental challenge or the mental health issue is diagnosed first and the other is recognized later on. Services Ontario (DSO).
For our reference and for many other professionals in Waterloo Region, dual diagnosis is referring to a developmental disability PLUS a diagnosis of a mental health disorder. If a diagnosis of a developmental disability has been made, regardless of other diagnoses, the family/guardian can access services through Developmental Services Access Centre (DSAC) or through Developmental
If a diagnosis regarding mental health is suspected, or developmental disability is unclear or not officially diagnosed, please contact Front Door (formerly the Children’s Mental Health Access Centre (CMHAC)) to access services for children and youth. Parents who want to know about Front Door can visit the kidsLINK website, call (519) 749-2932 to book an appointment, or come to the walk-in clinic located at 1770 King St. E., Suite 1 in Kitchener on Wednesdays between the hours of 3:00 and 7:30 p.m. (last appointment at 6:30 p.m.).
Links or Useful Resources for DUAL / CONCURRENT / CO-MORBID DIAGNOSES: Canadian Mental Health Association – www.cmha.ca Child and Parent Resource Institute (CPRI)- www.cpri.ca or call 1-519-858-2774 Developmental Services Access Centre (DSAC) – 519-741-1121 or www.dsac-wr.com Front Door – 519-749-2932 KidsAbility Centre For Child Development – www.kidsability.ca or 519-886-8886 KidsLINK – www.kidslinkcares.com or access through Front Door at 519-749-2932 Mayo Clinic – www.mayoclinic.com Mood Disorder Parent Support Group of Waterloo Region – email: kidsmood@gmail.com Waterloo Region Family Network – www.waterlooregionfamilynetwork.com or 519-804-1786
Last update: 18-Oct-11
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Developmental Disability The Developmental Services Act defines a developmental disability as "a condition of mental impairment, present or occurring during a person's formative years, that is associated with limitations in adaptive behaviour." A developmental disability is a life-long condition and can be accompanied by other physical conditions. This disability varies greatly among individuals. A person with a developmental disability may have limitations in intellectual ability and difficulties in many common daily activities or life skills, such as personal hygiene and dressing, communication, learning, mobility, ability to live independently, and economic self-sufficiency. To determine eligibility for service, the Developmental Services Access Centre in Waterloo Region uses the Ministry definition for developmental disability noting that intellectual disability and/or Autism Spectrum Disorder constitutes this. Documentation is needed to support eligibility, i.e. psychological assessments.
Links or Useful Resources for DEVELOPMENTAL DISABILITY: Developmental Services Access Centre (DSAC) – 519-741-1121 or www.dsac-wr.com Ministry of Community & Social Services www.mcss.gov.on.ca/en/mcss/programs/developmental/improving/newLegislation.aspx
Last update: 14-Oct-11
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Eating Disorders Eating disorders include anorexia, bulimia and binge eating disorder. Food restrictions, food rituals, binge eating, starving, purging or compulsive physical activity are some of the behaviours of people with eating disorders. Eating disorders can be difficult to detect. Glamorization of so-called ideal bodies, coupled with the view that dieting is a normal activity, can obscure a person's eating problems. It can be difficult for a person with an eating disorder to admit they have a problem, let alone someone whose life is inhibited by weight preoccupation. Gaining an understanding of these conditions is the first step in the journey to wellness. Education and awareness activities are crucial.
If you suspect your child has an eating disorder, act quickly. Someone with an eating disorder needs professional help. It is vital to recognize and treat the symptoms early. Someone with an eating disorder may be:
Obsessed with their appearance Severely preoccupied with food, weight and exercise Weighing themselves frequently Avoiding eating with others Making abusive remarks about themselves Depressed or irritable
Characteristics of: Anorexia Nervosa drastic weight loss or
Bulimia Nervosa uncontrolled, secretive
Binge Eating Disorder eating frequently in large
keeping weight below a
binge eating
quantities
healthy level
purging of food (e.g. self
feeling out of control &
intense fear of gaining
induced vomiting)
unable to stop
weight (may be
- fasting or excessive
may eat rapidly or
accompanied by excessive
exercise
secretly
exercising)
eating to avoid difficult
- possible loss of
relationships or people
menstrual cycle
finding comfort in eating feeling guilty/ashamed of over-eating - may have a history of diet failures.
Recovery from eating disorders is possible, especially when identified and treated early on. Last update: 14-Oct-11
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Eating Disorders (continued) There is no known single cause of eating disorders. Research suggests a combination of psychological, physiological, genetic and social factors may contribute to the development of anorexia or bulimia nervosa. Many individuals have symptoms of both conditions. It is also essential that professionals receive specialized training for the treatment of eating disorders.
Links or Useful Resources for EATING DISORDERS: Bulimia Anorexia Nervosa Association – www.bana.ca Canadian Mental Health Association, Grand River Branch – 519-744-7645 or 1-877-627-2642 Eating Disorders Awareness & Prevention Inc. – www.edap.org Eating Disorders Awareness Coalition – www.edacwr.com, phone: 519-745-4875 National Eating Disorders Information Centre – www.nedic.ca Overeaters Anonymous – www.oa.org, phone: 519-886-9975 Trellis Mental Health & Developmental Services Regional Eating Disorders Services – www.trellis.on.ca or 519-576-2333 (covers Kitchener, Cambridge and Guelph)
Last update: 14-Oct-11
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Fetal Alcohol Spectrum Disorder Fetal alcohol spectrum disorder is an umbrella term used for Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (pFAS) and Alcohol-related Neurodevelopmental Disorder (ARND). Proper treatment and accommodations will help to prevent secondary disabilities* such as cognitive disorders, psychiatric illness and psychological dysfunction.
FASD is an invisible disability. It lasts a lifetime, but it may change over time. It cannot be cured, but can be prevented. This disorder affects how information is processed in a person’s brain. The disorder is a spectrum disorder because of the range of effects from mild to severe.
FASD may also look like: • • • •
Attention Deficit Disorder (ADD or ADHD) Attachment Disorder Autism or Pervasive Developmental Delay Conduct Disorder
• • • •
Hyperactivity Learning Disabled Oppositional Defiant Disorder Sensory Integration Dysfunction
Diagnosis of this disorder will provide parents/caregivers and educators with direction and guidance for interventions. Proper treatment and accommodations will help to prevent secondary disabilities* such as cognitive disorders, psychiatric illness and psychological dysfunction. A diagnosis helps people involved with these children’s care and education to establish realistic expectations based on child’s strength and weaknesses. To diagnose FASD, there must be a confirmed knowledge/history of prenatal alcohol consumption and a combination of: Prenatal and/or postnatal growth deficiency 3 facial characteristics (short palpebral fissures, indistinct philtrum, thin upper lip) 3 neurobehavioural domains below 2nd standard deviation. No two people with FASD are alike.
* Secondary disabilities that may occur with undiagnosed FASD are: • mental health problems (90%) • dependent living arrangements (80%) • employment difficulties (80%)
• involvement with the legal system (60%) • school difficulties (60%) • substance abuse (30%)
Waterloo and Wellington Regions each have FASD diagnostic clinics where local children are assessed for FASD and ARND (Alcohol -Related Neurodevelopmental Disorder). For the Wellington clinic, contact Trellis at 519-576-2333. For Waterloo Region, children can only be referred for a FASD assessment through their involvement with a participating agency or practitioner. These include: kidsLINK, Lutherwood, Grand River Hospital, KidsAbility, Dr, Malholtra, Dr. Louise Scott, and the Waterloo Catholic District School Board.
Last update: 14-Oct-11
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Fetal Alcohol Spectrum Disorder (continued) Links or Useful Resources for FETAL ALCOHOL SYNDROME DISORDER: Canadian Centre on Substance Abuse – www.ccsa.ca KidsAbility Centre For Child Development – www.kidsability.ca, search under “diagnosis” London: Children’s Hospital of Western Ontario, Genetics Dept. 1 - 519-685-8140 Mayo Clinic – www.mayoclinic.com Toronto: The Hospital for Sick Children, Motherisk Program –www.motherisk.org or 416-813-7500 Toronto: St. Michaels Hospital – FASD Diagnostic Clinic –www.stmichaelshospital.com or 416-867-3655 (by referral only) Waterloo Region FAS Support Group – 519-883-2223 Trellis Mental Health & Developmental Services – 519-576-2333
NOTES
Last update: 14-Oct-11
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Learning Disabilities Children with learning disabilities can succeed when solid coping skills and strategies are developed.
Learning disabilities (LDs) affect one or more of the ways that a person takes in, stores, remembers, or uses information. Between 5 and 10 percent of Canadians have LDs.
LDs are a life-long condition -- they do not go away -- but can be coped with successfully when solid coping skills and strategies are developed. For example, using areas of strength to compensate and accommodations such as technology. LDs and their effects are different from child to child, so a child’s pattern of learning abilities needs to be understood in order to find good, effective strategies for compensation. LDs result from impairments in one or more psychological processes related to perceiving, thinking, remembering or learning. These include, but are not limited to: language processing; phonological processing; visual spatial processing; processing speed; memory and attention; and executive functions (e.g. planning and decision-making). Learning disabilities are specific, not global impairments and as such are distinct from intellectual disabilities. Learning disabilities range in severity and invariably interfere with the acquisition and use of one or more of the following important skills: oral language (e.g., listening, speaking, understanding) reading (e.g., decoding, comprehension) written language (e.g., spelling, written expression) mathematics (e.g., computation, problem solving) LDs may also cause difficulties with organizational skills, social perception and social interaction. LDs are due to genetic, other congenital and/or acquired neurobiological factors. They are not caused by factors such as cultural or language differences, inadequate or inappropriate instruction, socio-economic status or lack of motivation. Any one of these and other factors may, however, compound the impact of learning disabilities. Frequently learning disabilities co-exist with other conditions, including attentional, behavioural and emotional disorders, sensory impairments or other medical conditions. For success, persons with learning disabilities require specialized interventions in home, school, community and workplace settings, appropriate to their individual strengths and needs, including: specific skill instruction; the development of compensatory strategies; the development of self-advocacy skills; appropriate accommodations.
Last update: 14-Oct-11
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Learning Disabilities (continued) Types of Learning Disabilities LDs take so many forms, and vary in intensity so much, that it is not simple to list them all, but there are some broad categories which they all fall into: LDs that affect Academics: Difficulties with spelling, reading, listening, focussing, remembering and writing can all have an impact on all areas of school subjects. LDs that affect Organization and Focus: A series of executive functions allow us to do things like plan, predict, organize and focus. LDs that interfere with these things can interfere with how we manage our lives and physical space. ADHD, which does affect executive functions, is coming to be seen as an LD because of this. LDs that affect Social Life: We learn how to be socially successful, even though we don't notice that we're learning. So LDs that make it difficult to interpret facial expressions, body language, or tones of voice can have a real impact on a person's social life. LDs that affect Physical Interaction With the World: Again, without knowing, we are constantly receiving information about our surroundings and about our bodies: our balance, coordination and movement are all based on this information. So an LD that interferes with how we understand that information can cause a person to be uncoordinated or “clumsy.”
Links or Useful Resources for LEARNING DISABILITIES: Children’s Mental Health Ontario – www.kidsmentalhealth.ca Learning Disabilities Association of Ontario – www.ldao.ca Learning Disabilities Association of Canada – www.ldac-taac.ca Learning Disabilities Association of K-W – 519-743-9091 or e-mail: ldakw@golden.net Coordinated Campaign for Learning Disabilities – www.ldonline.org
Last update: 14-Oct-11
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Learning Disabilities (continued) The following is a checklist of characteristics that may point to a learning disability. Most people will, from time to time, see one or more of these warning signs in their children. This is normal. If, however, you see several of these characteristics over a long period of time, consider the possibility of a learning disability.
What Are Some Common Signs of Learning Disabilities?* Preschool
Grades K-4
- speaks later than most children - pronunciation problems - slow vocabulary growth, often unable to find right word - difficulty rhyming words - trouble learning numbers, alphabet,
- slow to learn the connection between letters & sounds - confuses basic words (run, eat, want) - makes consistent reading & spelling errors, incl. letter reversals (b/d), inversions (m/w), transpositions (felt/ left) and substitutions (house/home) - transposes number sequences and confuses arithmetic signs (+, -, X, /, =) - slow to remember facts - slow to learn new skills, relies heavily on memorization - impulsive, difficulty planning - unstable pencil grip - trouble learning about time - poor co-ordination, unaware of physical surroundings, prone to accidents
days of week, color shapes - extremely restless and easily distracted - trouble interacting with peers - difficulty following directions or routines - fine motor skills slow to develop
Grades 5 - 8
High school students & adults
- reverses letter sequences, (i.e. soiled/solid, felt/left) - slow to learn prefixes, suffixes, root words and other spelling strategies - avoids reading aloud - trouble with word problems - difficulty with handwriting - awkward, fist-like or tight pencil grip - avoids writing compositions - slow or poor recall of facts - difficulty making friends - trouble understanding body language & facial expressions
- continues to spell incorrectly, frequently spells same word differently in a single piece of writing - avoids reading & writing tasks - trouble summarizing - trouble with open-ended questions on tests - weak memory skills - difficulty adjusting to new settings - works slowly - poor grasp of abstract concepts - either pays too little or too much attention to details - misreads information
* Chart source: Co-ordinated Campaign for Learning Disabilities booklet, www.ldonline.org.
Last update: 14-Oct-11
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NOTES
Last update: 14-Oct-11
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Mood Disorders Mood problems affect everything about a person, the way they think, the way they feel about themselves and the way they act. The most common mood problem is depression. Please see information under that category.
Mood disorders include: Major Depression – long-lasting and disabling (see Depression in this section) Dysthymia – chronic low level depression lasting for at least two years (see Depression in this section) Bipolar Disorder (see Bipolar Disorder in this section)
How you can help: Learn as much as you can about the mood disorder – it’s signs, causes, treatment and symptoms Ensure that treatment or medications are being taken View the mood disorder as an illness, not a character flaw Learn to distinguish a good day from a bad day.
Links or Useful Resources for MOOD DISORDERS: American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org Canadian Mental Health Association – www.cmha.ca Centre for Addiction and Mental Health (CAMH) – www.camh.ca Child and Parent Resource Institute (CPRI)-www.cpri.ca - or call 1-519-858-2774 Children’s Mental Health Ontario – www.kidsmentalhealth.ca Mood Disorder Association of Ontario (MDAO)-www.mooddisorders.ca or 1-888-486-8236 Offord Centre of Knowledge on Healthy Child Development – www.knowledge.offordcentre.com Families for Depression Awareness – www.familyaware.org Mood Disorder Parent Support Group of Waterloo Region – email: kidsmood@gmail.com Book title: “All Together Now: How families are affected by depression and manic depression” by MDAO
Last update: 14-Oct-11
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Last update: 3-Aug-11
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Obsessive-Compulsive Disorder (OCD) OCD is treatable. Both medications and therapy or counselling are often used and are sometimes used together.
Parents may notice that their child worries sometimes. When these worries consume a child they are called “obsessions”. These are uninvited thoughts, urges or images that repeat themselves in the child’s mind over and over again.
When children act out one of these thoughts in the same way every time it is called a ritual. The child can become stuck on this ritual and need to do it over and over again. Then it is called a “compulsion”. When obsessions and compulsions happen over and over again they are called obsessivecompulsive disorder (OCD).
Symptoms of Obsessive-Compulsive Disorder -
recurrent obsessions or compulsions that interfere with a person’s life take up more than one hour a day, or cause marked distress or significant impairment
Common Obsessions
Common Compulsions
fear of contamination repeated doubting focus on exactness and order preoccupation with religious images and thoughts or fear of having blasphemous thoughts - fear of harming oneself or others - fear of blurting out obscenities in public - forbidden or unwanted sexual thought, images or urges
-
-
cleaning/washing (hands, household items, objects) too often checking repeatedly ordering/arranging objects in a certain order hoarding mental rituals
Links or Useful Resources for OBSESSIVE-COMPULSIVE DISORDER: Centre for Addiction and Mental Health – www.camh.ca American Academy of Child and Adolescent Psychiatry – www.aacap.org Child and Parent Resource Institute (CPRI)-www.cpri.ca or call 1-519-858-2774 University of Waterloo, Centre for Mental Health Research-519-888-4567 Ext. 33842 or cmhr@uwaterloo.ca Children’s Mental Health Ontario – www.kidsmentalhealth.ca Canadian Mental Health Association – www.cmha.ca Hamilton Health Sciences - www.macanxiety.com Ontario OCD Network – www.ocdontario.org Tourette Syndrome Plus – www.tourettesyndrome.net
Last update: 14-Oct-11
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Last update: 19-Jul-11
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Oppositional Defiant Disorder (ODD) All children from time to time are oppositional when tired, hungry or under stress. They talk back, disobey, defy teachers and parents and argue with other adults. This is normal for two to three year olds and early teens. Oppositional Defiant Disorder however occurs when the behaviour is so often and consistent that it affects the family, school and social life of the child. There will be an ongoing pattern of defiant and hostile behaviour towards anyone seen as an authority figure and it will interfere with the day to day functioning of the child.
Symptoms of ODD may include: Frequent temper tantrums Excessive arguing Defiance and refusal to comply with adult rules and requests Deliberately annoying or upsetting people Blaming others for their mistakes and misbehaviour
Being irritable or easily annoyed by others Frequent anger and resentment Mean and hateful speech when upset Revenge seeking
Symptoms will be seen in more than one setting, but may be more apparent at home or at school. Five to 15 percent of all school-age children have ODD. Causes are unknown.
Treatment Children presenting with these symptoms should have an evaluation by a professional. ODD may often be present in other disorders such as ADHD, learning disabilities, depression, bipolar disorder and anxiety. Often the other disorder needs to be treated first. Treatment can include cognitive behaviour therapy, anger management therapy, social skills training and medication. Caregivers can have a very difficult time with a child with ODD but REMEMBER:
Always build on the positives Pick your battles Set reasonable, age appropriate limits Be consistent with consequences Keep interested in other activities See Tips For Self-Care in the Getting Started section
Links or Useful Resources for OPPOSITIONAL DEFIANT DISORDER (ODD): ABC’s of Mental Health – www.brocku.ca/teacherresource/ABC/ American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org Child and Parent Resource Institute (CPRI)-www.cpri.ca or call 1-519-858-2774 Canadian Mental Health Association – www.cmha.ca
Last update: 14-Oct-11
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Psychosis “Psychosis” is defined as persistent changes in behaviour, functioning or personality. Psychosis is treatable. Psychosis can happen to anyone and usually develops during teen years.
Signs of Psychosis: Hear voices that no one else hears See things that aren’t there Believe that others can influence their thoughts Believe that they can influence the thoughts of others Believe that they are being persecuted by others Thoughts have sped up or slowed down Believe that they are being followed, watched by others
Other symptoms that family may notice: Loss of interest in socializing No energy or motivation Memory and concentration issues Study or work issues Lack of self-care Confused speech Difficulty communicating Inappropriate emotional display or lack of response Suspiciousness Appetite and sleep disturbances Unusual behaviours
Treatment If you see persistent changes that strike you as strange don’t wait. Trust your instincts. Talk to your doctor or a mental health professional.
Links or Useful Resources for PSYCHOSIS: Child and Parent Resource Institute (CPRI)-www.cpri.ca or call 1-519-858-2774 Canadian Mental Health Association – www.cmha.ca Front Door – 519-749-2932 Mood Disorder Parent Support Group of Waterloo Region – email: kidsmood@gmail.com Trellis Mental Health & Developmental Services – 519-576-2333
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Re-Active Attachment Disorder (RAD) Re-active attachment disorder is most often used to describe emotional and behavioural problems of children related to the inability to form healthy attachments to caregivers. Reactive Attachment Disorder (RAD) of Childhood is a very specific diagnosis that can only be made by a qualified psychiatrist, psychologist or physician, as with other formal diagnoses. RAD refers to the very limited set of circumstances in which a child is thought to not have the opportunity to develop any attachment to a caregiver. Diagnostic criteria have not yet been agreed on. RAD can be broken into two types – inhibited and disinhibited. Many children have both. Symptoms are listed below for the combined type.
Symptoms Resists affection on parents’ terms Affectionate with strangers – shows bad judgment Continuous and intense control battles, bossy and argumentative; defiant and angry Lack of eye contact, especially with parents but will look into your eyes when lying Manipulative - superficially charming and engaging Poor peer relationships Steals Lies about the obvious even when confronted Shows no remorse - lack of conscience Destructive to property, self and/or others Lack of impulse control Hyper-vigilant/Hyperactive Learning delays Speech and language problems Incessant chatter and questions Inappropriately demanding and/or clingy Food issues - hordes, gorges, refuses to eat, eats strange things, hides food Very concerned about tiny hurts but brushes off big hurts
Possible Causes Neglect or abuse Separation from the primary caregiver Changes in the primary caregiver or frequent moves and/or placements Environmental disruption (a “chaotic” home) Traumatic experiences (exposure to domestic violence) Caregiver mental health problems (depression, psychosis) Maternal addiction - drugs or alcohol Undiagnosed, painful illness such as colic, ear infections, etc.
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Re-Active Attachment Disorder (RAD) (continued) RAD can be a lifetime disability. Seek help from a knowledgeable professional as soon as possible. Consider getting a second opinion if you have questions or concerns about the diagnosis or treatment plan.
Links or Useful Resources for RE-ACTIVE ATTACHMENT DISORDER (RAD): Attachment Disorder Site - www.attachmentdisorder.net Child and Parent Resource Institute (CPRI) - www.cpri.ca or call 1-519-858-2774 Institute for Attachment – www.instituteforattachment.org Mayo Clinic – www.mayoclinic.com
NOTES
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Schizophrenia Schizophrenia is a complex illness that affects a person’s behaviour. It causes strange thinking, strange feelings, and unusual behaviours. It is uncommon in children and is hard to recognize in its early phases. The cause of schizophrenia is not known. Current research suggests a combination of Early diagnosis and medical brain changes, bio-chemical, genetic and environmental treatment are important. factors may be involved. Early diagnosis and medical Schizophrenia is a life-long treatment are important. Schizophrenia is a life-long disease that can be controlled disease that can be controlled but not cured. but not cured. The behaviour of children with schizophrenia may start slowly over a period of months or years. For example, children who used to enjoy relationships with others may start to become more shy or withdrawn and seem to be in their own world. They might begin talking about strange fears and ideas. They may start to cling to parents or say things, which do not make sense. The following symptoms and behaviours can occur in children or adolescents with schizophrenia. The behaviour must persist for at least 6 months. seeing things and hearing voices which are not real (hallucinations) odd and eccentric behaviour, and/or speech unusual or bizarre thoughts and ideas (delusions) confusing television and dreams from reality confused thinking (thought disorder) extreme moodiness ideas that people are out to get them, and or talking about them (paranoia) severe anxiety and fearfulness difficulty relating to peers, and keeping friends withdrawn and increased isolation decline in personal hygiene
Treatment
Children with schizophrenia must have a complete evaluation. Parents should ask their family physician or paediatrician to refer them to a psychiatrist, preferably a child and adolescent psychiatrist, who is specifically trained and skilled at evaluating, diagnosing, and treating children with mental health symptoms. Children with schizophrenia need a comprehensive treatment plan. A combination of medication, individual therapy, family therapy, and specialized programs (school, activities, etc.) is often necessary. Psychiatric medication can be helpful for many of the symptoms and problems identified. These medications require careful monitoring by a psychiatrist.
Links or Useful Resources for SCHIZOPHRENIA: American Academy of Child and Adolescent Psychiatry – www.aacap.org Canadian Mental Health Association – www.cmha.ca Children’s Mental Health Ontario – www.kidsmentalhealth.ca Mood Disorders Association of Ontario (MDAO) – www.mooddisorders.ca Schizophrenia Society of Ontario – www.schizophrenia.on.ca
Last update: 14-Oct-11
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Schizoaffective Disorder What You Should Know Schizoaffective disorder combines the problems of schizophrenia with those of a mood disorder. As with schizophrenia, victims lose touch with reality. However, schizoaffective disorder is more likely to come and go, like depression and mania tend to run in cycles. The condition affects more girls than boys. Look at Bipolar Disorder and Schizophrenia descriptions for more information.
Causes An imbalance in the brain's chemical messengers is the most likely cause, but its exact nature and the reason for it are still unclear. Stress alone will not trigger this illness, though it can make the symptoms worse. The problem is more likely to develop if you have a family member with a mood disorder. If you suspect your child of having any disorder you must seek help from a mental health professional as symptoms can worsen and be harder to treat over time.
Links or Useful Resources for SCHIZOAFFECTIVE DISORDER: See also Schizophrenia and Bipolar resources in this section. Centre for Addiction and Mental Health – www.camh.ca Canadian Mental Health Association – www.cmha.ca Mood Disorders Association of Ontario (MDAO) – www.mooddisorders.ca Schizophrenia Society of Ontario – www.schizophrenia.on.ca
Last update: 14-Oct-11
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Sensory Integration Dysfunction/Sensory Processing Disorder Sensory Integration Dysfunction (SID), also called sensory processing disorder is a neurological disorder causing difficulties with processing information from the five classic senses (vision, auditory, touch, smell, and taste), the sense of movement (vestibular system), and/or the positional sense (proprioception). They vary from person to person in characteristics and how severe the symptoms are. Some symptoms may include tags on clothing, bright lights, noises, smells. Sensory Integration Dysfunction is not yet included in the DSMIV manual but is recognized by many professionals.
Sensory Integration Dysfunction is not yet included in the DSM-IV manual but is recognized by many professionals. There is no known cure; however, there are many treatments available. Not everybody agrees that this is a disorder and it is only diagnosed when the sensory behaviour interferes significantly with all activities of daily living. Co-morbid conditions are common – anxiety, ADHD, Fragile X and Autism Spectrum Disorders to mention just a few. There are 3 types classified: Type I – Sensory Modulation Disorder – Under or over response to stimuli or trying to find stimulation. Type II – Sensory Based Motor Disorder – output is disorganized due to processing information incorrectly. Type III – Sensory Discrimination Order – sensory discrimination challenges. Symptoms of Sensory Integration Dysfunction
Sensory Auditory
Visual
Taste/Smell
(Reproduced with permission from the Apraxia-Kids Web page)
Symptoms
Responds negatively to unexpected or loud noises Holds hands over ears Cannot walk with background noise Seems oblivious within an active environment Prefers to be in the dark Hesitates going up and down steps Avoids bright lights Stares intensely at people or objects Avoids eye contact Avoids certain tastes/smells that are typically part of children's diets Routinely smells non-food objects Seeks out certain tastes or smells Does not seem to smell strong odours
Continued on next page...
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Sensory Integration Dysfunction/Sensory Processing Disorder (continued) Symptoms of Sensory Integration Dysfunction (cont’d) (Reproduced with permission from the Apraxia-Kids Web page)
Sensory
Symptoms
Continued from previous page Body Position
Movement
Continually seeks out all kinds of movement activities Hangs on other people, furniture, objects, even in familiar situations Seems to have weak muscles, tires easily, has poor endurance Walks on toes Becomes anxious or distressed when feet leave the ground Avoids climbing or jumping Avoids playground equipment Seeks all kinds of movement and this interferes with daily life Takes excessive risks while playing, has no safety awareness
Touch
Avoids getting messy in glue, sand, finger paint, tape Is sensitive to certain fabrics (clothing, bedding) Touches people and objects at an irritating level Avoids going barefoot, especially in grass or sand Has decreased awareness of pain or temperature
Attention, Behaviour and Social
Jumps from one activity to another frequently and it interferes with play Has difficulty paying attention Is overly affectionate with others Seems anxious Is accident prone Has difficulty making friends, does not express emotions
As with any other disorder, if you think your child may be experiencing sensory dysfunction issues seek the help of a professional. A referral to an Occupational Therapist with knowledge of this disorder would be preferred.
Links or Useful Resources for SENSORY INTEGRATION DYSFUNCTION: Apraxia Kids – www.apraxia-kids.org Kid Power – www.kid-power.org Tourette Syndrome Plus – www.tourettesyndrome.net Waterloo Region Family Network – www.waterlooregionfamilynetwork.com or 519-804-1786
Last update: 14-Oct-11
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Stress Stress affects children in different ways and all children handle stress differently. Stress can be positive as well as negative. There are many factors that influence this. Some kids internalize stress.
Sources of Stress: At School fear of wetting themselves being away from home and missing caregivers worry about changing bodies worry about getting lost in school hallways fear of teacher punishment worry about getting along with peers worry about school work worry about being last chosen on a team
Other sources of stress major family change – divorce of parents, etc. move to new town or city serious illness
Signs of Stress physical – headaches, stomach aches, vomiting, bed-wetting emotional – sadness, irritability, fear behavioural – losing temper, nervous tics, crying interactions with others – teasing or bullying, shyness, withdrawal
How You Can Help Your Child Manage Stress Encourage your child to talk about what is bothering them. Take opportunities like road trips. Don’t ask what’s wrong. Instead ask “How are things at ___ _.” Spend one-to-one-time. Find hobbies that you can do with the child. Encourage healthy eating. Teach relaxation skills. Give back rubs and hugs. Show them that mistakes are o.k. Be clear about rules and consequences. Role play and talk through difficult situations. Tell stories about similar situations. Be a role model. Seek out professional support if necessary.
Links or Useful Resources for STRESS: Families for Depression Awareness – www.familyaware.org BC Partners For Mental Health & Addiction Information - www.heretohelp.bc.ca Mood Disorder Parent Support Group of Waterloo Region - email: kidsmood@gmail.com Last update: 14-Oct-11
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Suicide Nobody likes to talk about this topic. It is difficult to think that your child may be at risk. Children often leave a trail of warning signs but often do not make a direct plea for help. If you can pick up these warning signs you may be able to do something. Warning signs include: Withdrawal from friends, family and activities Change in eating patterns Preoccupation with death (e.g. music, movies, reading, writing, artwork) Giving away valued personal possessions Glorification of someone’s completed suicide – often famous people – musicians, etc. Suicide pact or suicide of significant other Changes in school work: lower grades, missing classes Increased use of drugs and/or alcohol Excessive risk taking Sudden change of behaviour – either positive or negative Depression, moodiness or hopelessness Excessive anger and impulsivity Previous attempts of suicide Serious illness of family or friend Treatment has been proven to be 70% effective in preventing suicide.
How to Respond 1. In an emergency, GET HELP! Call 9-1-1! 2. GET HELP! You can’t do it alone. Contact: Family, friends, relatives, clergy, doctors, crisis lines*, mental health services or hospital emergency departments. It is crucial to get a suicide/self-harm assessment completed by a certified professional if a person is suicidal. 3. Take every cry for help seriously. 4. Ask directly: Are you thinking about suicide? Are you thinking of killing yourself? 5. Offer support and reassurance that suicidal feelings do not last forever. 6. If the person has thought of suicide, a professional needs to determine the degree of suicidal risk.
Links or Useful Resources for SUICIDE: CMHA – Grand River Branch – www.cmhagrb.on.ca- 519-766-4450 or 1-866-448-1603 Centre for Suicide Prevention – www.suicideinfo.ca Waterloo Region Suicide Prevention Council – c/o CMHA – 519-744-7645 Ext. 310 Mood Disorders Association of Ontario – www.mooddisorders.ca – 1-888-486-8236 Ontario Association for Suicide Prevention – www.ospn.ca Wilmot Family Resource Centre – Suicide Awareness for Wilmot-Wellesley (SAWW) – www.familyresourcecentre.ca or 519-622-2731 Last update: 14-Oct-11
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Tourette Syndrome (TS) Tourette Syndrome (TS) is a neurological or "neurochemical" disorder characterized by tics -involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way. The majority of people with TS are not significantly disabled by their tics or behavioural symptoms and therefore do not require medication. However, there are medications to help control symptoms when they interfere with functioning.
The cause has not been established, although current research presents considerable evidence that the disorder stems from the abnormal metabolism of at least one brain chemical (neurotransmitter) called dopamine. Very likely other neurotransmitters, such as serotonin, are also involved. The most common first symptom is a facial tic, such as rapidly blinking eyes or twitches of the mouth. However, involuntary sounds, such as throat clearing and sniffing, or tics of the limbs may be the initial signs. For some, the disorder begins abruptly with multiple symptoms of movements and sounds.
Symptoms of Tourette Syndrome 1. Both multiple motor and one or more vocal tics present at some time during the
illness although not necessarily in the same way; 2. The occurrence of tics many times a day (usually in bouts) nearly every day or intermittently throughout a span of more than one year; 3. The periodic change in the number, frequency, type and location of the tics, disappear for weeks or months at a time; and 4. Onset before the age of 18.
Common Examples of SIMPLE Tics
Common Examples of COMPLEX Tics
Motor tics: Eye-blinking, head jerking, shoulder shrugging, facial grimacing Vocal tics: Throat clearing, yelping and other noises, sniffing and tongue clicking.
Motor tics: Jumping, touching other people or things, smelling, twirling about Vocal tics: Uttering ordinary words or phrases out of context, echolalia (repeating a sound, word or phrase just heard)
Less Common Tics Complex: Coprolalia (vocalizing socially unacceptable words). Complex: Self injurious actions, including hitting or biting oneself
The term "involuntary" used to describe TS tics is a source of confusion since it is known that most people with TS do have some control over the symptoms. What is recognized is that the control which can be exerted from seconds to hours at a time, may merely postpone more severe
Last update: 14-Oct-11
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Tourette Syndrome (TS) (continued) outbursts of symptoms. Tics are experienced as irresistible as the urge to sneeze and must eventually be expressed. People with TS often seek a secluded spot to release their symptoms after delaying them in school or at work. Typically, tics increase as a result of tension or stress (but are not caused by stress) and decrease with relaxation or concentration on an absorbing task. The range of tics or tic-like symptoms that can be seen in TS is enormous. The complexity of some symptoms often confuses family members, friends, teachers and employers who may find it hard to believe that the actions or vocal utterances are "involuntary". The frequency of co-occurrence is still controversial, but some people with TS may have additional difficulties resulting from: Obsessions - which consist of repetitive, unwanted or bothersome intrusive thoughts Compulsive behaviours - repetitive, often ritualistic actions in which the person feels that something must be done over and over, often in a very specific manner Attention Deficit Disorder (ADD or ADHD) (with or without hyperactivity) Learning Disabilities - such as dyslexia, reading, writing and perceptual difficulties, problems with visual/motor integration Behavioural problems - which may result from obsessive-compulsive traits, attention problems, poor self-esteem due to TS symptoms, and poor school performance Sleep disorders - which may include walking or talking in one's sleep, delayed sleep onset and frequent awakenings Difficulties with impulse control - in which routine interactions may rapidly escalate into major confrontations resulting in inappropriate behaviours, ranging from mild unruliness to explosive, defiant rage and aggression altogether out of proportion to the underlying incident. The majority of people with TS are not significantly disabled by their tics or behavioural symptoms and therefore do not require medication. However, there are medications to help control symptoms when they interfere with functioning. Other types of therapy may also be helpful. Sometimes psychotherapy can assist a person with TS and help his/her family cope with the psycho-social problems associated with TS. Some behavioural therapies can teach the substitution of one tic with another that is more acceptable. The use of relaxation techniques and/or biofeedback may help during prolonged periods of high stress.
Links or Useful Resources for TOURETTE SYNDROME: Child and Parent Resource Institute-www.cpri.ca or call 1-519-858-2774 Life’s A Twitch, Dr. Duncan McKinlay – www.lifesatwitch.com Publication: “Understanding Tourette Syndrome: A Handbook for Families” available at www.tourette.ca. Tourette Syndrome Association of Ontario - www.tourettesyndromeontario.ca/Chapters -1-888-274-1639 or email tsao@primus.ca Tourette Syndrome Foundation of Canada - www.tourette.ca, visit site for local chapter contact. Tourette Syndrome Plus - www.tourettesyndrome.net
Last update: 14-Oct-11
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Trauma Trauma is an emotional wound resulting from a shocking event or multiple and repeated life threatening and/or extremely frightening experience(s). It may cause lasting negative effects on a person, disrupting the path of healthy physical, Children who suffer from child emotional, spiritual and intellectual development. traumatic stress have developed There are numerous kinds of traumas, such as reactions to trauma that linger and automobile accidents, intense and ongoing affect their daily lives long after the emotional upset, medical procedures, unexpected death, or natural disasters just to name a few. traumatic event has ended. (Source: The National Child Traumatic Stress Network.)
Not every child experiences difficulties after a trauma. All children are different and many are able to adapt to and overcome difficult situations. However, one out of every four children will experience a traumatic event before the age of 16 and some of these will develop trauma. How parents, caregivers and the community respond to the trauma will also impact the recovery of the child. The trauma can interfere with healthy development and lead to long-term difficulties with school, relationships, etc. if not treated. The trauma can continue to be a priority in the child’s thoughts long after the trauma is over. Even very young children can be affected. The diagnosis of Trauma usually is based on three elements: 1. The repeated reliving of memories of the traumatic event 2. The avoidance of reminders of the traumatic event 3. A pattern of increased distress (hyper-arousal)
Some Effects of Trauma Physical Eating
Behavioural Self-harm
Emotional Depression
Cognitive Memory
Spiritual Guilt
distur-
Hopelessness
Substance
lapses
Shame
bances
Anxiety
abuse
Difficulty
Self-hatred
Sleep distur-
Compulsive and
Self-
making
Turning away
bances
obsessive
destructive
decisions
from faith
Low energy
behaviour
behaviour
Thoughts of
or
Chronic pain
Anger
Suicide
suicide
obsessively
Difficulty in
attempts
relationships
Last update: 20-Oct-11
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attending services
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Trauma (continued) Early intervention for the child and family are critical to deal with trauma. Therapy can greatly improve the situation for both parents and child. Look for a therapist that is trauma-informecd. There are varying degrees of Trauma – from the milder end of the spectrum to COMPLEX DEVELOPMENTAL Trauma which is a history of severe, long term trauma that may include caregiviers that were inconsistent and unresponsive. We will not examine this issue in this guide but there are numerous websites if you wish to explore this domain further. Post Traumatic Stress Disorder (PTSD) and Child Traumatic Stress are different. PTSD has many similarities to trauma but includes an anxiety disorder and can be severely disabling.
Links or Useful Resources for TRAUMA: Child Trauma Academy – www.childtrauma.org Australian Child and Adolescent Trauma, Loss and Grief Network (ACATLGN) – www.earlytraumagrief.anu.edu.au kidsLINK – www.kidslinkcares.com or via Front Door – 519-749-2932 Klinic Community Health Centre – www.clinic.mb.ca The National Child Traumatic Stress Network – www.ncts.net.org Trauma Center at Justice Resource Institute – www.traumacenter.org
Last update: 14-Oct-11
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Crisis/Emergency Services
Remember…It is not your fault, take time to breathe, relax and don’t be afraid to ask for help.
Ensure that you and your family are safe.
In An Emergency – dial 911 911 is for police emergencies, fire or serious accidents, or when you fear the safety of the child or yourself. Try to avoid calling the police or ambulance if possible.
Waterloo Regional Police Service 200 Maple Grove Rd., Cambridge
Ontario Provincial Police Ambulance Dispatch
519-570-3000 519-653-7700 519-650-8500 1-800-265-2525 519-653-2154
Crisis Services of Waterloo Region
Walk-in Service @ The Centre for Mental Health in Kitchener 67 King St. East, Kitchener, ON (Non-crisis - 519-744-7645)
Prevention, assessment, intervention and resolution for urgent crisis situations within Waterloo Region. Crisis Services of Waterloo Region will talk to you and help you by providing a risk assessment of your current situation. They will help you access resources and supports in the community. In Waterloo Region we are fortunate to have access to a MOBILE CRISIS SERVICE.
Cambridge Crisis Outreach Response
Walk-in Service @ The Centre for Mental Health in Cambridge 9 Wellington St. #3, Cambridge, ON 519-7782 Monday to Friday from 1 p.m. to 5 p.m.
519-744-1813 1-866-366-4566 (toll free)
519-744-1813 1-866-366-4566 (toll free)
Canadian Mental Health Association Distress Centre
This service is confidential and provides a place to talk and get support. It operates 24 hours a day, 365 days a year and is staffed by trained volunteers and staff. They will help you find your own solutions to difficulties.
Canadian Mental Health Association Youth Line
This phone line is similar to above but geared to serving youth.
Kids Help Line (for kids only)
Free phone counselling or web counselling available 24/7 for ages 20 and under. Anonymous and confidential.
Last update: 15-Oct-11
www.PCMHwaterloo.com
519-745-1166
519-745-9909 1-800-668-6868
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Crisis/Emergency Services (continued) Other Helpful Numbers Mental Health and Addictions Data Base Line
This phone line will give you access to a data base that lists resources, people and organizations that serve the mental health community
519-744-5594
Your Family Doctor, Pediatrician, Psychologist or Psychiatrist: (Enter the names and phone #’s here for handy reference) Telehealth Ontario. Ontario Ministry of Health & Long Term Care
1-866-797-0000
Emergency Room Locations
(for more information about services at a specific hospital, please see Hospitals under Finding Support section of this guide)
519-621-2330 519-621-2333
Cambridge Memorial Hospital 700 Coronation St., Cambridge
Grand River Hospital Central Access – Crisis Nurse available
835 King St. W., Kitchener
St. Mary’s Hospital
519-744-3311
911 Queen’s Boulevard, Kitchener 211 Waterloo Region 211 services include a three-digit phone helpline, 2-1-1, and its website, www.211ontario.ca, providing access to 56,000 programs and services in the community, social, health and related government sectors. 211, a joint initiative of the Province of Ontario, Region of Waterloo and United Ways of Kitchener, Waterloo, and Cambridge, is a non-emergency number that connects callers to organizations that can help them with a multitude of challenges from finding employment, language classes and settlement services, to accessing food programs
Last update: 15-Oct-11
519-749-4310
www.PCMHwaterloo.com
2-1-1
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Crisis/Emergency Services (continued) Protocol In Event of Emergency/Crisis 1. Ensure that you and your family are safe. 2. Assess the situation and then proceed with one of the following: give the person time to calm on his/her own. If possible maintain a calm, quiet environment. call one of the information or crisis line numbers listed if you think they are applicable. call family and friends to care for other family members if required. call 911 if you cannot transport person to hospital and make arrangements to follow or accompany ambulance. if you can transport patient go to Cambridge Memorial or Grand River Hospital Emergency room – have basic information, medications and money for parking meters with you.
3. Reassure the person that is in crisis. “I’m here to help”, “I’d like to know how I can help.” Create a crisis plan if you believe this could happen again. See our template for
creating a safety plan. This includes what to do in crisis and emergency situations.
Last update: 15-Oct-11
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Crisis/Emergency Services (continued) What to Have Prepared For A Trip To Hospital It is best to have reviewed the pages on Crisis before you need them. Your name, relationship to ill person, medications or list of medications, phone #, etc. We have included a sample form that can be handed to police, ambulance, nurses, etc. when in crisis. Keep a copy in your vehicle or in a safe place that can be easily accessed. A roll of quarters, loonies or toonies should also be available in the same location for parking and phone call needs. If you have time jot down your main concerns and what was happening to cause you to come to emergency – in the case of teens this can be passed on to team if they do not want you involved. The sample form (next page) includes room for medications – if possible bring medications with you. An updated copy of a Safety Plan for your child. (see Creating A Safety Plan under Advocacy)
What to Expect at Hospital
(This will vary, of course, depending on hospital visited.) Triage will determine urgency of situation and there may be a wait time or the person may be escorted to a safe room (an empty room, sometimes with cameras to watch patient) for safety reasons. If this was a police escort, police will need to stay until doctor has seen patient. Psychiatric team member will take patient and talk to them for further assessment. If patient is younger you will accompany them. You may or may not be given an opportunity to provide background information. The best way to deal with this is to have written notes that you can pass on to the team. Assessment and follow-up may take several hours as an on-call psychiatrist or the patient’s own psychiatrist may need to be contacted. Discharge with care advice or admission to hospital will be the final step. If you have legal questions you may want to look at the attached version of a newsletter called "The Updater". It is focused on Human Services and Justice Coordinating in Waterloo-Wellington.
Last update: 15-Oct-11
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Dosages, times given, etc.
Specialty:
DATE:
Tetanus/TB or other
DTP Polio MMR TB Hep B Haemophilius b
Pharmacy Info Phone: Fax no.: Pharmacist: Location/address:
Phone #:
Address: Certificate #:
Parents Names: Home Address: Home Phone: Cellular:
Š PCMH - Waterloo Region, PCMHwaterloo.com, Children's Mental Health Resource Guide - July 2010
Previous Surgeries:
Medication Sensitivity Food Allergies: Other Allergies: Previous Ilness:
Current Medications
Medical Info Doctor(s) Name:
****attach a copy of your Safety Plan if available**** Health Insurance Plan Info Carrier name: Plan Number: Hospital Room Type: (private, semi-private)
Diagnosis
Legal Name: Date of Birth: Sex: Health Card No.:
Your Child's Medical History
Immunizations Date Date
mm/dd/yy
Date
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
NOTES
Last update: 15-Oct-11
www.PCMHwaterloo.com
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The Updater
October 2008
An information newsletter about Mental Health and Addiction Services in Waterloo, Wellington and Dufferin
The Updater Crisis Line Numbers
Welcome This edition of The Updater will be focused on activities related to the
Wellington, Dufferin 519-821-0140 or toll free 1-877-822-0140 ++++++++++++++
Waterloo Region 519-744-1813 or toll free 1-866-366-4566 Inside this issue: What is the HSJCC?
1
Who are the HSJCC Members
2
Objectives of the Court
2
A “Readers Digest” History of the HSJCC
3
Pre-Charge Diversion Support Coordination
4
Bail Support Coordination
4
Probation Support Coordination
4
Mental Health Court Support Program—Wellington-Dufferin
5
Mental Health Court Support Program—Waterloo Region
6
Kitchener Mental Health Court Program Third Anniversary
7
A Brief Introduction to the Recovery Approach
7
Mental Health Court Support Program - Cambridge
8
Veronique’s Story
9
Relationship Within the HSJCC
9
Definitions
10-11
A Typical Day
12
Human Services and Justice Coordinating Committee (HSJCC) within the Waterloo-Wellington LHIN area. Unfortunately, people who experience significant mental health issues can sometimes find themselves in contact with the criminal justice system. Stress, isolation, stigma and the impact of a mental illness on a person’s behaviour or decision-making, can put an individual at greater risk for unnecessary involvement with the law. Service partners and providers in our community are working to help divert such individuals away from the traditional justice system, where the complexity of cases can be more appropriately addressed. In this edition of The Updater, readers will be presented with some of the services and options that are in place for people in our community who, as a result of a mental health issue, find themselves in contact with the justice system. Jessie Baynham, Editor HSJCC’s greatest strength is our relationship with one another as service providers. As we meet, we are learning about each other’s mandates and priorities. Though we are separated by agency policies and procedures, more often than not, our struggles are similar. As we work together, the conversation is less about what is impossible, but what is possible when we work together! Marion Evans, Chair Waterloo-Wellington HSJCC
What is the HSJCC?
Submitted by: Marion Evans. Chair Waterloo-Wellington HSJCC
The Human Services and Justice Coordinating Committee of Waterloo-
Wellington is a regional committee with three local committees who seek to coordinate resources and services for people who are in conflict with the law, and who struggle with a serious mental illness, developmental disability, acquired brain injury, drug and alcohol addiction, and/or fetal alcohol spectrum disorder (now referred to as alcohol-related neurodevelopmental disorder – ARND .
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Who are the HSJCC Members
Objectives of the Court • To deal with persons
with mental disorders or disabilities in an effective manner, in accordance with the Mental Health Act and Criminal Code of Canada. • To hold the accused accountable for their actions, while providing effective treatment in the least restrictive fashion. • To provide proper, as opposed to “special” attention to accused persons. • To protect the rights of the public as well as the accused, while at the same time maintaining the integrity of the Criminal Justice System. Justice Hearn
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Submitted by: Marion Evans, Chair Waterloo-Wellington HSJCC
As we sit around the table, our mandates often are miles apart and even conflict on occasion! Yet we are drawn together by a common desire to meet needs of individuals with serious mental health challenges who are in conflict with the law. Perhaps the best way to illustrate our diversity and our common commitment is to list all the agencies who participate in HSJCC: Guelph Police Services Wellington OPP Waterloo Regional Police Crown Attorney’s Office (Ministry of the Attorney General) Defence Lawyers Bail Support (Youth in Conflict with the Law) Probation and Parole (Ministry of Community Safety and Correctional Services) Legal Aid Federal Parole (Correctional Services Canada) Grand River Hospital St. Mary’s Counselling (Addictions) Cambridge Memorial Hospital Guelph General Hospital Homewood Health Centre Canadian Mental Health Association Trellis Mental Health & Developmental Services Community Torchlight/Distress Centre Central Ontario Specialized Network (Dual Diagnosis) Salvation Army Self Help Alliance Stonehenge Therapeutic Community Waterloo Regional Homes for Mental Health Inc.
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A “Readers’s Digest” History of HSJCC In 2004, the Ministry of Health
and Long Term Care, in partnership with the Ministry of Community and Social Services, the Ministry of the Attorney General, the Deputy Solicitor General and Deputy Minister of Correctional Services funded regional committees across Ontario to address mental health and criminal justice issues. The first official meeting of the Waterloo-Wellington HSJCC took place in the spring of 2005 with the mandate of finding “locallybased solutions to issues” particularly in the areas of : • Prevention • Crisis Planning • Court assessment/support • System design • Case management Before long, the HSJCC of Waterloo-Wellington had a regional committee and three local committees in Guelph, Kitchener and Cambridge. The Guelph committee focussed on local training needs and set up education opportunities for court staff and police officers. In Kitchener, the committee worked on the development and implementation of the Mental Health Court (Fall 2005) (see article by Steven Potje). The Cambridge committee acted as a steering committee for the funds allocated from Trillium research Page 3
project “The Cambridge Youth Mental Health and Justice Needs Assessment: A Framework for Mental Health Diversion for Youth, 2004”. (see article by Julie Wallis) Wanting to clearly identify system gaps in service, the Regional HSJCC funded a research project “to gather and synthesize information that would assist the HSJCC to optimize the delivery of mental health services across the region.” In June 2006, the Orchard Park Institute presented their findings. The research identified gaps in service at the pre-charge phase, in the court system and following release from custody, or during probation. At each of these critical juncture points, the research made recommendations for enhanced, specialized staffing, greater communication between agencies and increased services such as transitional housing. On the basis of this research, the Waterloo-Wellington HSJCC prepared a funding proposal to receive new resources from the Ministry of Health and Long Term Care. Eventually, new funds were allocated for positions in Precharge Diversion, Bail Support Coordination, and Probation Support Coordination.
Submitted by: Marion Evans. Chair Waterloo-Wellington HSJCC
Partnerships within the Mental Health Court in Kitchener "In my role as the Mental Health Coordinator, I rely heavily on the partner agencies to link individuals to receive various kinds of support and/or treatment assistance. The networking and participation of partner agencies (involved directly or indirectly with the Kitchener HSJCC and/or the Mental Health Court), has resulted in a vigorous spirit of cooperation and collaboration, benefiting all parties, especially the individuals with mental health and/or other exceptional issues, who intersect with the criminal justice system." Steven Potje Mental Health Court Coordinator, Kitchener Mental Health Court Canadian Mental Health Association Grand River Branch
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Pre-Charge Diversion Support Coordination
Submitted By: Marion Evans, Chair Waterloo-Wellington HSJCC :
The Pre-Charge Diversion position, although still in its infancy, seeks to provide the police with
alternatives to arrest under the Criminal Code or apprehension under the Mental Health Act. Where a person’s behaviour and actions do not warrant the laying of a charge and there is no risk of harm to self or others, the police have the discretion to call upon the Mobile Crisis Team (administered by Trellis in Guelph-Wellington and the Canadian Mental Health Association Grand River Branch in Waterloo) to assess the situation and determine what further intervention is most appropriate. If there is a need for short term support, the Pre-Charge Diversion Support Coordinator may assist the individual to access treatment, medication, housing or other supports as needed. Intervention and support at this juncture keeps individuals out of an already overburdened criminal justice system, and gives them the necessary supports to address the challenges related to mental health issues.
Bail Support Coordination When a person is charged with an offence under the Criminal Code of Canada, the individual is brought
before a judge for a “Show Cause” hearing, also known as Bail Court. Mental health issues may not have been identified and yet may be a contributing factor to the behaviour which resulted in the criminal charge. This is another juncture at which the Bail Support Coordinator may identify an individual with mental health challenges, assist them to complete bail conditions and/or refer them for a diversion program, if appropriate.
Probation Support Coordination Within the Ministry of Community Safety and Correctional Services, Probation Officers supervise
individuals placed on probation for up to 3 years. Often, a mental health challenge is not identified until this juncture. The Probation Support Coordinator provides consultation to Probation Officers and support to individuals who may require access to treatment, medication or other mental health supports. Regarding the building of formal relationships between Waterloo Regional Police and Crisis Services “It has dramatically increased the working relationship on the front line.”
Inspector Barry Zehr Waterloo Regional Police
The Probation Support Coordinator “Having a mental health worker linked directly with the Probation and Parole office has meant that staff are quickly able to consult with the worker to ensure that access to (this) service is suitable. The offender is often then seen within a week at the P & P office. This has meant that the offender more reliably links with the assistance he needs, the waiting time is very short, and the first meeting is in a setting that the offender is already familiar with. We think that these elements will assist the offender in making more solid, longer term connections to mental health services which will hopefully have a longer term benefit to our community by reducing recidivism and increasing safety.” Cheryl Sikkes Area Manager, Probation & Parole
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Mental Health Court Support Program Wellington and Dufferin This court program
at the correlation of an consists of a manager and individual’s mental health issue with the 2 mental health court criminal charge(s) they support and pre-charge have incurred. Once the diversion support assessment is complete, coordinators. this information is shared with the Ministry The role of the support coordinators is to provide of the Attorney General for final approval of the service to individuals with mental health issues diversion. who have or may become Pre-charge diversion involved in the court provides a service to the system. police to assist in The service includes; connecting individuals court support, mental with mental issues to health diversion assessments, pre-charge appropriate services, diversion and assistance rather than charging with the Form 2 process. them with a criminal offense. Court support involves If family members, assisting people to friends or concerned navigate the court citizens believe that a process. This may person may be a harm to include connecting with legal services, answering others, a harm to himself/herself, or is not questions about the able to care for himself/ system or just being herself, they may bring available to support evidence to a Justice of someone while they are the Peace. Based on this in court. evidence, the judge can Mental health diversion is order a person to be a very specific part of the examined by a doctor. A “Form 2” authorizes the mental health court police to take the person program. It involves to the hospital for completion of an assessment. In these assessment which looks
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cases, our role is to assist the family and/or community members with completion of the required documentation and support them through the process. Referrals are received from a wide variety of sources including the Crown Attorney’s office, Defence Lawyers, Police, physicians, family and/or community members.
Submitted By: Mary Hanlon and Chris Aramini Mental Health Court and Pre-Charge Diversion Support Coordinators
“Without the HSJCC there would have been no bridges built, which serve as pathways to those meandering through the criminal justice process. Now both offenders and lawyers have accessible information regarding community resources, and can more easily discern the direct route to address mental health issues. " Pamela Borghesan Assistant Crown Attorney (Guelph-Wellington) Ministry of the Attorney General
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Mental Health Court Support Program Waterloo Region
Waterloo Mental Health Court Tuesdays are designated days. Hours 10:30 AM to 5:00 PM. To address issues on other days, CMHA Court Support has a daily presence to assist with bail release planning.
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Prior to 2005 the Kitchener Mental Health Court did not exist. The Deputy Crown Attorney Sharon Nicklas (now Madame Justice Sharon Nicklas) and defence counsel Stephen Gehl, followed mental health cases from court to court. An increase in workload was to the point where it became a daily occurrence to see Sharon and Stephen literally run into Court to deal with a case. This coincided with the announcement of Mental Health and Justice funding for the Canadian Mental Health Association (CMHA) – Grand River Branch. Justice Gary Hearn was approached about the possibility of a designated Court, and he was very enthusiastic. A community partners meeting was held, including the Waterloo Regional Police Services (WRPS) in which great enthusiasm and support was expressed. After that community show of support, Justice Hearn announced that the Mental Health Court would start in 6 weeks on September 20, 2005.
Prior to the “grand opening” of the Mental Health Court, CMHA, the Crown Attorney’s Office for Waterloo Region, and WRPS studied various other Mental Health Courts and adopted many of their practices. However, practices were modified to fit this particular region and the available resources. Local issues to reconcile included: not having a forensic psychiatric hospital in this region, but having a local hospital willing to cooperate with the Court as they can; not having a local forensic psychiatrist to attend the Court; not having the volume of cases to merit the Court sitting five days a week, but having enough volume that the CMHA Mental Health Court Coordinator, Mental Health Court Crown and police, must be available all five days a week to deal with cases as they arise. In November of 2005, the Kitchener-Waterloo Human Services Justice Committee was created
Submitted by: Steven Potje Mental Health Court Coordinator Canadian Mental Health Association Grand River Branch
involving a wide crosssection of judicial, hospital, addiction, mental health and developmental services community partners. Committee members have been meeting since this time on a regular basis to provide feedback to the mental health court, to identify and create service protocols and identify service gaps. The work of the committee has resulted in additional in the funding of one fulltime pre-diversion coordinator, a part-time bail support coordinator and one full-time probation support coordinator. The biggest intangible success has been the development of the relationships among all the judicial and community partners. This has resulted in collaborative problemsolving in a timely manner, in many instances outside of the regular meetings.
The Updater
Kitchener Mental Health Court Support Program Third Anniversary
Submitted by: Steven Potje Mental Health Court Coordinator Canadian Mental Health Association
The Kitchener Mental Health Court (serving Waterloo Region) reached its third anniversary on
September 20, 2008. The Mental Health Court has been and continues to be, an evolving process in which all the judicial and community partners have played significant roles. All partners work hard to understand each others’ roles, balancing the requirements of Criminal Code and at the same time recognizing and understanding the unique challenges of people with significant mental health and other challenges. For the judicial partners the safety of the community is always paramount. For the community partners, enhancing the individuals’ quality of life from a recovery perspective is a primary focus. Together, both community and judicial partners, look at every situation individually and where possible, all partners work to divert these individuals away from the criminal justice system and toward the support services available from the community partners.
A brief introduction to the Recovery Approach Recovery can be defined as a personal process of tackling the adverse impact of experiencing mental health problems, despite their continuing or long-term presence. Used in this sense, recovery does not mean "cure". Recovery is about people seeing themselves as capable of recovery, rather than as passive recipients of professional interventions. The personal accounts of recovery suggest that much personal recovery happens without (or in some cases in spite of) professional help. Recovery involves personal development and change, including acceptance that there are problems to face, a sense of involvement and control over one's life, the cultivation of hope and using the support from others, including collaborating in solution-focused work with informal supports and professional workers. Some people recovering from mental illness claim that this "disability" has increased the depth and reach of their lives. Out of adversity has come change, personal development and growth. This is in stark contrast to the still predominant, yet rarely spoken belief that people may never make a recovery from a mental illness. Those who have made their own personal recovery have provided important accounts of their experience. Mary Ellen Copeland has turned her experiences into self-help strategies for others. Mary Ellen’s significant contribution has been in creating and developing WRAP (wellness recovery action planning). More information on WRAP is available at: http://www.mentalhealthrecovery.com/. Recovery starts with the individual and works from the inside out. For this reason it is personalised. It challenges traditional approaches in mental health to reorganise the way people are supported and involved in their own recovery. It is consistent with the recent drive towards mental well-being and the improvements necessary to affect the whole of a person’s life, rather than only addressing individual problems in isolation. Source: www.rethink.org
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Mental Health Court Support Program Cambridge The local Human Services
and Justice Coordination Committee of Cambridge took a closer look at youth with mental health issues who come in contact with the legal system. A Cambridge Youth Mental Health and Justice Needs Assessment conducted by the Orchard Park Institute, created a framework for youth Mental Health Diversion. The committee submitted a proposal for Cambridge Youth Diversion to The Ontario Trillium Foundation and was granted funding in March 2006. Many other funding decisions were being made around the same time. The Ministry of Children and Youth announced funding for a variety of ongoing services and the Canadian Mental Health Association received funding for 3 new justice positions; Probation, Precharge and Bail Support Coordination. All of these programs were welcome and needed additions, however they did impact the original direction for Cambridge Youth Diversion. Regardless, the project moved forward and in
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January 2007, CMHA hired a fulltime Diversion Project Coordinator to implement what became known as “Cambridge Mental Health Diversion”. Although there have been some twists and turns along the way as Cambridge Mental Health Diversion worked to coordinate and integrate with existing services rather than duplicate them, some valuable work has been done. In addition to offering short-term support to individuals between 18 and 29 years of age with mental health issues who are in contact with the legal system, the service also serves as a link to CMHA’s Mental Health and Justice Services. As a member of this team which is comprised of Court Support, Bail, Pre-charge, Probation and Diversion and Non-Diversion Support Coordination, the Diversion Project Coordinator also took on the task of promoting these services by creating a brochure as well as updating the services’ web site information. The activities of the project also shed light on a gap in services that is not being addressed: re-integration and release planning for individuals leaving correctional facilities and returning to the Waterloo Region Community. Many of the individuals who accessed short-term support served time in custody and were released back to the Cambridge
Submitted By: Julie Wallis Diversion Project Coordinator
community with little if any supports in place. Often these individuals find themselves with no medication, no identification and no mental health treatment and community supports in place. Re-establishing themselves in the community becomes very challenging. Over the next few months, the Diversion Project Coordinator will take a closer look at this issue to identify what supports could assist individuals in making a smooth transition back to the community.
The work of the HSJCC “The HSJCC has been a wonderful example of what can be achieved when people work together toward a common goal.” Linda Bender Regional Chair of Waterloo-Wellington HSJCC 2006 - June 2008
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Veronique’s Story I am 45 years old. I don’t have a criminal record and I have no intention of getting one! I have been given an opportunity to be on a diversion support plan as opposed to probation and for this I am grateful. This has given me a chance to work on personal, mental health issues with Joslyn Gaston as my support worker. This has enabled me to express my emotions and deal with personal losses and past issues. The preliminary diversion support plan was very helpful because it clearly stated a plan of action that I needed to pursue. Within this time period I have continued to meet with Joslyn on a regular basis. As a result of this relationship I was able to work on my recovery plan. I was able to continue to attend a methadone program with Dr. Frank, I got assistance with budgeting and I had access to supports in other areas of my life if I needed them. I also remained actively involved with groups offered by Waterloo Region Self-Help. Reflecting on my past experience, I strongly believe that if I had been given probation it would have reinforced my feelings of hopelessness and despair leading only to a state of severe depression. With the support that I have been given I gained a sense of hope, power and personal responsibility for my actions.
Relationship Development within the HSJCC • • • • • • • • • •
The commencement of the Mental Health Court in Waterloo Region Service Agreements Developed between Mobile Crisis Services in Guelph-Wellington and: Guelph Police Service, Wellington OPP, Shelburne OPP, Mount Forest OPP, Orangeville Police Service. Memorandum of Understanding between Mobile Crisis Services in Waterloo Region and the Waterloo Regional Police Service “Form 2” Bail Procedure between the Crown Attorney’s Office and Grand River Hospital (In practice and soon to be formalized) Development of Orange Information Cards specific to Guelph, Rural Wellington and Waterloo Region (shared widely by front line police officers and community mental health workers to individuals in crisis or in need of services) Presentation by Michael Bay on the Personal Health Information Protection Act (PHIPA) in November 2006 Mental Health Training for Court Staff in January 2007 HSJCC Conference free to the community with speakers on the Mental Health Act, Dual Diagnosis, The Regional Crisis System and the Mental Health Court in Kitchener and Guelph in January 2008 Purchase of Mental Health and Justice Resource books for Court Support Staff in the region. Financial support for staff to attend justice and mental health conferences to increase and share collective knowledge.
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The Updater
Definitions Accused A person or company charged with a crime; the defendant in a criminal trial. Arrest The taking or keeping of a person in custody by legal authority, usually in response to a criminal charge. Assessment 1. The determination of the rate or amount of something. For example, damages or a fine imposed. 2. In family law cases, an analysis by a qualified professional who investigates, assesses and reports on the needs of the child(ren) and the ability of the parties to meet those needs. 3. In criminal law cases, a determination by a qualified person of the mental condition of an accused person. 4. In civil cases, a determination of the capacity of an individual to manage property, to make personal care decisions, or to properly retain and instruct counsel. Fitness Assessment An analysis performed by a psychiatrist or psychologist to determine whether a person is fit to stand trial. Page 10
(A selection of definitions taken from the Ontario Ministry of the Attorney General website)
Bail
A commonly used term for a Recognizance of Bail. When a person is not released by the arresting officer, the person must be taken before a judicial officer to determine whether the person should remain in custody pending trial. The term "bail" is often used to refer to the money paid as security for person showing up the next time he or she is required to appear in court.
Admissible Evidence Evidence that is relevant and is of such a kind that the court will receive it. Character Evidence Evidence that shows the kind of person that someone is. Circumstantial Evidence Evidence which creates an inference that a particular fact exists.
Charge A formal accusation of an offence as a preliminary steto prosecution.
Corroborating Evidence Evidence that strengthens and confirms other evidence.
Crown Attorney A lawyer who acts as an agent of the Attorney General in civil lawsuits; a lawyer who prosecutes criminal matters on behalf of the Crown.
Demonstrative Evidence Physical evidence that can be seen and inspected.
Diversion In criminal law, removal of a case from the usual process. The police or Crown attorney may divert a case if certain conditions are met. There are various formal and informal pre-charge and postcharge diversion programs. Some of these are also referred to as extrajudicial measures or sanctions. Evidence Statements, information, and things that are used to prove or disprove an alleged fact.
Derivative Evidence Evidence discovered by using illegally obtained evidence. This evidence may be found to be inadmissible. Direct Evidence Evidence based on personal knowledge or observation that, if true, proves a fact. Expert Evidence Opinion evidence given by a person whom the court finds to be qualified to act as an expert. Forensic Evidence Evidence collected and studied through the use of sciences and other specialized knowledge,
The Updater
Definitions such as, biology, chemistry, medicine, physics, computer science, psychiatry and psychology. Forensic experts examine various things, including: a person's mental condition, documents, substances, chemicals, tissue traces, or impressions left at a crime scene. Hearsay Evidence Evidence based on what someone else has told the witness. "Secondhand" evidence. Hearsay evidence is often not admissible in court. Viva Voce Evidence Evidence that is given orally, as opposed to written evidence. Fitness Hearing The Criminal Code procedure to see if an accused is mentally fit to stand trial. Mentally Incapable When someone cannot understand relevant information or cannot appreciate what may happen as the result of decisions they make or do
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R. v. (name)/The Queen v. (name) The title of proceeding of a criminal case. The 'R.' stands for Regina or Rex, which are the Latin words for Queen or King. The 'v.' stands for versus, but it is often read aloud by using the term "and" instead.
the sentence be served in the community subject to conditions. Consecutive Sentence Two or more terms of imprisonment served one after the other.
Custody and Community Supervision/Custody Recognizance and Conditional A legislated form used Supervision by the court that sets out The Youth Criminal the terms under which a Justice Act makes person will be released provisions for a custody on bail or on a peace and community or bond and when he or she conditional supervision is expected to return to order, where two thirds appear before the court. of the sentence is served in custody and one third is served in the Remand To adjourn a hearing to community under supervision. a future date, most often used in criminal cases Fine when the accused is in A monetary penalty. custody. Sentence The penalty imposed on the finding of guilt. Concurrent Sentence Two or more terms of imprisonment served simultaneously. Conditional Sentence Where a sentence of imprisonment of less than two years is given, the judge may order that
Imprisonment The act of confining someone in a jail or prison. Intermittent Sentence A sentence consisting of periods of imprisonment interrupted by periods of probation. Intermittent sentences may be given for sentences of imprisonment for 90
days or less, usually to avoid loss of employment or interruption of education or childcare. Probation An order authorizing a person to be in the community subject to conditions listed in the order. Restitution An order requiring a convicted person to restore property to its rightful owner, compensate for a loss, or repair damage caused. Suspended Sentence The release of the convicted person on certain conditions contained in a probation order. Show Cause Hearing A hearing where the prosecutor must "show cause" that the accused should be held in custody until the trial. (see Bail Hearing) Stay of Proceedings An order suspending a legal proceeding.
An information newsletter about Mental Health and Addiction Services in Waterloo, Wellington and Dufferin
Submitted By: Joslyn Gaston Support Coordinator Kitchener Mental Health Court
A Typical Day
When I was trying to decide the best approach for this article, I thought of a few things. For instance, a typical day...however, there is no 'typical day' at work for me. Each day offers a unique person with a unique need. It could be as simple as an individual that needs to talk, to think something through or to vent a frustration. Or it could be as complex as the person that I start to support; who has just been released from custody. I meet that person in court for the first time and he has no money, no identification, no medication and no place to live. So now it is 4:00 in the afternoon and we need a plan - fast. This is when I have to take a step back and look at one thing at a time, starting with the most immediate need. The rest we can start to tackle tomorrow. At the beginning of our relationship, I generally spend a great deal of time with the individual I am supporting. We need this time to develop a relationship and create a plan for what they believe is necessary to gain some stability in his or her life. Gradually we work away at the plan, “step by step�, and eventually I begin to take a back seat in the person’s daily life. Sometimes I miss the small accomplishments, or I forget what they may be. This is easy to do when you start to support someone who is overwhelmed by all that he needs to get done in order to have some stability in the community. Stability that he knows will (hopefully) prevent him from getting arrested again. There are also days, more than I care to count, when I start feeling overwhelmed. How in the world do I assist this person in securing housing, a steady source of income, a family doctor, a psychiatrist, and identification while staying well in the community? More often than not, these complex arrangements must be made in a very short period of time. I often hear from others that they believe my job sounds interesting, rewarding and not at all boring. Is it all of those things? Yes, definitely. Each day offers a new challenge. So when I am feeling frustrated by limited resources, doctors in short supply and paperwork, I stop and remember that someone I support no longer feels that he/she's is alone. No longer alone to face the infinite struggles that exist for someone who has a mental illness and finds themselves facing criminal charges, sometimes for the first time in their life.
For more information www.hsjcc.on.ca Article submissions can be forwarded to Karen Guse at kguse@trellis.on.ca. A call for article submission outlining the theme as determined by the PAC Facilitation group will be sent 2-3 weeks prior to the email distribution target date. Suitable material such as articles of interest, new issues, important notices, changes in service, current research initiatives, coming events/conferences, etc, will be identified and submitted to the editor(s) for inclusion. The editor(s) will edit for spelling, grammar and format but will not be ultimately responsible for content errors and will not significantly alter submissions unless otherwise notified. Updater Newsletter Contact Info: Editorial support for this issue was provided by Jessie Baynham, Executive Director, Community Torchlight Inc. o/a Distress Centre Wellington/Dufferin 519-821-3761 x210 (fax) 519-821-8190 ED@dc-wd.org ~ www.dc-wd.org Karen Guse (Administrative Support, email distribution contact) Regional Support Worker, Waterloo, Wellington, Dufferin Regional Crisis System Email: kguse@trellis.on.ca Phone: 519-821-8089, ext 236, or 519-576-2333 ext. 236 Fax: 519-576-8980 Page 12
The Coping Centre ............................................. 519-650-0852 www.cmhagrb.on.ca
Waterloo Region Active Self-Help ..................... 519-570-4595 www.self-help-alliance.ca
St. Mary’s Hospital Counselling Services........... 519-745-2585 www.smgh.ca
Golden Triangle Area Narcotics Anonymous ...... 519-651-1121 www.gtascna.on.ca
Kitchener-Waterloo Alcoholics Anonymous …... 519-742-6183 www.kwaa.ca
Grand River Hospital Withdrawal Management....................................................... 519-749-4318 www.grhosp.on.ca
Alcoholics Anonymous Cambridge .................... 519-658-8222
Al-Anon and Alateen Cambridge ....................... 519-658-8222
Al-Anon and Adult Children of Alcoholics and Alateen Kitchener-Waterloo .............................. 519-896-5678
Waterloo Region Family Network...................... 519-804-1786 www.waterlooregionfamilynetwork.ca
Waterloo Fetal Alcohol Syndrome Support Group .................................................... 519-341-0295
Trellis Mental Health & Developmental Services Regional Eating Disorders Services ................... 519-576-2333 www.trellis.on.ca
Tourette Syndrome Foundation of Canada Waterloo Wellington Chapter .............................519-576-7957 tourettewellingtonwaterloo@gmail.com
Parents for Children’s Mental Health ................ 519-746-5437 parent.advocacy@hotmail.com
Self-Help Directory (C.M.H.A.) ......................... 519-744-7645 www.cmhagrb.on.ca
Substance Abuse
Overeaters Anonymous ...................................... 519-886-9975 www.oa.org
OCD Support Group ........................................... 519-744-7645 Ext. 319
Mood Disorder Parent Support Group of Waterloo Region ................................................. 519-743-1422 www.mooddisorders.on.ca
Eating Disorders Awareness Coalition .............. 519-745-4875 www.edacwr.com
Cambridge Memorial Hospital - Eating Disorders Clinic .................................... 519-621-2333 www.cmh.org Ext. 3305
Cambridge ADHD Support Group ..................... 519-624-7312 canadian.kruger@rogers.com
Autism Ontario - Waterloo Chapter .............................................. 519-742-1414 www.autismontario.com
Attention Deficit Hyperactivity Disorder Parent Support Group of Waterloo Region ...................519-579-3800 www.adhdparentsupportgroupkw.com
Alcoholics Anonymous - Kitchener ....................519-579-3800 www.kwaa.ca
Alcoholics Anonymous - Cambridge ..................519-658-8222
Al-Anon & Adult Children of Alcoholics ............ 519-896-5678
Support Groups
Self-Help Alliance of Waterloo Wellington - Cambridge ........................................................519-623-6064 - Kitchener-Waterloo ......................................... 519-570-4595 www.wrsh.ca
Mood Disorders Association of Waterloo Region................................................. 519-884-5455 www.self-help-alliance.ca
Cambridge Active Self-Help (C.A.S.H) .............. 519-623-6024 www.self-help-alliance.ca
Self-Help
Waterloo Regional Homes for Mental Health .... 519-742-3191 www.waterlooregionalhomes.com
Trellis Mental Health and Developmental Services Early Psychosis Program.................................... 519-576-2333 www.firststeptorecovery.ca
Suicide Intervention Through Youth Talk Canadian Mental Health Association ................ 519-766-4450 www.cmhagrb.on.ca
Regional Mental Health Care (R.M.H.C.)........... 519-455-5110 www.sjhc.london.on.ca
Region of Waterloo Infant Development ...........519-883-2268 njudi@region.waterloo.on.ca
Psychiatric & Mental Health Outpatient Services Grand River Hospital ......................................... 519-749-4310 www.grhosp.on.ca
Current as of June 18, 2010
Parents for Children’s Mental Health
Parents for Children’s Mental Health would like to thank kidsLINK, Lutherwood and the Student Support Leadership Initiative Waterloo for their generous support in developing the guide.
Providing current information is important to us. Please send updates to parent.advocacy@hotmail.com
The organizations and services listed in this guide provide support and assistance to families of children coping with mental health issues. This guide is for reference purposes only and is not meant as an endorsement of any of these organizations or their services by Parents for Children’s Mental Health or any of its supporters.
Resource List
Parents for Children’s Mental Health
Counselling Services Community Care Concepts ................................ 519-669-3023 www.communitycareconcepts.ca Community Mental Health Clinic (Cambridge Memorial Hospital) ............ 519-740-4900 www.cmh.org Family Counselling Centre of Cambridge & North Dumfries............................................... 519-621-5090 www.fcccnd.com Front Door: Access to Child & Youth Services... 519-749-2932 Health Connect Counselling Partners www.lutherwood.ca
Emergency Services Police, Fire & Ambulance Emergency................................. 911 Ambulance Dispatch .......................................... 519-653-2154 www.chd.region.waterloo.on.ca Anselma House - Women’s Crisis Services ........ 519-742-5894 www.wcswr.org Anselma House - Haven House, Cambridge ..... 519-653-2422 www.wcswr.org Cambridge Memorial Hospital........................... 519-621-2330 www.cmh.org Crisis Line (Canadian Mental Health Assoc.) ..... 519-744-1813 www.cmhagrb.on.ca 1-866-366-4566 Grand River Hospital - Emergency ........................................................ 519-749-4242 - Hazelglen Outreach Cambridge .......................519-624-5716 - Hazelglen Outreach Kitchener ......................... 519-749-4213 - Psychiatric & Mental Health Outpatient Services ........................................... 519-742-3611 www.grhosp.on.ca
Interfaith Community Counselling Centre ................................................................. 519-662-3092 www.interfaithcounselling.ca
K-W Counselling Services Inc. .......................... 519-884-0000 www.kwcounselling.com
Ontario Provincial Police ............................... 1-800-265-2525 www.opp.ca
kidsLINK ............................................................ 519-746-5437 www.kidslinkcares.com
Langs Farm Village Association ..........................519-653-1470 www.langs.org
Waterloo Regional Police Services ..................... 519-653-7700 www.wrps.on.ca
Wilmot Family Resource Centre ........................ 519-662-2731 www.wilmotfamilyresourcecentre.ca
Mental Health Database www.communitylinks.ca
Lutherwood .........................................................519-884-1470 www.lutherwood.ca
Waterloo Wellington Addiction and Mental Health Network (W.W.A.M.H.N.) ..................... 519-821-8089 www.wwamh.ca Ext. 734
Waterloo Region Suicide Prevention Council .... 519-744-7645 www.wrspc.ca Ext. 310
Telecare .............................................................. 519-658-6805 www.telecarecambridge.com
Mental Health Service Information Ontario (M.H.S.I.O) ..................................................... 1-866-531-2600 www.mhsio.on.ca
Woolwich Community Services.......................... 519-669-5139
Help Line AIDS and Sexual Health Infoline ...................1-800-668-2437 www.toronto.ca/health Anselma House ................................................... 519-742-5894 www.wcswr.org Distress Centre (C.M.H.A.) ................................. 519-745-1166 www.cmhagrb.on.ca Drug & Alcohol Registry of Treatment (D.A.R.T) ..................................... 1-800-565-8603 www.dart.on.ca
Legal Services
Wilmot Family Resource Centre - Suicide Awareness for Wilmot Wellesley (S.A.W.W.) .... 519-662-2731 www.familyresourcecentre.ca Grand River Hospital (Young Adult Program) .. 519-749-4218 www.grhosp.on.ca
Legal Aid Ontario - Kitchener Branch ............... 519-743-4306 www.legalaid.on.ca
Gambling Hot Line .........................................1-888-230-3505 www.opgh.on.ca
Kids Help Phone ............................................ 1-800-668-6868 www.kidshelpphone.ca
Waterloo Region Community Legal Services .....519-743-0254 www.wrcls.ca
Children’s Mental Health Ontario(C.M.H.O.)1-888-234-7054 www.kidsmentalhealth.ca Front Door: Access to Child & Youth Services ... 519-749-2932 Grand River Hospital - Withdrawal Management ................................ 519-749-2932 www.dart.on.ca Developmental Services Access Centre ................519-741-1121 www.dsac-wr.com kidsLINK ............................................................. 519-746-5437 www.kidslinkcares.com
Lutherwood ........................................................ 519-884-1470 www.lutherwood.ca
kidsLINK ............................................................ 519-746-5437 www.kidslinkcares.com
KidsAbility - Autism .............................................................519-886-8886 - Cambridge Office .............................................. 519-621-7580 www.kidsability.ca
Healthy Start (C.M.H.A.) .................................... 519-744-7645 www.cmhagrb.on.ca
Grand River Hospital - Child and Adolescent Inpatient Unit ......................................................519-742-3611 www.grhosp.on.ca
Front Door: Access to Child & Youth Services ...519-749-2932
Community Mental Health Clinic (Cambridge Memorial Hospital) ....................... 519-740-4900 www.cmh.org
Child and Parent Resource Institute (C.P.R.I.) .. 519-858-2774 www.cpri.thehealthline.ca
Mental Health Services
Ombudsman of Ontario.................................. 1-800-263-1830 www.ombudsman.on.ca
Youth Line (C.M.H.A).........................................519-745-9909 www.cmhagrb.on.ca
Psychiatric Patients Advocate Office .............. 1-800-578-2343 www.ppao.gov.on.ca
Family Violence
Information
Argus Residence for Young People (female) ......519-650-0452 Argus Residence for Young People (male) ......... 519-623-7991 www.argushouse.com Canadian Mental Health Association (FRIENDS -school program 4 - 15).................... 519-744-7645 www.cmhagrb.on.ca
Family Counselling Centre of Cambridge & North Dumfries ............................................... 519-621-5090 www.fcccnd.com
Family & Children’s Services of the Waterloo Region ................................................. 519-576-0540 www.facswaterloo.org
Oasis Outreach Ministries.................................. 519-744-2794
Lutherwood Safe Haven Shelter (12-15) ............ 519-749-1450 www.lutherwood.ca
Canadian Mental Health Association - Beautiful Minds ................................................519-766-4450 - Cambridge ........................................................ 519-740-7782 - Kitchener .......................................................... 519-744-7645 - Working Against Youth Violence Everywhere . 519-744-7645 www.cmhagrb.on.ca 1-877-627-2642
Anselma House ................................................... 519-742-5894 www.wcswr.org
St. Mary’s General Hospital ................................ 519-744-3311 www.smgh.ca
Lutherwood Family Counselling Services.......... 519-622-1670 www.lutherwood.ca Mosaic Counselling & Family Services .............. 519-743-6333 www.mosaiconline.ca Psychiatric & Mental Health Out Patient Services (Grand River Hospital) ........................ 519-749-4310 www.grhosp.on.ca Salvation Army Correctional & Justice Services ............................................... 519-744-4666 Shalom Counselling Services ............................ 519-886-9690 www.shalomcounselling.org St. John’s Kitchen (The Working Centre) .......... 519-745-8928 www.theworkingcentre.org Woolwich Community Health Centre ................ 519-664-3794 www.self-help-alliance.ca
Drop-In
Reaching Our Outdoor Friends (R.O.O.F.)........ 519-742-2788 www.roof-agency.net
Cambridge Active Self Help (C.A.S.H.).............. 519-623-6024 www.self-help-alliance.ca
Salvation Army ................................................... 519-744-4666
Mosaic Counselling & Family Services (Family Justice Centre) ...................................... 519-743-6333 www.mosaiconline.ca
St. John’s Kitchen .................................................519-743-1151 www.theworkingcentre.org
Access to Child and Youth Services in Waterloo Region
Access to Child and Youth Services in Waterloo Region
One Call: •
We will listen to your concerns.
•
We will find answers to your questions.
•
We will work with you to understand the unique needs of your family.
•
We will link you to services that best address your needs.
Many Options: •
Walk-In Service
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Short–term counselling
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Group programs
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Home-based family counselling
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Specialized school day programs
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Residential treatment
Access to Child and Youth Services
Access to Child and Youth Services A Joint Initiative of:
www.kidsLINKcares.com
www.lutherwood.ca
Front Door (Formerly The Children’s Mental Health Access Centre) is funded by the Ministry of Children and Youth Services.
Access to Child and Youth Services A Joint Initiative of:
1770 King Street East Unit, 1 Kitchener, ON, N2G 2P1 Phone: 519-749-2932
Access to Child and Youth Services
Your family doesn’t have to struggle on its own. Is your family struggling with parenting challenges?
We can help. Come on in and let’s talk.
Do you have concerns about: • your child‘s behaviour • your child‘s emotional state • your child’s mental health diagnosis (e.g. anxiety, depression, ADHD) • a family conflict • school-related issues • other parenting challenges The Walk-In Service at Front Door helps families with children up to 18 years of age to get started on the road to understanding. Through a single family counselling session, our experienced counsellors help identify issues and equip families with tools and strategies to address their concerns. The focus of the session is determined by each family’s unique needs. Walk-In Service Hours: Wednesdays 12 p.m. to 7:30 p.m. Appointments are available on a first come basis and are free of charge. Family members directly involved in the concern are encouraged to attend (please note: childcare is not provided).
Walk-In ServIce
Walk-In ServIce
Access to Child and Youth Services
A Joint Initiative of:
www.kidsLINKcares.com Access to Child and Youth Services
A Joint Initiative of:
Access to Child and Youth Services
www.lutherwood.ca
Front Door (Formerly The Children’s Mental Health Access Centre) is funded by the Ministry of Children and Youth Services.
1770 King Street East, Unit 1 Kitchener, Ontario N2G 2P1 Access to Child and Youth Services Phone: 519-749-2932
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Hospitals Cambridge Memorial Hospital
700 Coronation Blvd., Cambridge, ON, N1R 3G2 Phone: 519-621-2330 | fax: 519-740-4938 | www.cmh.org/patients_services Cambridge Memorial Hospital provides supportive and therapeutic services to people in Cambridge and North Dumfries who are experiencing mental health difficulties. Their Child and Family Services program provides assessment and counselling to persons 17 years of age and younger with psychiatric and emotional difficulties, and their families. Counselling may be provided on an individual, family or group basis. Services provided include: crisis intervention; individual, family and group therapies; medication and psychiatric consultation; family support and education; community consultation and outreach; psychiatric emergency services; consultations to the Hospital. Professional staff available to work with you includes nurse psychotherapists, social workers, psychologists, recreation therapists, occupation therapists, psychiatrists and support staff. Services include:
Child and Family Services
Provides assessment and counselling to persons 17 years of age and younger with psychiatric and emotional difficulties, and their families. Counselling may be provided on an individual, family or group basis.
Adult Services
Services to individuals over 17 years of age who have mood, anxiety and adjustment disorders.
Psychosocial Rehabilitation
Services to adults who have a serious and persistent mental illness. This includes assessment, case management, group programs and recreation and leisure therapy.
Seniors Mental Health Services
Assessment and treatment for people over 65 years of age that have a deteriorating complex health condition that includes mental, physical and/or behavioural difficulties. Services are primarily provided through home visits and visits to long-term care facilities.
Mental Health Transition Unit (5B):
CMH has a 10-bed transition mental health unit. This unit enables the hospital to provide mental health programming to patients requiring psychiatric treatment and who in the past were admitted to the medical units. The transition mental health unit is the first building block towards the hospital's 23-bed Schedule 1 mental health facility. In the meantime, CMH will continue to access services in psychiatric facilities in other communities when intensive or specialized services are required to treat patients.
Emergency Services:
Emergency Mental Health Services are available though Cambridge Memorial Hospital’s emergency department, which provides emergency assessment and crisis intervention between 9:00 a.m. and 9:00 p.m.
Last update: 15-Oct-11
www.PCMHwaterloo.com
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Hospitals (continued) Grand River Hospital
835 King St. West, Kitchener, ON, N2G 1G3 | Phone: 519-742-3611 | www.grhosp.on.ca/Mentalhealth For psychiatric emergencies, come to GRH Emergency Dept. GRH provides mental health and addictions assessments 24 hours a day in the Emergency Department. For urgent or non-urgent psychiatric services contact Central Access for Psychiatry at (519) 749-4310.
Child and Adolescent Inpatient Program (CAIP):
The child and adolescent program is an eight-bed, short-stay inpatient unit for children and adolescents up to 18 years of age with an average length of stay of five days The CAIP team works together with the patient and family to assess and stabilize psychiatric symptoms; engage the person in treatment and to develop a plan for further care upon discharge. Temporarily location on the ninth floor in the C wing at the KW site.
Outpatient Services: Triage
There is a new service in place for professionals and family doctors to access for quick referrals to Grand River Hospital mental health services. They can access immediate services or do a referral.
Preschool Diagnostic and Treatment Services
Preschool diagnostic services provide early identification, assessment, consultation and treatment services for children and their families between the ages of 2 and 5, who are experiencing behavioural, emotional, and developmental difficulties. Consultation to preschools, schools and community agencies. Ext. 2629
Child and Family
The Child and Family Centre's multidisciplinary team provides assessments, consultations and treatment for children from birth to 12 years of age who are experiencing complex problems that impact their social, emotional, learning and behaviour functions. The centre works with parents, schools, and community services to develop a plan based on the child's needs and strengths and focusing on skill development, coping strategies and symptom management. Ext. 2629
Adolescent Team Outpatient Services
The adolescent team's multidisciplinary staff provides mental health assessment, consultation and treatment for adolescents between 12 and 19 years of age with suspected or confirmed severe or complicated psychiatric diagnosis.
Young Adult Program (YAP)
The Young Adult Program is an intervention program for young adults ages 16 to 21 with mental health problems that have seriously impacted their functioning. The program runs on a daily basis, including a therapeutic classroom placement, group based intervention, and individual and family based treatment with a focus on social, emotional and academic issues that have made learning in a regular school setting difficult. Location 850 King St. across from the hospital.
Privacy Concerns
Patients, parents/legal guardians or substitute decision makers are given a “privacy code” number which they may share with a couple of people to serve as family spokespeople. When friends or family call they will be asked for the patient name and privacy code number. This lets staff know that you have permission to share general health information about your family member.
Last update: 15-Oct-11
www.PCMHwaterloo.com
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Hospitals (continued) St. Mary’s Hospital
911 Queen's Boulevard, Kitchener, ON, N2M 1B2 Phone: 519-744-3311 | www.smgh.ca At Emergency Services, you will be assessed by a triage nurse. You will be seen by a physician based on your triage assessment, which measures the severity of your condition or illness. You may be referred to another hospital for Mental Health Services.
St. Mary’s Counselling Service St. Mary’s Counselling Service provides outpatient services for individuals in the Region of Waterloo who are concerned about alcohol, drugs, or gambling. Professional counsellors help individuals review their lifestyle, identify changes they might like to make, and help them develop the necessary skills to make those changes. Referrals to residential treatment programs or community programs are provided. Consultation is also available for family members or friends of individuals who have issues with alcohol, drugs, or gambling. Services are free of charge. Funding for the programs is provided by the Ministry of Health and Long-Term Care, Addictions and Mental Health Branch.
Locations and Hours of Operation: KITCHENER OFFICE 600-30 Duke Street West, Kitchener, Ontario, N2H 3W5 Monday-Friday: 9:00 a.m. to 5.00 p.m. Wednesday & Thursday evenings until 8:00 p.m. BY APPOINTMENT ONLY CAMBRIDGE OFFICE 887 Langs Drive, Cambridge, Ontario, N3H 5K4 Monday, Thursday and Friday: 9:000 a.m. to 5:00 p.m. Tuesday and Wednesday: 9:00 a.m. to 8:00 p.m. BY APPOINTMENT ONLY All counselling sessions are by appointment only. They are unable to provide immediate appointments. To schedule an appointment, please call: (519) 745-2585 Ext. 232 (24 hour voice message available)
Clients arriving at the agency under the influence of alcohol or drugs will have their appointment rescheduled. Transportation by taxi to the Withdrawal Management Centre will be offered. In the event of disruptive behaviour, the police will be notified.
Last update: 15-Oct-11
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NOTES
Last update: 3-Aug-11
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Treatment Centres kidsLINK
1855 Notre Dame Drive, P.O. Box 190, St. Agatha, ON, N0B 2L0 Phone: (519) 746-KIDS (5437) | www.kidslinkcares.com
kidsLINK provides a broad range of programs and services to help children, youth and their families facing or at risk of social, emotional and mental health challenges such as depression, bipolar disorder, anxiety disorder, conduct disorder, and attention deficit hyperactivity disorder (ADHD), as well as children and youth who have experienced trauma. kidsLINK also provides consultation and training for professionals who work with children and youth. Consistent with its commitment since 1858 to help children and youth achieve their potential, kidsLINK specializes in enabling wellness, building resilience and reducing the impact of emotional trauma. kidsLINK is committed to a holistic approach to wellness and well-being. It believes difficulties experienced by children and youth do not exist in isolation, and therefore require a multidisciplinary approach to developing therapies, treatments and follow-up plans which include professionals, the family, cultural group, school and the community. Whenever possible, kidsLINK works with families in their own homes and community, and also offers respite care. Those facing more severe challenges receive treatment in our residential program and school. kidsLINK also works with children and youth in places like community schools and child care centres. There, we teach social skills, identify potential social, emotional and mental health concerns, and help children learn to manage their feelings and resolve conflicts. Parents, guardians and caregivers concerned about the well being of their children benefit through our workshops and consultations, and from our extensive resource centre. We also support families in making informed child care decisions. kidsLINK services include: Children's Mental Health Services
Front Door (formerly Children’s Mental Health Access Centre)* Partners Program (Intensive Child and Family Service)* Mobile Crisis Response* Zero2Six Services* Child and Family Therapy Program School Treatment Program Residential Treatment Services Child & Family Journal
Respite Services Early Intervention Services
Preschool Support Services Early Identification Early Intervention Program Child Care Connection Child Care Special Needs Access Point (SNAP)
* joint initiatives with Lutherwood
Last update: 21-Oct-11
www.PCMHwaterloo.com
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Treatment Centres (continued) Lutherwood
Head Office: 139 Father David Bauer Dr., Waterloo, ON, N2L 6L1 Phone: 519-884-7755 | www.lutherwood.ca 35 Dickson St., Cambridge, ON, N1R 7A6 | Phone: 519-622-1670 30 Wyndham St. N., Guelph, ON, N1H 4E5 | Phone: 519-822-4141 165 King St., Kitchener, ON, N2G 2K8 | Phone: 519-743-2246 285 Benjamin Rd., Waterloo, ON, N2J 3Z4 | Phone: 519-884-1470 Follow the link above to look at brochures and list of services.
Lutherwood provides a complete range of preventative and supportive interventions for children, adolescents and their families who are coping with behavioural, emotional or psychological problems. Our mental health services staff work in partnership with families and other community agencies to build on a client's individual strengths and to help them learn constructive behaviours and positive relationship skills. Whenever possible, we use approaches that help families prevent mental health problems and offer a range of services that are community based. Through our services, we see many young people develop a new sense of competence, personal satisfaction and community responsibility.
Child & Parent Resource Institute (CPRI)
600 Sanatorium Road, London, ON N6H 3W7 Phone: (519) 858-2774 or 1-877-494-2774 | www.cpri.ca Follow the link above to look at brochures and list of services. A referral is NOT required. The Child and Parent Resource Centre (CPRI) provides a variety of highly specialized services to children and youth 0 – 18 years of age (and families) with complex mental health and/or developmental challenges on a short term residential and community basis. The services provided are highly specialized and include assessment, consultation, treatment, research and education. Programs and clinics are also provided for children and youth, their families and caregivers. CPRI provides outpatient services to clients who come for scheduled appointments as well as provide service to clients in their own community. Community services are scheduled similar to scheduled appointments and occur in the client's community. CPRI has 7 residential units on site. Residential units vary by bed capacity (from 6 to 12), age, sex and needs of clients served on the unit. They provide residential services on a short term basis so children/youth are out of their home community for the least amount of time possible. Areas that CPRI work with include Attachment Disorder; Autism Spectrum Disorder; Brake Shop; Dual Diagnosis; Emotional Disorders; General Clinical Services; Home Visiting for Infants; Mood Disorders; Sexual Behaviours; Selective Mutism and a program called Triple P Parenting.
Last update: 15-Oct-11
www.PCMHwaterloo.com
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Treatment Centres (continued) St. Joseph’s Regional Mental Health Care London 850 Highbury Ave. N., London, ON, N6A 4H1 Phone: (519) 455-5510 Ext.48600 | www.sjhc.london.on.ca Referral and Program Admission – (519) 631-6568
A referral is needed. New Facility Development is under way so link to adolescent programs is currently not available.
The Adolescent Program at RMH-London is available to youth between the ages of 13-18 who are living in Southwestern Ontario (this includes Waterloo region). They cover a wide spectrum of emotional and psychiatric difficulties including but not limited to adjustment; mood disorders such as depression and bipolar disorder; anxiety disorders; suicidal thoughts and psychosis. They provide consultation, education, assessment, treatment, stabilization and community re-integration. The team that works with your adolescent may include psychiatry, medicine, nursing, psychology, social work, dietary, occupational therapy, family therapy, art therapy, education, recreation, spiritual care and child and youth workers. They will work with your adolescent and the family to provide the best therapeutic plan that utilizes the youth and family’s strengths to improve the areas of concern. They value the family/caregiver relationships. Treatment is available in various ways, including: Inpatient treatment or hospital day-treatment Outpatient therapy Community counselling Their aim is “to inspire hope and empower youth and family on their journey towards well-being.”
Last update: 15-Oct-11
www.PCMHwaterloo.com
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Last update: 15-Oct-11
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Counselling Services It is a myth that only “crazy” people get counselling. Many people from all areas of life benefit from counselling at some point in their lives. These people are seeking help with common life concerns. Counselling is simply a conversation between two people and requires the building of a relationship that deals with the concerns you have. Dealing with a child with mental health issues can be very difficult. You may need to talk to someone. You may wish to seek counselling for a variety of reasons including concerns about behaviour or understanding yourself and your reactions to the child with mental health issues. It’s o.k. to be depressed or worried or to feel helpless or hopeless. Counselling can help get you or your child past these issues. Support groups can not provide this service.
Counsellors can help you define the problem and decide what’s important and what to do next. It can be a safe place to express feelings and needs.
Counsellors can help you define the problem and decide what’s important and what to do next. It can be a safe place to express feelings and needs. The best way of finding a counsellor is to explore some of the centres in Waterloo Region or by asking your Doctor for a referral. Please refer to the insert called “Finding A Therapist” (on the next page). Also check out www.waterlooregion.org/CounsellingServices.pdf. There are counsellors that deal with a variety of issues for both the child and the adult in the family. These issues include anxiety, anger, stress management and sometimes Dialectic Behaviour Therapy. These services are free or have fees based on the ability to pay. Some of the services available are listed below. This is by no means an exclusive list. There are also other counselling services available in the community or you may have an Employee Assistance Plan that will help you find one.
Links or Useful Resources for COUNSELLING SERVICES: See “Finding A Therapist” (insert on next page) – www.mooddisorders.ca See “What you Can Expect from a Mental Health Professional” www.cymhin.ca/downloads/What%20to%expect.pdf – Child and Youth Mental Health Information Network (CYMHIN) Lutherwood Family Counselling Services (formerly Cambridge Interfaith Counselling Centre) - 519-622-1670 Cambridge Memorial Hospital 519-621-2330 - see also Hospitals in this section Front Door - 519-749-2932 Grand River Hospital Outpatient Services –519-749-3410 - see also Hospitals in this section Interfaith Pastoral Counselling Centre, Kitchener – 519-742-6781 K-W Counselling Services- www.kwcounselling.com Langs (Cambridge) – www.langs.org or 519-653-1470 Mosaic Counselling and Family Services – www.mosaiccounselling.com or 519-743-6333. Ontario Psychological Association - www.psych.on.ca, under “referral service” Shalom Counselling Services – www.shalomcounselling.org or 519-886-9690 ROOF (Reaching Our Outdoor Friends) – 519-742-2788 St. Mary’s Hospital Counselling Service, Kitchener – 519-745-2585 – see also Hospitals in this section The Therapy Directory - www.therapists.psychologytoday.com, search Ontario Woolwich Counselling Centre (Elmira) –www.woolwichcounselling.org - 519-669-8651
Last update: 18-Oct-11
www.PCMHwaterloo.com
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Last update: 15-Oct-11
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M D A O | Quick Facts
Finding a Therapist There are as many different types of therapists as there are types of problems. The result for you as you look for help can be confusion and frustration. This document is for you. We hope that you will be able to use it as a guide as you negotiate the “Finding A Therapist Maze”. Psychotherapy or counselling is a therapeutic partnership between someone experiencing emotional difficulties and a mental health professional. It is a contractual agreement between the therapist and the client for the purposes of supporting the client through a problem solving and healing process. The psychotherapist/counsellor brings knowledge and skill to the therapeutic relationship. The primary role of the counsellor is to provide the safety, containment and guidance that is necessary in order to make sure that you feel supported and secure in the important work that you are doing.
Ask these questions • What’s your education? • What’s your professional / clinical training? • Do you have experience in treating mood disorders? • Are you a member of a professional association or college? • How long have you been practicing? • Do you have experience with my specific problem? • What are your fees? • How many sessions do you think it will take to reach my goals? • Can we work as a team to set the goals for my therapy? • Do you have a waiting list?
Before you begin make sure that you know what you want. Here are a few things to keep in mind.
Make sure that you write down the responses in order to review them later. As you ask the questions check how you feel about the responses. Your “gut” feelings about the person on the other end of the phone shouldn’t be ignored. Pay attention to the “ease” or “dis-ease” that you feel as you go through your checklist. A good thing to do is to rank your gut feeling from 1-5.
• How much can I afford to pay?
1. I felt really uncomfortable with this one.
• How long do I want to be in therapy?
2. I felt moderately comfortable with this one.
• Do I want therapy that is interactive?
3. I felt comfortable with this one.
• Do I want therapy that is more analytical and less interactive?
4. I felt very comfortable with this one.
Remember that the therapist is actually working for you. The work that you do together must be done as a team if you are to be successful in your journey.
• Is the therapist’s office in a location that I feel comfortable with? • How often do I want to see the therapist? There are a few good questions that you can ask. All therapists should be willing to answer them. If they won’t, move on! Buyer beware. There are lots of people who claim to be therapists but who do not have the credentials or professional memberships to support the claim. When you are making your first exploratory phone calls:
5. This is the one for me. Once you have ranked your gut feeling, review the other questions to make sure that the therapist is a fit. Now you can make an appointment. You will know that the therapist you have chosen is the right one within the first two to three sessions.
The Mood Disorders Association of Ontario provides support, information and education as a complement to traditional and alternative therapies. MDAO services are not intended as a replacement for other treatment options and encourages individuals to seek treatment by a qualified health professional.
Mood Disorders Association of Ontario (MDAO) 36 Eglinton Avenue West, Suite 602, Toronto, Ontario M4R 1A1 Telephone: 416.486.8046 Fax: 416.486.8127 E-mail: info@mooddisorders.on.ca Website: www.mooddisorders.on.ca
Toll-free: 1.888.486.8236
Here are some questions to ask yourself after the first couple of sessions:
Where can I start to look?
• Am I beginning to trust this therapist?
TRADITIONAL
• Does the therapist seem to understand me?
College of Physicians and Surgeons: Telephone: 416.967.2603 Toll free: 1.800.268.7096 ext. 306 Website: www.cpso.on.ca
• Do I feel at ease with the therapist even though it’s a difficult situation? • Are the fees okay? • Is the location good? • Do I feel comfortable in the therapist’s office? • Can the therapist accommodate my schedule needs? • Do I feel that we make a good team? • Do I feel heard? • Do I feel supported? Make sure that you feel comfortable. Remember, this is an important and courageous step that you have taken and you need to be on the journey with someone that you know you can count on. If you don’t feel that you and the therapist are a good fit, let him/her know. Some problems can be resolved but sometimes it’s just a matter of “mismatched personality”. This is no one’s fault but will require you to find a different counsellor. If you do need to find a new therapist ask your current therapist to help you by providing some names of other therapists. He/she should be able to accommodate this request.
How much will this cost me? • OHIP covers Psychiatrists and Medical Doctors. • Psychologists and Clinical Social Workers aren’t covered by OHIP but are often covered by private or company insurance policies. • Fees can range from as low as $0.00 per hour at public agencies all the way up to $160+ per hour. Some therapists have a sliding fee scale. It’s important to know that there are lots of people who call themselves therapists or counsellors. The price for services isn’t a gauge of the quality of service. You are the gauge and you will know which therapy fits best for you.
Therapy can be the key to unlocking all of your hidden potential. You need to respect and trust your ability to choose the right counsellor. Once you’ve done that, the work may be difficult but you will succeed.
You’re worth it!
G.P. Psychotherapy Association: Telephone: 416.410.6644 Ontario Association of Social Workers: Telephone: 416.923.4848 Website: www.oasw.org Ontario College of Social Workers: Telephone: 416.972.9882 Toll free 1.877.828.9380 Website: www.ocswssw.org Ontario Psychological Association: Telephone: 416.961.5552 Toll free: 1.800.268.0069 Website: www.psych.on.ca ALTERNATIVE Friends of Alternative & Complementary Therapies (FACT): Telephone: 416.299.5113 Website: www.thefacts.org You’re on your way You’ve done a lot of work to get here. If you have any questions or concerns, please call us at MDAO. We’ll be happy to support you through this complicated but important decision-making process.
Note: The Mood Disorders Association of Ontario does not recommend individual therapists.
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
PCMH Waterloo Region Affiliated Support Groups
“Together we can make a difference” PCMH PARENT SUPPORT GROUP - CAMBRIDGE Having a child with emotional and behavioural disorders can be confusing and overwhelming. As parents, we need information so that we can make decisions that are best for our child. Emotional & practical support from other parents experiencing similar issues in a judgment-free atmosphere can be very helpful. You are not alone!
MEETINGS: 3rd Monday of the month *MUST CALL AHEAD* (Sept. – June) 7:00 – 9:00 p.m. Dickson Arena (Cambridge) Contact: kidsLINK @ 519-746-5437 and ask for the PCMH representative or e-mail us @ parent.advocacy@hotmail.com *with some exceptions, please request a calendar
MOOD DISORDER PARENT SUPPORT GROUP OF WATERLOO REGION We are a volunteer parent support group for families of individuals with various mood disorders (i.e.- depression, bipolar, manic depressive, panic or anxiety disorders, post-traumatic stress disorder, etc.). Parents share information and stories, coping strategies, provide support and network with others with common experiences.
MEETINGS: rd 3 Monday of the month (Sept. – June) 7:00 – 9:00 p.m. Extend-A-Family. 91 Moore Ave., Kitchener – entrance at rear Contact: email: kidsmood@gmail.com
TOURETTE’S SYNDROME SUPPORT GROUP Dedicated to helping families, educators, the community, and individuals with Tourette Syndrome and related disorders, through programs of: education, advocacy, self-help and the promotion of research. Join us for Speakers, Videos, Parent sharing, Child and Youth & Family Events. We have a resource lending Library and provide Inservice presentations.
MEETINGS: 3rd Thursday of the month (Sept.-June) 7:00 pm – 9:00 pm Extend-A-Family 91 Moore Avenue, Kitchener – entrance at rear Contact: Tina Blanchette at 519-880-8715 or email: tina.blanchette@sympatico.ca
Not sure where your child’s needs might best be met? Call kidsLINK at 519-746-5437 and ask for the PCMH representative or email us at parent.advocacy@hotmail.com and someone will help you decide which group might best be able to help. Our parent support groups are not substitutes for medical professionals. We do not provide treatment services. For a more extensive listing of local support groups please visit “Local Parent Support Groups” in this section of the guide.
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Why Join a Parent Support Group? There are several reasons to join a parent support group: You will meet other people who are having similar experiences, which can also lead to lasting friendships for you and your child. You can ask questions and clarify things you may not understand. You can see and hear guest speakers on relevant subjects. You will learn about workshops and seminars that are pertinent to you. You can learn about the newest technologies to accommodate your child, or breakthroughs in the medical treatments or alternative therapies that are successful. Some groups offer resources such as libraries from which you may sign out books, DVDs, etc. for yourself and your child. You may receive handouts on parenting tips, or tips for teachers & schools. Some groups offer in-service. In-service consists generally of an accredited person (someone the group recommends, either from within the group, or a professional) providing through assemblies in school, or at a staff meeting, a speaker to address the issues around the child’s disability or disorder. Some groups offer workshops or courses that teach parents new skills, from dealing with a child with a disability to advocating for that child in school. You can share your stories with other adults without judgment. You can learn advocacy skills. Your group may have representation on your school board’s Special Education Advisory Committee (SEAC). Hearing from you can help your representative advocate for all children’s needs.
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Local Parent Support Groups General Mental Health Support Groups Mood Disorder Parent Support Group of Waterloo Region Parents for Children’s Mental Health (PCMH) – Waterloo Region
e-mail: kidsmood@gmail.com 519-746-5437 and ask for the PCMH representative or e-mail: parent.advocacy@hotmail.com
Addictions/Substance Abuse Al-Anon and Adult Children of Alcoholics and Alateen Kitchener-Waterloo Al-Anon and Alateen Cambridge Golden Triangle Area Narcotics Anonymous Teen Challenge
519-896-5678 519-658-8222 Cambridge 519-651-1121 519-744-4744
Attention Deficit Hyperactivity Disorder (ADHD) Cambridge AD/HD Support Group
519-624-7312 or e-mail: canadiankruger@rogers.com Attention Deficit Hyperactivity Disorder Parent 519-648-2942 or Support Group of Kitchener Waterloo www.adhdparentsupportgroupkw.com See general mental health support groups
Anxiety Disorder Autism Autism Ontario - Waterloo Region Chapter
519-742-1414 (answering machine) See general mental health support groups See general mental health support groups See general mental health support groups See general mental health support groups See general mental health support groups See general mental health support groups
Bipolar Disorder Borderline Personality Disorder Bullying Conduct Disorder Cutting/Self Harm Depression Dual Diagnosis Waterloo Region Family Network
519-804-1786 or e-mail: admin@waterlooregionfamilynetwork.com
Eating Disorders Eating Disorders Awareness Coalition Overeaters Anonymous Trellis Mental Health & Developmental Services – Regional Eating Disorders Services
Last update: 15-Oct-11
519-745-4875 www.edac.wr.com 519-886-9975 519-576-2333
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Local Parent Support Groups Fetal Alchohol Syndrome Disorder (FASD) Waterloo Fetal Alcohol Syndrome Support Group
519-341-0295
General Mental Health Support Groups Mood Disorder Parent Support Group of Waterloo Region Parents for Children’s Mental Health (PCMH)
e-mail: kidsmood@gmail.com 519-746-5437 and ask for the PCMH representative or e-mail: parent.advocacy@hotmail.com
Learning Disabilities The Learning Disabilities Association of K-W
519-743-9091 or email: ldakw@golden.net See general mental health support groups
Mood Disorders Obsessive Compulsive Disorder OCD Support Group
519-744-7645
Oppositional Defiant Disorder
See general mental health support groups
Psychosis
See general mental health support groups
Re-active Attachment Disorder (RAD)
See general mental health support groups
Schizophrenia
See general mental health support groups
Schizoaffective Disorder
See general mental health support groups
Sensory Integration/Dysfunction
See general mental health support groups
Stress
See general mental health support groups
Tourette Syndrome (TS) Tourette Syndrome Foundation of Canada Waterloo Wellington Chapter Tourette Syndrome Association of Ontario - Waterloo Region Chapter (Cambridge)
519-576-7959) e-mail: tourettewellingtonwaterloo@gmail.com 519-212-1639 or1-888-274-1639 e-mail: tsao@primus.ca
Trauma
See general mental health support groups
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Social Skills Training Programs School-based Programs To our knowledge, there are several school-based social skills training programs running in the region. One of these is called the “FRIENDS” program, coordinated by the Canadian Mental Health Association and the other is called the “Tools for Life” program by kidsLINK. The FRIENDS service operates in partnership with local school boards to develop self-esteem and social skills with children between the ages of 4 and 15 years. Friends matches trained adult volunteers (16 years of age or older) with children and youth who are experiencing significant difficulties in their lives. Children may be experiencing issues related to social, emotional, behavioural, developmental or mental health concerns. Volunteers act as positive role models and confidantes to provide emotional support to children and assist them to build/enhance their selfesteem and confidence while developing strong social skills. (available in Waterloo Region only) For more information on the Friends Service, please call (519) 744-7645 ext. 229 or visit www.cmhawrb.on.ca. Tools for Life®: Relationship-building Solutions is a training curriculum and set of tools for adult use with 3 to 10 year olds to teach positive language and behaviour that help build strong relationships and resilience. The program is designed with complementary versions for use in schools, Early Childhood Care & Learning, community organizations and in the home. The program progressively develops more sophisticated skills in the areas of self understanding, self management, interpersonal communication, and relationship problem-solving. Through the use of common language and consistent strategies. Tools for Life provides the foundation for character development, conflict resolution, peacemaking, and anti-bullying. For more information on the Tools for Life program, please go to their website www.toolsforlife.ca or www.kidsLINKcares.com, the EIEI (Early Identification, Early Intervention) Program, or call 519741-1122 ext. 237 or e-mail: info@toolsforlife.ca. Note Not all schools are participating in the above two programs. Firstly, there has to be a need in the school for such a program, and secondly, volunteers and/or staff are needed to support these programs.
By Referral ASPEN is a 10-week social skills training group for 12-17 year old youth with a diagnosis on the Autism Spectrum including Asperger’s Syndrome, High Functioning Autism, Pervasive Developmental Disorder (PDD) or Non-verbal learning disability. ASPEN is provided at no cost to families and is funded by The Ministry of Children and Youth as well as the Lutherwood Child and Family Foundation. Sessions typically run during school breaks; Summer, December and March breaks. Please contact Front Door at 519-749-2932 Mon. to Fri., 8:30 am to 4:30 pm for more information about accessing this program.
Cont’d on next page…
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Social Skills Training Programs cont’d Note: PCMH encourages parents to advocate for social skills training through any agencies you may be involved with, whether it is through occupational therapy, mental health agencies or treatment centres. Any of these centres may offer training if parents of children in similar age ranges can band together and request this support for their children.
Useful resources/links for SOCIAL SKILLS TRAINING: Canadian Mental Health Association – www.cmhawrb.ca – “Friends” Developmental Services Access Centre (DSAC) – www.dsac-wr.com or call 519-741-1121 Front Door – (519) 749-2932 ASPEN Group – www.lutherwood.ca kidsLINK - www.kidslinkcares.com, “Tools For Life” KidsAbility Centre For Child Development – www.kidsability.ca – 519-886-8886
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Cognitive Behavioural Skills Training Children with mental health concerns often have challenges in the areas of social skills, problem-solving and managing Cognitive Behaviour Therapy their frustration. Cognitive Behaviour Therapy (CBT) is (CBT) is based on scientific based on scientific research, and is the process of teaching research. people the skills and attitudes necessary to associate with others in ways that are mutually satisfactory and gratifying. CBT involves learning how to change your thoughts (or cognitions) and your actions (or behaviours), which is why it is called Cognitive Behavioural Therapy. CBT was primarily developed out of behaviour therapy, cognitive therapy and rational emotive behaviour therapy and has become widely used to treat various kinds of mental health concerns, including mood disorders and anxiety disorders and has many clinical and non-clinical applications. You can ask your family physician, your psychologist or your psychiatrist about CBT and they can direct you to a health care professional dealing specifically in this area. The principles of CBT have also been incorporated in some self-directed resources (i.e. self-help books, computer programs, DVDs). Some parenting and teaching strategies to help change behaviour and promote problem-solving are: A presentation called ―Cognitive-Behavioural Brake Jobs‖ by Dr. B. Duncan McKinlay, psychologist. To view his presentation slides, visit www.cpri.ca and type in the upper Search Box ‗cognitive-behavioural‘. A DVD called ―Leaky Brakes: What they are. What they AREN‘T‖ by Dr. Duncan McKinlay, psychologist. This DVD can be purchased online at www.cpri.ca and type in the upper Search box ―DVD‖ or call 1-519-858-2774 ext. 2074.This DVD is an excellent resource for parents, children and youth, educators and medical professionals. This DVD is also available at the KidsLink Resource Centre – 519-741-1122 Ext. 225. A DVD or book called ―The Explosive Child‖ by Dr. Ross Greene. Almost everyone knows an explosive child, one whose frequent, severe fits of temper leave his or her parents standing helpless in their fear, frustration, and guilt. Most of these parents have tried everything — reasoning, behaviour modification, therapy, medication — but to no avail. Throughout this compassionate book, Dr. Greene demonstrates why traditional treatments don't work for these kids and offers a new conceptual framework for understanding their behaviour, along with new language to describe it. He explains the latest neuroscience findings about the importance of flexibility, and, most important, he shows parents specific, practical ways they can recognize the signs of an impending explosion, defuse tension, and reduce frustration levels for the entire family. This DVD is available at Kitchener Public Library and Waterloo Public Library as well as through the KidsLink Resource Centre. A book called ―Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them‖ by Dr. Ross Greene. Emphasizing the revolutionarily simple and positive notion that ―kids do well if they can‖, Dr. Greene persuasively argues that kids with behavioral challenges are not attention-seeking, manipulative, limit-testing, coercive, or unmotivated, but that they lack the skills to behave
Last update: 15-Oct-11
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Cognitive Behavioural Skills Training (continued) adaptively. And when adults recognize the true factors underlying difficult behavior and teach kids the skills in increments they can handle, the results are astounding: the kids overcome their obstacles; the frustration of teachers, parents, and classmates diminishes; and the well-being and learning of all students are enhanced. In Lost at School, Dr. Greene describes how his road-tested, evidence based approach – called Collaborative Problem Solving – can help challenging kids at school. Available through Waterloo Public Library or KidsLink Resource Centre. A book called “Teaching the Tiger” by Marilyn Dornbush, Ph.D. and Sheryl Pruitt, M.Ed. Provides information to teachers and parents to aid in the teaching of students with attention deficit hyperactivity disorder, Tourette Syndrome or Obsessive-Compulsive Disorder. Available at Kitchener Public Library and kidsLINK Resource Centre. “Educators Resource Kit” by the Tourette Syndrome Foundation of Canada. This kit contains a DVD, an Interactive Workbook, a Facilitators Guide, Symptom Checklists, and a copy of Understanding Tourette Syndrome: A Handbook for Educators, 2nd Edition! This handbook provides a comprehensive overview of Tourette Syndrome and other neurological disorders such as Obsessive-Compulsive (OCD) and Attention Deficit Hyperactivity (ADHD). It is an invaluable guide for educators looking for strategies to use in the classroom. Available through kidsLINK Resource Centre.
Useful resources/links for COGNITIVE BEHAVIOURAL SKILLS TRAINING: Child & Parent Resource Institute – www.cpri.ca – or 519-858-2774 for information on the Brake Shop and Leaky Breaks 101 Dr. Ross Greene, Ph.D. – “The Explosive Child” book, video or DVD or “Lost at School” book “Teaching the Tiger” available online at Chapters.ca or Amazon.ca or www.parentbooks.ca “Educators Resource Kit” available online www.tourette.ca KidsLink Resource Centre – 1770 King Street East, Unit 1, Kitchener – 519-741-1122 x225
Last update: 15-Oct-11
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Dialectic Behaviour Therapy Dialectic Behaviour Therapy (herein referred to as DBT) is a type of cognitive behavioural therapy. Its main goal is to teach the client skills to cope with stress, regulate emotions and improve relationships with others. It is often used with those who have experienced complex/developmental trauma.
DBT requires that the person take responsibility for their behaviours and helps them examine how they deal with conflict and negative emotions. It is comprised of three fundamentals: 1. Cognitive Behavioural Therapy
2. Validation of the client’s behaviour and responses as understandable in relation to the current life situation, and showing an understanding of the difficulties and suffering. 3. Dialectics DBT is derived from a process called dialectics. The concept of dialectics is 1. All things are interconnected. 2. Change is constant and inevitable 3. Systematic reasoning that looks at contradictory ideas and seeks to resolve conflict DBT is based on the fact that some children react differently to emotional stimulation. This could be due to genetic, environmental or traumatic experiences. Their arousal goes up much more quickly, peaks higher and takes more time to return to baseline. It is often used to treat Borderline Personality Disorder and self-harmful behaviours. DBT requires that the person take responsibility for their behaviours and helps them examine how they deal with conflict and negative emotions. DBT often involves a combination of group and individual sessions.
Links or Useful Resources for DIALECTIC BEHAVIOUR THERAPY: About.com - http://depression.about.com/od/psychotherapy/a/dialectical.htm American Academy of Child and Adolescent Psychiatry (AACAP) – www.aacap.org Centre for Addiction and Mental Health – www.camh.net DBT Self Help – www.dbtselfhep.com Portland Dialectic Behaviour Therapy Program – www.portlanddbt.com
Last update: 15-Oct-11
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Last update: 13-Sep-11
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Complementary/Alternative Health Care There are a wide variety of treatments available in the field of alternative or complementary therapies. Complementary therapies are those that are used to complement traditional medicine. Alternative therapies can be used instead of traditional medicine.
“A long time ago, the (Western) medical profession separated the head from the body”.... quoted by Dr. Mehmet Oz
Canadians are visiting alternative and complementary health care providers more and more as the population ages. Some commonly used practices in this country include: chiropractic, body/energy therapies, relaxation techniques, massage, prayer, herbal therapies, special diet, folk remedies, acupuncture, yoga, self-help groups, lifestyle diets and homeopathy.
This approach to health care focuses on prevention, rather than “reactive” care. Practitioners take a holistic approach, that is, the whole person (mind, body and spirit) is considered when treating a health issue. Most complementary therapies are not covered under OHIP, but are sometimes covered under private health insurance benefits. Make sure that you are dealing with a qualified and registered practitioner. There are many practices originating from many different cultures. While we cannot make a comprehensive list here of all the services you can find of this nature, we should point out that other ways of healing are important also. Examples include; meditation, laughter, music, art, play, diet, sleep, nutrition, exercise, and spirituality. Acupuncture is an ancient Chinese art based on the theory that Chi or Qi energy flows along meridians in the body, and can be unblocked or re-programmed by inserting fine needles at specific points. Acupuncture is used to treat conditions such as, but not limited to asthma, addiction, allergies, arthritis, anxiety, blood pressure, depression, problems with the digestive system, etc. Aromatherapy involves the use of essential oils (extracts or essences) from flowers, herbs, and trees to promote health and well-being. Aromatherapy can help with symptoms, can affect your mood, or help alleviate or temporarily eliminate stress or other psychological factors. Ayurveda (meaning "the science of life") is an alternative medical system that has been practiced primarily in the Indian subcontinent for 5,000 years. Ayurveda includes diet and herbal remedies and emphasizes the use of body, mind, and spirit in disease prevention and treatment. It does this through a variety of cleansing and rejuvenating treatments and practices that can include diet, exercise, meditation and massage. Yoga is part of the ayurvedic tradition, too - when you perform some yoga positions, you’re engaging in a physical and spiritual exercise that is rooted in ayurvedic philosophy. Chiropractic (word comes from ancient Greek word for “done by hand”) is a system that focuses on the relationship between bodily structure (primarily that of the spine) and function, and how that relationship affects the preservation and restoration of health. Energy Therapy - There are a variety of approaches to healing that involve energy flow in the body. Some are touch related (see massage therapies) and some are body and/or energy work such as
Last update: 15-Oct-11
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Complementary/Alternative Health Care (continued) biofeedback, reflexology, reiki, shiatsu, and gem-stone therapy. The general principal behind these practices is that blockages are cleared from the body’s energy meridians. Clearing these blockages can help clear up physical and mental problems that are preventing optimum functioning. Homeopathic medicine is a system based on the belief that "like cures like" meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms. Massage therapy or massotherapy is the manipulation of muscle and connective tissue to enhance function of those tissues and promote relaxation and well-being. There are a variety of techniques and practitioners practicing them, for example; acupressure, bio-dynamic, chair massages, craniosacral, deep muscle therapy, deep tissue, healing touch, integrative manual therapy, joint mobilization, kinesiology, reflexology, reiki, shiatsu, Swedish massage, therapeutic touch. Natural Health Products are defined as vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines (such as traditional Chinese medicines), probiotics, and other products like amino acids and essential fatty acids. Natural health products are available for self care and self selection, and do not require a prescription to be sold. In Canada, natural health products, also referred to as complementary medicines or traditional remedies, are subject to
Natural Health Products Regulations.
Naturopathic Medicine is a distinct primary health care system that blends modern scientific knowledge with traditional and natural forms of medicine. Naturopathic medicine is the art and science of disease diagnosis, treatment and prevention using natural therapies including botanical medicine, clinical nutrition, hydrotherapy, homeopathy, naturopathic manipulation, traditional Chinese medicine / acupuncture, and lifestyle counselling. Phototherapy (light therapy) for sufferers of Seasonal Affective Disorder and depression involves spending about 20 minutes a day in front of a light-box, particularly in the winter months when mood and energy levels can be affected by lack of light. Yoga has been shown to alleviate stress and, at the physical level, has been seen to be useful in the treatment of those who suffer conditions that affect or are affected by posture, such as backache and arthritis.
Links or Useful Resources for COMPLEMENTARY/ALTERNATIVE HEALTH CARE: Canadian Association of Naturopathic Doctors (CAND) - www.cand.ca Mood Disorders Association of Ontario - www.mdao.ca Government of Canada - www.canadabusiness.ca
Last update: 18-Oct-11
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NOTES
Last update: 15-Oct-11
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Access Waterloo Region Each year nine community agencies, including the Waterloo Catholic District School Board and the Waterloo Region District School Board work in partnership to provide and promote the publication of the Access Waterloo Region Booklet and organize an Information Evening in April for people with disabilities. In April 2008 the Committee also launched a website to help make information and resources more accessible. This information, as well as additional links, are available for online viewing, downloading and printing at www.accesswaterlooregion.ca. The intent of the website is to promote the great resources within Waterloo Region and to make the information concerning those resources within the booklet more accessible. This website is the first step in creating a unique resource for the Region of Waterloo for those living, working or supporting someone with a disability. It offers an easy way to search for options and make decisions about programs that may meet needs and interests. The Access
Waterloo Region Booklet is divided into 9 sections as follows:
Section 1 – Advocacy and Supports These groups provide assistance, mutual support and information to individuals with disabilities, their families and service providers. Advocacy work often focuses on raising public awareness about disability-related issues. Section 2 - Education Life-long formalized learning supports commencing at birth. Section 3 - Financial Assistance Financial supports that can assist individuals and their families with costs associated with disabilities. Section 4 - Health Specialized mental and physical health programs for people with disabilities, including therapy and counselling services. Section 5 – Personal Care and In-Home Supports Personal support services to those who require assistance with the activities of daily living. Section 6 - Recreation Year-round recreation and social activities within the community which are specialized and/or inclusive for individuals with disabilities. Section 7 – Respite and Residential Programs Respite Services provide temporary relief to families and individuals from the physical and emotional demands involved in caring for a family member who has a disability. A variety of community based residential services exist for people who have disabilities and need alternate supported living arrangements.. Section 8 - Transportation Specialized/adaptive transportation for people with disabilities. Section 9 – Work, Day Programs and Volunteer Supports Programs that assist adults who have disabilities to participate in community, volunteering and obtaining employment, including specialized day programs.
To view the complete 2011 version go to: http://accesswaterlooregion.ca/admin/sources/editor/assets/pdfs_documents/AWR%202011%20b ooklet.pdf Last update: 18-Oct-11
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Respite Services Respite Services recognize the need for parents and guardians to have a much needed break -time to regroup and recuperate away from the constant demands of caring for their child with serious social, emotional and behavioural concerns. This service provides temporary relief for families. Most children are referred through a local agency such as DSAC (Developmental Services Access Centre), Front Door, Grand River Hospital, Family and Children’s Services, Lutherwood or kidsLINK. Most services have waiting lists and need referrals.
kidsLINK Respite Services Caroline Respite Centre, 1855 Notre Dame Dr. N., St. Agatha Phone: (519) 746-5437 ext 136 | www.kidslinkcares.com | E-mail: respite@ndsa.on.ca Eligibility: Children 5-15 years with mental health concerns, or diagnosed with autism. Hours: Sat/Sun 9 am – 7pm (usually 1 day per month); also Mon-Fri 9am - 7pm during some of the school holidays.
Respite Services for children/youth with Developmental Disabilities K-W Habilitation Services* - (519) 884-8080 Parents for Community Living Kitchener-Waterloo Inc.* – (519) 742-5849 Parents of Technologically Dependent Children of Ontario* - (519) 651-2875 Community Living Cambridge* – (519) 623-7490 Kitchener-Waterloo Extend-a-Family Association - (519) 741-0190 Elmira Association for Community Living* * must contact DSAC to access.
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Recreation and Camp Services The Camp experience teaches children sharing, compromising, co-operation, problem solving, and communication skills. It enhances independence and builds self-esteem. All these skills are taught in a fun-filled environment and we encourage you to seek out camps with appropriate supports for your child. The cities of Kitchener, Waterloo and Cambridge each publish a quarterly Activities Guide or Leisure Guide which publishes current information on Inclusion Services for children and teens. Access Waterloo Region also has a comprehensive listing of recreational and Summer camping/playground activities, for both day and overnight camping, available in Waterloo Region for children with disabilities. A Personal Attendant for Leisure (PAL) Card allows registered card holders to bring an attendant with them to enable them to participate in designated programs at no charge to the attendant. An application is required. Children with significant impulsivity, excess energy, anxiety, difficulty transitioning, difficulty keeping focused, easily overwhelmed or frustrated, etc. often need help to be successful during recreational activities or at camp. There are programs or camps designed with this in mind, or an Inclusion Facilitator or Leisure Buddy can be provided in order that your child may attend regular programs, with no additional fees. This is often 1:1 support by a person trained by the City for a maximum of two weeks of support. Regular camp fees apply. These services are available for all City of Cambridge, City of Kitchener and City of Waterloo playgrounds, adventure programs, day camps and fun centres. Registration for both the specific camp and the inclusion facilitator are required (two separate registrations). An inclusion Facilitator form must be filled out and submitted in April if you hope to get one! To obtain an application form call: Kitchener-Waterloo (ages 4-17) – 519-741-2229 Cambridge (ages 3 – 25) – 519-740-4681 ext. 4689 or download form: www.city.cambridge.on.ca
Links or Useful Resources for RECREATION AND CAMPS: Activities Guide – City of Cambridge, City of Kitchener, City of Waterloo, published quarterly Access Waterloo Region – www.accesswaterlooregion.com
Last update: 15-Oct-11
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Financial Supports Ontario Disability Tax Credit Certificate (Form T2201)* Parents of dependent children with any Mental Health diagnosis are encouraged to apply for the Federal Disability Tax Credit Certificate. This certificate allows you to enjoy a tax savings at almost any income level (NOT just for lower income families)! Once approved, the tax credit is transferred from the child who qualifies to a parent or other supporting person. It is only useful to someone who pays taxes (in some cases a person with a disability has no taxable income). This tax credit is available whenever a child of any age is markedly restricted in the activities of daily living on an on-going basis. These restrictions can be cognitive, developmental, physical or mental, or a combination of disabilities. For children with mental health issues, the section of the form dealing with “Mental functions necessary for everyday life” is the area of interest to you. Some examples of the effects of your child’s impairments could be, but are not limited to: Constant supervision required due to hyperactivity or behaviour Parent must stay home to provide care (i.e., loss of income) Extra time/supervision needed to complete tasks like homework Supervision/re-direction needed in social situations Requires daily medication Requires frequent trips to the doctor/pediatrician Prolonged or repeated lessons (i.e. swimming) to be promoted or to progress Private lessons / tutoring In 2008, the credit returned approximately $1,600.00 each year to a taxpayer that made use of it. It could also be back-filed ten years on a rolling annual basis (your claim can be back-filed to the date of your child’s diagnosis). In the years prior to 2001, the tax credit return was $1,000.00 per year as was the previous allowance. This back-filing for the full period in 2008 would return approximately $15,000.00 to the taxpayer. To apply for this credit, the Disability Tax Credit Certificate (form T2201) must be completed by an authorized healthcare professional. In the case of learning disabilities, the authorizing professional can be a registered psychologist. Complete details about this tax credit are contained in the guide, RC4064-Medical and Disability-Related Information, which also contains the form T2201. http://www.cra-arc.gc.ca/E/pub/tg/rc4064/README.html. To check your eligibility, visit the Canada Revenue Agency website: http://www.craarc.gc.ca/bnfts/fq_cdb-eng.html#q4 or call toll free: 1-800-959-8281.
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Financial Supports (continued) Medical Expenses In addition to the standard medical expenses such as prescription drugs and a variety of assistive devices, in 1999, the Federal government recognized that individuals with learning disabilities may have a need for supplementary educational service. These expenses may also include tuition costs if a patient (for example, a dependent) suffering from a behavioural problem arising out of a mental or physical disability or suffering from a learning disability, including dyslexia, who attends a school, that specializes in the care and training of persons who have the same type of problem or disability is considered to qualify under P118.2(2) (e), and the expenses paid for the patient are qualifying medical expenses even though some part of the expense could be construed as being tuition fees. The school need not limit its enrolment to persons who require specialized care and training. These amounts can be deducted from the caregiver’s income under medical expenses on their tax return. The cost of therapy received by a person who qualifies for the disability amount, provided by someone who is not the spouse or common-law partner of the person who is claiming the expense and who is 18 years of age or older, when the amounts are paid. The therapy has to be prescribed and supervised by a medical doctor, a psychologist (for a mental impairment), or an occupational therapist (for a physical impairment) – Form T2201 required.
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Financial Supports (continued) Other Child and Family Benefits Other financial supports available to low-to-middle income families (use the Canada Revenue Agency’s calculator to determine if you qualify (http://www.cra-arc.gc.ca/benefits-calculator/) that your child may qualify for are as follows:
Canada Child Tax Benefit (CCTB) The Canada Child Tax Benefit is a tax-free monthly payment made to eligible families to help them with the cost of raising children under age 18. The CCTB may include the: A. National Child Benefit Supplement (NCBS) - The NCBS is a joint initiative of the federal, provincial, and territorial governments. This initiative is designed to: help prevent and reduce the depth of child poverty; ensure that families will always be better off as a result of parents working; and reduce overlap and duplication of government programs and services. The NCBS is included in the CCTB and paid monthly to low-income families with children under 18 years of age. It is the Government of Canada's contribution to the National Child Benefit (NCB). As part of the NCB, certain provinces and territories also provide complementary benefits and services for children in low-income families, such as child benefits, earned income supplements, and supplementary health benefits, as well as child care, children-at-risk, and early childhood services. B. Child Disability Benefit - The CDB, which is based on family net income, provides up to a maximum of $204.58 per month for each child eligible for the disability amount. This amount is calculated automatically for the current and the two previous benefit years for children who qualify and are under 18 years of age with an approved from T2201 (Disability Tax Credit certificate). Ontario Child Benefit - the Government of Ontario has created the Ontario Child Benefit (OCB) to help Ontario families with low or modest incomes to provide for their children. It will be delivered monthly with the Canada Child Tax Benefit (CCTB). For detailed information, please visit: http://www.cra-arc.gc.ca/bnfts/dsblty-eng.html.
Special Services at Home (SSAH) is for severe (usually developmental) disabilities Ontario Disability Support Program (ODSP) - (at age 17 start process for 18th year) Refundable Medical Expense Supplement Universal Child Care Benefit - The UCCB is designed to help Canadian families, as they try to balance work and family life, by supporting their child care choices through direct financial support. The UCCB is for children under the age of 6 years and is paid in installments of $100 per month per child. Children’s Special Allowances is for children kept in government approved agency care Children’s Fitness Amount - You can claim to a maximum of $500 per child, the fees paid in 2007 that relate to the cost of registering you or your spouse or common-law partner’s child in a prescribed program of physical activity. The child must have been under 16 years of age at the beginning of the year.
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Financial Supports (continued) Other Child and Family Benefits (continued) You can claim this amount provided that another person has not already claimed the same fees and that the total claimed is not more than the maximum amount that would be allowed if only one of you were claiming the amount. Children with disabilities – If the child qualifies for the disability amount and is under 18 years of age at the beginning of the year, an additional amount of $500 can be claimed provided that a minimum of $100 is paid on registration or membership fees for a prescribed program of physical activity. Note: You may have paid an amount that would qualify to be claimed as child care expenses (line 214) and the children’s fitness amount. If this is the case, you must first claim this amount as child care expenses. Any unused part can be claimed for the children’s fitness amount as long as the requirements are met. Prescribed program To qualify for this amount, a program must: be ongoing (either a minimum of eight weeks duration with a minimum of one session per week or, in the case of children's camps, five consecutive days); be supervised; be suitable for children; and require significant physical activity (generally, most of the activities must include a significant amount of physical activity that contributes to cardiorespiratory endurance plus muscular strength, muscular endurance, flexibility and/or balance). Reimbursement of an eligible expense – You can only claim the part of the amount for which you have not been or will not be reimbursed. However, you can claim all of the amount if the reimbursement is included in your income, such as a benefit shown on a T4 slip, and you did not deduct the reimbursement anywhere else on your return. For more information on any of the information listed above, please visit the Canada Revenue Agency website at www.cra.gc.ca or call 1-800-959-2221. Some tax consultants are well-versed in the specific supports or tax deductions available for your family. You may seek professional advice in this matter. We note that some parent support groups in the Region have facilitated speakers on the subject of tax savings. They may be a good resource for this information as well. (see Local Support Group listing in the Finding Support Section). For a complete list see Canada Revenue Agency list of what persons with disabilities claim as a deduction or credit, http://www.cra-arc.gc.ca/tx/ndvdls/sgmnts/dsblts/ddctns/menu-eng.html.
Links or Useful Resources for FINANCIAL SUPPORTS: Canada Revenue Agency website: www.cra.qc.ca or 1-800-959-2221 J.E. Arbuckle – www.finplans.net/documents.shtml
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Henson or Discretionary Trusts Caring for a child with a disability, and determining the support they will require over time is a big responsibility. It is one that needs to be considered seriously along with a will and powers of attorney. One of the best ways to provide for children after you die is to make legal arrangements that maximize your estate when you are no longer there to look after them. You have three options: 1. 2. 3.
You can fully support your child over his lifetime or until you die You can plan for the Ontario Disability Support Plan (ODSP) to take care of your child’s needs You can leave a trust fund for your child’s future
A Henson Trust is a type of trust designed to benefit disabled persons. It allows you to support your child without affecting ODSP payments.
A Henson Trust is a type of trust designed to benefit disabled persons. It allows you to support your child without affecting ODSP. It protects the inheritance of the special needs person, as well as that person’s right to collect government benefits and entitlements. At the same time it allows the child to have some funds for extra expenses such as services they may need and holidays.
The key provision is that the trustee has "absolute discretion" in determining whether to use the trust monies to provide assistance to the beneficiary, and how much. This means that the monies cannot be used to deny government benefits. In addition, the trust may provide income tax reductions by being taxed at a lower rate than if the total willed monies were considered. In most cases, the monies are immune from claims by creditors of the beneficiary. Your decision to create a trust should be based on the following: 1. 2.
Will you have assets/monies in your estate that you will leave to your child If the total amount is between $5,000 and $10,000, your child will lose ODSP without a trust set up
Please note that consideration should also be taken towards setting up a Power of Attorney for Personal Care and a Power of Attorney for Property. Samples of each are attached but using a professional to make lasting documents is recommended.
Links or Useful Resources for HENSON TRUSTS: Kenneth C. Pope -www.kpopelaw.ca or kpopelaw.com (includes podcasts) The Special Needs Planning Group - www.specialneedsplanning.ca Documentation on Power of Attorney, Mental Incapacity, etc. - www.attorneygeneral.jus.gov.on.ca Community Legal Education Ontario – www.cleo.on.ca or phone 416-408-4420 Henson Trust Handbook (2008) in PDF format – www.reena.org/pdfs/hensontrust.pdf J.E. Arbuckle – www.finplans.net
Last update: 18-Oct-11
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Registered Disability Savings Plan (RDSP) A registered disability savings plan (RDSP) is a savings plan that is intended to help parents and others save for the long-term financial security of a person who is eligible for the Disability Tax Credit. (see Ontario Disability Tax Credit Certificate at the beginning of this section). Contributions to an RDSP are not tax deductible and can be made until the end of the year in which the beneficiary turns 59 years of age to a lifetime maximum of $200,000. Contributions that are withdrawn are not to be included as income for the beneficiary when paid out of an RDSP. Contributions may qualify for payments from the Canada Disability Savings Grant (CDSG) program, up to a lifetime maximum of $70,000.00 per beneficiary. However, the Canada disability savings grant, Canada disability savings bond and investment income earned in the plan are included in the beneficiary's income for tax purposes when paid out of the RDSP.
Who can become a beneficiary of an RDSP? You will be able to designate an individual as beneficiary if the individual: is eligible for the disability amount; has a valid social insurance number (SIN); is a resident in Canada at the time the plan is entered into; and is under the age of 60. (This age limit is not applicable when a beneficiary's RDSP is opened as a result of a transfer from the beneficiary's prior RDSP) A beneficiary can only have one RDSP at any given time, although this RDSP may have several plan holders throughout its existence, and it can have more than one plan holder at any given time.
Who can contribute to the RDSP? Anyone can contribute to an RDSP with the written permission of the plan holder.
Who can open an RDSP? To open an RDSP, a person who qualifies to be a holder of the plan must contact a participating issuer that offers RDSPs. Generally, financial institutions are the issuers of RDSPs. If the beneficiary has reached the age of majority and is legally able to enter into a contract, then a disability savings plan can be established for such a beneficiary by the beneficiary and/or the legal parent who is, at the time the plan is established, a holder of a pre-existing RDSP of the beneficiary. If the beneficiary is a minor, another person can open an RDSP for the minor and become a holder if that person is: a legal parent of the beneficiary; a guardian, tutor, or curator of the beneficiary, or an individual who is legally authorized to act for the beneficiary; or a public department, agency, or institution that is legally authorized to act for the beneficiary. For the most current information about RDSPs, please visit the Canada Revenue Agency website: www.cra-arc.gc.ca
Last update: 21-Oct-11
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SAMPLE ONLY Copyright ©Queen’s Printer for Ontario
Continuing Power of Attorney for Property
Continuing Power of Attorney for Property (Made in accordance with the Substitute Decision Maker Act 1992) 1.
I, ___________________________revoke any previous continuing power of attorney for property made by me (print or type your full name here)
and APPOINT: ______________________________________ to be my attorney(s) for property
in accordance withyou theappoint Substitute (print or(Made type the name of the person or persons here)
2.
Decisions Act,1992)
If you have named more than one attorney and you want them to have the authority to act separately, insert the words “jointly and severally” here: _________________________________________________ (this may be left blank)
3.
If the person(s) I have appointed, or any one of them, cannot or will not be my attorney because of refusal, resignation, death, mental incapacity, or removal by the court, I SUBSTITUTE: _____________________________________________________________ to act as my attorney for property with the same authority as the person he or she is replacing.
4.
I AUTHORIZE my attorney(s) for property to do on my behalf anything in respect of property that I could do if capable of managing property, except make a will, subject to the law and to any conditions or restrictions contained in this document. I confirm that he/she may do so even if I am mentally incapable.
5.
CONDITIONS AND RESTRICTIONS: Attach, sign and date additional pages if required. (This part may be left blank)
6.
DATE OF EFFECTIVENESS: Unless otherwise specified in this document, this continuing power of attorney will come into effect on the date it is signed and witnessed. COMPENSATION: Unless otherwise stated in this document, I authorize my attorney(s) to take annual compensation from my property in accordance with the fee scale prescribed by regulation for the compensation of attorneys for property made pursuant to Section 90 of the Substitute Decisions Act, 1992.
7.
8.
SIGNATURE: _________________________________________ DATE: _____________________________________ (SIGN YOUR NAME IN THE PRESENCE OF TWO WITNESSES)
ADDRESS: ______________________________________________________________________________________ (Insert your full current address here.)
9.
WITNESS SIGNATURE: (Note: The following people cannot be witnesses: the attorney or his or her spouse or partner; the spouse, partner or child of the person making the document, or someone that the person treats as his or her child; a person whose property is under guardianship or who has a guardian of the person; a person under the age of 18)
Witness #1: Signature _________________________________ Print Name _________________________________ Address: _______________________________________________________________________________________ _________________________________________________________ Date: ________________________________ Witness #2: Signature _________________________________ Print Name _________________________________ Address: _______________________________________________________________________________________ _________________________________________________________ Date: ________________________________
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SAMPLE ONLY Copyright ©Queen’s Printer for Ontario
Continuing Power of Attorney for Property
Continuing Power of Attorney for Personal Care (Made in accordance with the Substitute Decision Maker Act 1992) 1.
I, ___________________________revoke any previous continuing power of attorney for personal (print or type your full name here)
care made by me and APPOINT: ________________________________ to be my attorney(s) for
(Made with the Substitute (print or type the namein of accordance the person or persons you appoint here)
Decisions Act,1992)
Personal care in accordance with the Substitute Decision Act 1992. [Note: A person who provides health care, residential, social, training or support services to the person giving this power of attorney for compensation may not act as his or her attorney unless that person is also his or her spouse, partner, or relative]. 2.
If you have named more than one attorney and you want them to have the authority to act separately, insert the words “jointly and severally” here: ______________________________________________________________ (this may be left blank)
3.
If the person(s) I have appointed, or any one of them, cannot or will not be my attorney because of refusal, resignation, death, mental incapacity, or removal by the court, I SUBSTITUTE: __________________________________________________________________________________________ (this may be left blank)
to act as my attorney for personal care in the same manner and subject to the same authority as the person he or she is replacing. 4.
5.
I give my attorney(s) the AUTHORITY to make any personal care decision for me that I am mentally incapable of making for myself, including the giving or refusing of consent to any matter to which the Health Care Consent Act, 1996 applies, subject to the Substitute Decisions Act, 1992, and any instructions, conditions or restrictions contained in this form. INSTRUCTIONS, CONDITIONS AND RESTRICTIONS Attach, sign and date additional pages if required. (This part may be left blank)
6.
SIGNATURE: ____________________________________ DATE: ______________________________________ (SIGN YOUR NAME IN THE PRESENCE OF TWO WITNESSES)
ADDRESS: ____________________________________________________________ (Insert your full current address here.)
7.
WITNESS SIGNATURES: (Note: The following people can not be witnesses: the attorney or his or her spouse or patner; the spouse, partner or child of the person making the document, or someone that the person treats as his or her child; a person whose property is under guardianship or who has a guardian of the person; a person under the age of 18)
Witness #1: Signature ___________________________ Print Name __________________________________ Address: __________________________________________________________________________________ ____________________________________________________ Date: ________________________________ Witness #2: Signature ___________________________ Print Name __________________________________ Address: __________________________________________________________________________________ ____________________________________________________ Date: ________________________________
Useful resources/links for Power of Attorney: For your free 24 page kit from the Ontario Government – www.attorneygeneral.jus.gov.on.ca/english/family/pgt/poa.pdf
Last update: 15-Oct-11
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Transitioning To Adult Services Transitions are about change. Sometime between the ages of 14 to 18 it may become more difficult for you, the caregiver, to be involved in your loved one’s life. Different services have different cut-off ages to allow this to happen. You need to start to consider knowledge transfer and service transfer for your child. You also should consider the need for a Substitute Decision Maker or Power of Attorney form if the need warrants. (See sample forms inserted ahead of this page). While this process is not the same for all young people the aim of successful transition is to optimize their abilities and what is available in the community to support them. A holistic approach needs to be used – your child has the same needs as anyone else – but the actual process needs to be tailored to your child’s mental status and should include your child as much as possible. Case management is one of the possibilities. This would be someone who would take responsibility for the transition, the co-ordination of community services, housing, social activities, further education, etc. while still being sensitive to the needs of the caregiver in beginning to let go. There are a few on-line resources regarding transition planning although they are not specifically aimed at Mental Health needs they can be adapted.Another helpful document is the BC Ministry of Children and Family Development: Your Future Now. A Transition Planning & Resource Guide for Youth with Special Needs and Their Families listed below.
Links or Useful Resources for TRANSITIONING TO ADULT SERVICES: Parent’s Guide to Transitions – Developmental Disability focused but valid. http://www.gnb.ca/0048/pcsdp/PDF/PublicationsWebpage/CONNECTIONS%20Guide%20to%20Transition %20Planning.pdf Community Connections Booklet – www.accesswaterlooregion.ca A Transition Planning & Resource Guide for Youth with Special Needs and Their Families” – www.mcf.gov.bc.ca/spec_needs/pdf/your_future_now.pdf “Connections” - www.cdrcp.com/transition.html Parents for Children’s Mental Health – www.pcmh.ca
Last update: 22-Oct-11
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Last update: 22-Oct-11
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Waterloo Region Homes for Mental Health, Inc. Waterloo Region Homes for Mental Health is a private, non-profit organization which provides a range of housing and support services for individuals experiencing or recovering from serious mental health issues. It was established in 1980 with one home consisting of eight beds. It has mushroomed into an organization that provides services to more than 1,000 people annually through a range of housing options; longer term (housing, support, case management, and the Assertive Community Treatment Team (ACTT)) and shorter term support services (case management and outreach). To be eligible you must be at least 16 years of age and have a diagnosis of a mental health issue. Priority is gi en to homeless or at risk of homelessness. More information will be made available on their website soon.
Links or Useful Resources for Waterloo Region Homes for Mental Health: Waterloo Region Homes for Mental Health, Inc. – www.waterlooregionalhomes.com or 519-742-3191
Last update: 15-Oct-11
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Last update: 14-Sep-11
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Why Advocate for Mental Health of Ontario’s Children? Numbers of Children in Need: 1 in 5 (18.1%) children and youth in Ontario had at least one diagnosable mental health issue, and two thirds of these children have two or more
Only 1 in 6 children who are in need of specialized therapeutic services actually receive them. Treatment has proven to be 70% effective. Effectiveness of treatment decreases the longer treatment is withheld.
Do you know that…
mental health issues. That equals
Canada’s youth suicide rate is the third highest in the industrialized world.' 654,000 children in Ontario who Surpassed only by injuries, mental would require mental health disorders in youth are ranked as the second highest hospital care expenditure treatment. in Canada.' Source: Ontario Child Health Study, 1989 In Ontario, suicide is the leading cause of non-accidental death among youth, claiming their lives more than any physical illness. In Canada, 24% of youth deaths each year are attributable to suicide – translated, ¼ of our youth deaths each year are preventable.' For every $1 spent on early intervention and treatment of mental illness in children and youth, an estimated $7 will be saved to the provincial economy ³ At any given time, 7,000 children are waiting an average of 6 months to get service.' If only half the children receiving treatment complete high school, $232 million would be returned to government in reduced social assistance and producing more taxpaying adults– nearly offsetting the annual expenditures for children’s mental health services in Ontario.' The likelihood that people with mental illness will commit violent acts: No greater than the general population.² The likelihood that people with mental illness will be the victims of crime: 2.5 times greater than that of the general population.² A foster family receives 10 times more financial support and access to resources for children with mental illness than if they are supported in their own families. Some families are forced to place their children with the Children’s Aid Society in order to get treatment.³
Links or Useful Resources for more FACTS AND STATISTICS: Canadian Mental Health Association -Ontario – www.ontario.cmha.ca ' Quick Facts: Mental Illness & Addiction in Canada – www.mooddisorderscanada.ca/page/quick-facts ² Parents For Children’s Mental Health – www.pcmh.ca ³
Last update: 21-Oct-11
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Did you know that there is NO legislation specifically directed at children’s mental health in Ontario? Parents for Children’s Mental Health in Waterloo Region invite all support groups and parents who are interested in affiliating with the regional PCMH group to join them. We would like to collaborate for the purpose of children’s mental health advocacy. We are working together to educate the people of our region to help drive the movement to legislate standards for the provision of mental health ser vices to our children. We also are looking for parents with new input and ideas to join us. Please contact the PCMH representative at kidsLINK, 519-746-5437 or by email parent.advocacy@hotmail.com. Our committee meets several times a year to discuss opportunities to educate, inform, advocate and advise parents, the general public and politicians regarding the state of children’s mental health in the province.
Please visit the
www.pcmh.ca website for upcoming events!
Watch for the annual Parent Conference . PCMH organizes courses with content that specifically teaches parents and mental health agencies about running parent support groups, advocacy, self-care, etc. It is a weekend filled with networking, learning, and above all, a common experience for parents who may feel that they are alone in their quest to improve services for their children! The conference fees are quite reasonable. You may try approaching your local children’s mental health service provider to assist you financially to attend. Look under What’s Happening on our website www.pcmhwaterloo.com. We will post the information as soon as it becomes available.
Last update: 16-Oct-11
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Advocacy Resources PCMH – Waterloo Region has compiled this listing with a brief description of various resources available for each to help you determine at a glance whether the information you seek is there. Name
Phone
Website or E-mail
Child Advocacy Project
416-977-4448
info@childadvocacy.ca
www.childadvocacy.ca
A service by Pro Bono Law Ontario that provides free legal services for low to moderate-income families who cannot afford a lawyer. Site includes advocacy tip sheets for school. Discover whether you are in need of legal advice regarding your child’s education. People For Education
www.peopleforeducation.com
416-534-0100
info@peopleforeducation.com
Tip sheets in many languages about topics such as: parent-teacher interviews, starting school, solving problems at school, special education, EQAO testing, high school course selection, school councils, etc. advocacy@provincialadvocate.on.ca 1-800-263-2841 French or English or 416-325-5669 www.provincialadvocate.on.ca For children who live outside their family’s care who feel they are being abused or treated harshly and their rights violated. Office of the Provincial Advocate for Children and Youth
Parents For Children’s Mental Health 416-921-2109 admin@pcmh.ca Head Office Via CMHO www.pcmh.ca Site offers tip sheets for parents, teachers. Youtube videos, resources Parents For Children’s Mental Health – parent.advocacy@hotmail.com Waterloo Region www.PCMHwaterloo.com Site offers Waterloo Region Parent and Youth Resource Guide Parent’s Advocacy in the School 416-429-8511 www.parentsadvocacy.com A comprehensive variety of services relating to educational advocacy for children with exceptionalities Book: -“Exceptional Children – Ordinary Schools” Getting the Education You Want for Your Special Needs Child by Dr. Norm Forman ISBN 1-55041-759-2 Child Advocacy www.childadvocacy.ca/library/folder.81 404-Education_Law_Resources A variety of fact sheets – education law resources library
Last update: 16-Oct-11
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Last update: 16-Oct-11
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QUILT OF HONOUR CAMPAIGN Do you live or work with children? Can you recognize the signs of mental illness in children? Discover ways to help your child, your student, your friend, your client with a Quilt of Honour presentation.
A speaker, mother, widow, and award-winning volunteer, Susan Hess speaks from the heart of real life experience. She moves audiences to both laughter and tears with stories about bringing up a child with mental illness. While others ask what can be done about “out-of-control” kids, sad kids or angry kids, Susan is providing answers and changing lives. Choose from among Susan’s distinctive, informative, motivational and inspirational presentations. If you live or work with children in any way, you will gain fresh insight and understanding from Susan’s presentation.
Presentations Please don’t forget my daughter: Stories behind the Quilt of Honour
A strong advocate on behalf of children with mental health problems, Susan uses the Quilt of Honour as a visible testament to all children who struggle with mental illness. Susan shares the compelling stories of the children on the Quilt of Honour, including her own daughter’s journey from chaotic violent illness to award-winning volunteer. The stories of the children who are featured on the Quilt of Honour emphasize the importance of mental health services, treatments and supports for the child as well as the family.
Stigma: We Can, We Will, We Must
A gripping presentation about how stigma affects people’s reactions to traumatic illness or tragedy in the lives of others. Drawing from her family’s experience with suicide, cancer, and mental illness, Susan tells what stigma looks like, its impact on people’s lives, and how to overcome stigma in yourself and others.
A note for high schools:
Susan has developed a special stigma presentation suitable for teenage audiences. Working with selected student leaders, she presents an interactive demonstration of the impact of bullying, name-calling and labeling. Susan’s no-holds-barred approach holds the students’ interest and helps them understand clearly the reality of stigma and how to triumph over it. Students have said, “Thank you for telling our story.
Quilt of Honour Campaign (cont’d) Zero Tolerance
School is both the social and work environment for children. Using examples from her daughter’s experiences at school, and her own knowledge as a teacher, Susan distinguishes between discipline and punishment in the schools, and how those terms might have different applications for children with mental health problems. The presentation includes practical suggestions for educators on recognizing and nurturing children with mental health problems.
Resiliency
Coping with mental illness tears families apart, destroys lives, and plunges survivors into darkness. Children and families can become victims, adapt and survive. By following a small light of hope and finding the fragments of joy, Susan Hess tells the story of how she held herself and her family together and brought them successfully into a new life. In this presentation, Susan inspires her audience to believe that finding the light in the darkness is not only possible, but the only choice.
From Here to There: Parent Mobilization
Susan outlines the steps taken to develop the Quilt of Honour Campaign and expand it into a model of parent mobilization that works. From an idea to presentations to workshops, Susan talks about the vision, the risks and the results of giving parents a voice.
Workshop: Caring for the Caregiver
This workshop is especially designed for anyone caring for someone who is seriously physically or mentally ill. Find out how to be selfish in a positive way, recognize warning signs of overload, and techniques of caring for yourself so you can care for others.
Workshop: Coping with Suicide
This workshop follows Susan Hess’ personal journey as she describes the impact of suicide on her family and her community. The workshop includes a discussion of the reality of stigma associated with suicide, and the family’s eventual triumph over it.
What do people say about the Quilt of Honour presentation?
“Thank you for telling your story and removing the stigma and isolation that exist for those of us affected by children’s mental illness.” “Your gentle and compassionate spirit invites warmth and love in all you do.” “You have moved my soul.” “Your seminar reminds us of why we come to work each day. We understand that we do make a difference.” “No book can teach in the way a person sharing their personal journey can.” Past Volunteer President of Parents for Children’s Mental Health, Susan is available to speak to your organization, church, school, community or business about the impact of children’s mental health problems on the children and their families. Susan draws universal truths from her experiences that resonate with many types of audiences including social workers, medical professionals, high school students, teachers, parents, business leaders, legal professionals and politicians. For more information or to book Susan Hess, please call or email: Susan Hess 519-254-1514 susan.hess@sympatico.ca
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Parent To Parent: Mental Health And Our Kids by: Susan Hess, January 2006, revised October 2006 Our children and youth describe mental health as: "Mental Health means I feel comfortable in my own skin. I handle stressful situations without freaking out or losing control. I am comfortable talking with others. I like my life. I am not afraid to ask for help. I can bounce back from unexpected occurrences or upsetting situations. I have dreams and hopes for the future. I know I can be successful by doing the best I know how. I enjoy being with my friends. I can come up with positive solutions to solving a problem." WHEN to be CONCERNED: If your child or youth is: really sad all the time cries a lot often irritable with many temper outbursts overreacts in their responses feels hopeless anxious or worried about everything feels worthless consistently afraid and frightened most of the time, with no explained reasons "hates life" wishes they were dead no friends....disconnected feel they have no control over their life angry and aggressive much of the time WATCH FOR: trouble at school with other kids school marks going down sleeping and eating patterns changing for no apparent reason feeling exhausted, not much energy wanting to be alone all the time daydreaming a lot and cannot get things done wanting to kill themselves hurting themselves or others hearing voices talking to them or about them unable to concentrate difficulty in making decisions most of the time such words as "You'd be better off without me" or " I may as well be dead" in their conversation HOW TO HELP? Pay attention to your child or youth's distress. Their pain must not be minimized. The important thing is your child or youth's behaviour tells you there is a problem, and / or if your instinct tells you something is wrong, reach out for help!
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Parent To Parent: Mental Health And Our Kids (continued) by: Susan Hess, January 2006, revised October 2006
WHO CAN HELP? Talk with those you trust: Family members Teachers, Guidance Counsellors, Child Youth Workers, Vice Principal, Prinicipal Friends Community Mental Health Agencies in your area Family Doctor Minister, Priest, Rabbi Check for Support Groups for parents who have a child or youth who has a mental illness / mental health problems WHY REACH OUT? Treatment really does work. Early intervention is essential. IT CAN SAVE YOUR CHILD OR YOUTH'S LIFE! Talking with someone can help connect you to those professionals who can best help your child or youth. Talking with someone you trust will create a support network for you and you will know that you are not alone. Often our kids do not have the words or know how to ask for help. As parents, we need to be observant and try to understand what is going on in their life, so we can be their words and their voice.
About Susan Hess: Susan Hess is a speaker, mother, widow, and award-winning volunteer, Susan Hess has the ability to move audiences to both laughter and tears with stories of children and their families who have faced the challenge of mental health problems in children. Past Volunteer President of Parents for Children’s Mental Health, Susan is available to speak to groups of all types about the impact of children’s mental health problems on the children and their families. For more information go to: www.pcmh.ca (permission to reproduce granted S.Hess – Nov. 2008)
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Organize Yourself Enough cannot be said about the benefits of keeping your child’s records in an organized fashion. Being organized presents you on a more professional level at meetings and saves a lot of time, energy and frustration if everything you need is on hand. Like it or not, you are really a “case manager” advocating on behalf of your child. We do however acknowledge that in our busy lives that organization is easier said than done. There are several organizational tools on the market that can be purchased, as well as a number of templates that can be downloaded from web-sites and put in your own binder. Microsoft Works also has several templates that can be adapted to keep a running record of your child’s medical needs. In addition, there are on-line registries where you can keep your child’s medical history. (see also “Your Child’s Medical History” under Tab 3: Crisis Services in this binder) (see also “Sample Assessments Chart” on the following page) Examples of resources that can be purchased include sample forms to track assessments, hospitalizations, medications, reactions to medications, power of attorneys, etc. 1. CANCHILD K-I-T (Keeping It Together) – www.canchild.ca This kit can be ordered from the McMaster University Bookstore or online or by calling Customer Service at 1-800-238-1623. Cost is $29.95 for a single copy. If you are an approved member some of the forms used can be downloaded as well. They are in the process of planning a Youth Kit as well. 2. Ontario Association for Families of Children with Communication Disorders (OAFCCD) Parents as Partners – www.parents-as-partners.ca Funding for this program came from an Ontario Trillium Foundation grant. They developed a resource binder to be used to collect and file records about your child’s education. The binder is available through workshops and directions are given on the website for creating your own. An “ALL ABOUT ME” template is also available on this site. This booklet was designed for parents of young children with special needs and defines your child and his family for the teacher and the school. It can also transfer into other settings and can be used as an add-on to an IEP. 3. The Advocate’s Journal – www.caddac.ca/cms/page.php?41 This is a profiling diary that guides you step-by-step through the educational process. It covers a student’s life from birth to graduation and beyond. It is available for $20.00 from The Advocate’s Journal, 5 Martin Road, Toronto, Ontario M4S 2V1. 4.
The Care Notebook and The Care Organizer - www.cshcn.org These tools are distributed by Seattle’s Children’s Hospital. The forms can be downloaded but keep in mind they are based on United States information. (Note: most forms on this site can be ordered in Spanish, English, Vietnamese, Russian, Chinese and Somalian.)
Links or Useful Resources for ORGANIZING YOURSELF: Waterloo Region Family Network – www.wrfn.com. Numerous courses offered throughout the year. See “Sample Assessments Chart” on page 110 See “Creating Your Child’s Profile” on reverse of this page.
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Creating Your Child’s Profile In the “Organize Yourself“ material it was touched on (in item #2), a resource called “All About Me” (a PDF booklet available on the OAFCCD web-site). Particularly for young children who do not yet have the words to self-advocate, this is an excellent way to help teachers, or others (i.e. doctor, dentist, camp staff, recreation centre staff, church, etc.) understand the unique needs of your child. We highly recommend that you provide this type of information for your child when they are entering into school, or are entering a new situation where people might not know your child. There is something very powerful about having a document that begins with a picture of your child and sets out some valuable information that a person might not be aware of, particularly in the first days of school, or starting a new year with a new teacher. The more details you can include that will help your child be successful, the better! Here is a sample letter written by parents of a special needs child to his classmates’ parents. Keep in mind your comfort level (and your child’s) when deciding how much information you wish to share, or how much contact you would like with other parents! September 2012 Dear Families, As this new school year begins, we would like to take this opportunity to share with you some of our son Dylan’s special qualities and needs. Dylan is a grade 4 student in your child’s class. He is a bright, creative, and fun-loving boy who has been diagnosed with Tourette Syndrome (TS), Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Some of Dylan’s’ vocalizations (tics) are snorts or sniffing, meowing, and sometimes inappropriate words or phrases. He may pull/twirl his own hair or tap walls and desks. These will change over time too. We have found when people know a little bit about Dylan and can ignore these symptoms they actually decrease in frequency or do not occur. Additional information to explain these neurological disorders are on the back*. Dylan’s symptoms often vary, but for the most part, he appears to be a regular kid, and a good friend. Should you have any questions, please don’t hesitate to contact us. (*not included here) We are informing you of Dylan’s needs so you can be familiar, and we are looking for your much appreciated support. You can be an important role model for your child. Should at any time over the year, you or your child have a concern, please communicate it to (teacher’s name) at (School name) - phone (519) xxx-xxxx. We appreciate having your information to help Dylan; otherwise he will miss out on an important learning opportunity. Having a neurological condition can be an explanation, but not an excuse, and we expect Dylan to take responsibility for his behaviour. Your child will have the benefit of experiencing a person who is a bit different, they will learn about the value of diversity and tolerance. They will also learn that it’s ok and important to speak up if they have a concern. These are great life lessons to learn at an early age. As parents we want Dylan to grow up learning and demonstrating the importance of respect and responsibility. It is our hope that he will be happy and that society will become better informed and accepting of people like Dylan. Dylan had a successful year last year at (School name) with the understanding and help of the dedicated teachers, staff, children and parents. We are looking forward to another successful year. Sincerely, (Your name), Optional: (Phone), Email).
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Rotary Children’s Centre
Feb. 10, 2003
Updated: 16-Oct-11
Rotary Children’s Centre
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SLP O/T
regular basis needed to address oral-motor abilities and to develop strategies to facilitate play and fine motor
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walks with mild knee varus (bow leg) right more so than left mild intoeing will continue to check him in relation to mild right sided tightness and knee varus. Orthopaedic Clinic to assess joints
some delays in understanding and use of language for both chronological and corrected ages very active brief attention span doesn’t respond to signing attempts recommendation to see on a regular basis
Milestones summary
Discharge report - age appropriate motor skills - heel-toe gait pattern - safety issues - some dystonia which causes him to trip Application for Preschool Program - delayed development - delayed expressive - communication
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Occupational Therapist P/T
Jan. 27, 2003
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Results
Physical Therapist
Speech Therapist
Rotary Children’s Centre
Jun. 2001 to Aug. 2004 Jun. 25, 2002
Parent
Who
Where
Date
Sample “Assessments Chart” (Page 1 of 2)
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Children and Youth Mental Health Resource Guide
www.PCMHwaterloo.com
Updated: 16-Oct-11
Resource Teacher
chronological age of 35 months - personal-social – 21 months - adaptive – 22 months - motor – 28 months - communication – 24 months - cognitive – 27 months - BDI total – 24 months Battelle – 36 months - personal-social – 21 months - adaptive – 22 months - gross motor – 29 months - fine motor – 26 months - receptive – 27 months - expressive – 26 monthss - cognitive – 35 months - ADHD – Combined Type - Language disability - Generalized Anxiety disorder - Limited coping mechanisms - Limited understanding of social pragmatics - Clinical pattern of oppositional behaviour - Weak fine motor skills
Results
Psychologist
K-WHS Preschool Outreach
Nov. 22, 2003
ECE class
Who
Sep. 9, 2006
KidsAbility Compuscore BDI
Where
Nov. 21, 2003
Date
Sample “Assessments Chart” (Page 2 of 2)
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Creating A Safety Plan “A Safety Plan” is defined as an organized set of guidelines used to supervise and structure space and time, due to the behaviour of your child in that space. It is used to work with and for the safety of the child that is acting out as well as for the other people in the space, including pets and property. A safety plan may be needed in a variety of settings including school and home. If you are concerned about any safety issues with your child you should consider creating a safety plan with the appropriate professionals as well as with the child’s involvement if possible. It is a good idea to have the child agree with the plan. There is no right or wrong way to create a plan and each child’s needs are unique.
How Do You Know If You Need A Safety Plan? 1. Sexual Acting Out The child is openly masturbating in public areas or in family areas of the home. The child is acting out with the family pet The child is acting out with dolls, stuffed animals or other toys The child is acting out with other children in the school, neighborhood or family. This may include sexualized talk or touch that is inappropriate. 2. Anger Problems The child is verbally abusive to staff, students or family members The child is physically abusive to staff, students or family members or pets. The child destroys property when angry which can result in harming others. 3. Escape Artist The child gets up in the middle of the night to eat or explore or sleep walks. The child leaves school, activities or the house when someone isn’t looking or when angry, anxious, etc. 4. Fire Starter The child has a history of, or is known to have a fascination with fire.
How to Create a Safety Plan 1. 2. 3. 4. 5. 6. 7.
Define the issue or problem. Be clear and precise. Be clear about who needs to be protected – the child, other children, teaching staff, property. Try to pinpoint when the behaviour occurs if it is predictable. Is it when the child is left unsupervised, when they are anxious, before tests or when told no. Determine who needs to be involved with the plan and who it should be shared with. Set a time limit for the safety plan re: how long you will use it, how often it will be re-assessed and what change in behaviour you are looking for, if any. What happens if the safety plan fails – do you have a list of crisis numbers to call and are you prepared to call the proper authorities if needed – i.e. – police, case workers, etc. Re-evaluate the plan and decide if it was a success, what worked, what didn’t, what can be changed and what did we leave out. With educational safety plans they may need to be modified frequently.
We recommend that you attach the personal health information to the safety plan so that all data is quickly available.
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Sample Safety Plans Sample 1 What are the issues? What the child/family can do to be safe? Participants in the creation of this plan?
Safety Strategies
Easiest Strategy (ie: self calming) this could be as simple as having a favorite stuffed animal, listening to a CD, etc. 1) 2) 3) More Difficult Strategy 1) 2) 3) Special Instructions for Support Persons – this could include allergies, sensitivities, physical and mental health issues
Date:
When to put the strategy in place
Person(s) responsible
Sample 2 Attachment to the IEP for (name). Date: Developed by: (names of parent, teacher, principal, CYW, SERT, consultant, psychologist, etc.) Shared with: (involved staff, parents)
Behaviour
Triggers
Physical Aggression or Verbal Aggression - hitting - spitting - throwing objects - swearing - negative self-talk
- Transitions - Being overwhelmed, frustrated - Anxious - Close proximity of others (i.e. line-ups) - Changes in routines - State of health & wellbeing (is he/she ill?) - Heightened sensory stimulation
Inappropriate touching of others
- Sensory overstimulation - Unaware that act is inappropriate
Last update: 16-Oct-11
Prevention Strategies
- Daily routines - Chunking of work - Take a break tickets - Recognize his/her frustration - Allow time for deescalation - Give choices - Limit dialogue - Take time/space/break - Appropriate social skills need to be taught directly. - direct teaching of appropriate skills
Interventions
- Safe Place to allow for de-escalation. - EA or CYW support - Remove other children from the room if child cannot be made to leave room - Call Emergency Response Team - If being physically aggressive, parents to be called in. - Safe place to talk or de-escalate
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Sample Safety Plans (continued) Sample 3 Attachment to the I.E.P. for student name Date: current date Reviewed and revised by: insert everyone who attends meeting here Shared With: Above parties, include any names as appropriate, Emergency Response Team BEHAVIOUR
General: Non-compliance where safety is at risk Physical Aggression Verbal Aggression Specific: Growling Name calling/ swearing Pushing furniture Within personal space of others (female) Gives unwelcome signs of affection (female) - Verbal - “I Love You”, “Mama”, or Physical - hugging/touching Kicking Leaving/running out of school boundaries
TRIGGERS
Writing tasks Social Stress Less structured social interactions Transitions Adult demands and pressures Need for justice/ fairness issues Using a “stern” tone of voice Close proximity to others that is not initiated by student name Telling student name “NO” vs. “Let’s think about this” or “STOP” Loud noises Punitive discipline
PREVENTATIVE STRATEGIES
Establish cueing system to indicate the need for breaks Teach how to recognize the early warning signs to anger and frustrations - Student name may motion for staff to monitor him from outside the room (space) Closely monitor social interactions to facilitate appropriate social connections Teach social skills Support and structure leadership opportunities Use cooperative vs. competitive activities Coach student name to “take space” during time of stress Use MP3 player to block out loud noises
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Sample Safety Plans (Example 3 continued) Offer gum to help with stress relief Prepare student name for upcoming transitions Speak calmly using a gentle tone of voice Avoid touching and reduce talking to a minimum once overloaded Provide ample “wait time” for student name to process requests Approach problem situations in a collaborative way and encourage student name to generate solutions (i.e. Dr. Ross Green – Collaborative Problem-Solving Approach) When calm explain reasons for adult expectations Use a scribe, AlphaSmart or tape recorder to reduce writing frustration Encourage use of a manipulative (i.e. Stress ball) to assist in focusing Facilitate goal setting as a way to reinforce successes and identify skill focus areas Ensure student name is aware of school boundaries (leaving/running) Establish two safe places with Student name that he is able to go to, to de-stress - within the school - designated room/spot - outside - primary area benches
INTERVENTIONS
Identify an appropriate in-class and out-of-class break location to provide student name with a safe, low stress location Verbalize “student name, are you refusing?” during times of inflexibility/opposition Allow “wait time” for student name to process information and requests Provide Student name with a “wide berth” when he becomes stressed and do not try to de-escalate the situation through close proximity/touching
IN THE CASE OF ESCALATING BEHAVIOR, the following process will be followed: If CYW is not present, do an -ALL CALL – NORTEL 620, “Teacher name to location of incident” Redirect behaviour by cueing a break. Use Break Card to cue an out-of-class break Directed inappropriate language dealt with by immediate withdrawal (2 mins.) Involuntary noises/ language dealt with by using a visual template, which is attached to his/her desk (three reminders then BREAK) If student name does not respond to prevention strategies and outlined interventions or becomes physical with staff, remove class to an alternate safe area (P20) to allow Student name to de-escalate Provide a “quiet down” reflection time for student name to compose himself after an escalation and provide positive support Once calm, debrief the situation using visual template (CPRI Beaker) *see attachment* Staff will continue to pursue student name as long as he is within school boundaries; once out of sight, police and parents are to be immediately notified STAFF AVAILABLE TO SUPPORT SAFETY PLAN:
Enter names of teachers etc. available to help; Emergency Response Team RESOURCES: List parents, reports, and other people who have helped, OSR Reports
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Navigating The School System There are a number of different resources you should be aware of that can help you successfully advocate for your child’s special needs. Keep advocating until you are satisfied that your child is receiving the help that he or she needs!
Even though you may have an IPRC and an IEP for your child, every school year can be like beginning all over again. This is also true if the school principal changes. You are faced with coaching the new staff involved with your child with all the nuances and quirks that are unique to them. Kids tend to change over time, so that is why it’s helpful to begin the year with an updated profile of your child (see “Creating your Child’s Profile” in this section). Be sure to include as many of your child’s strengths as possible to help school staff build on them.
Often, the best way for you and your school to understand the nature of the difficulties for your child is to perform a psychological assessment or psycho-educational assessment (see “Psychological Assessments”, in the Getting Started section). This should be performed ideally every four years while in elementary school. This assessment will help advise the development of the IEP and help you learn more effective ways of dealing with your child’s difficulties. Schools have a limited budget to contract this service for pupils. If you cannot get one provided through the school, you could check with your employer’s benefit package to see if this can be covered by insurance.
Occupational Therapy can be accessed in school. For example, if your child has great difficulty with tasks associated with writing, the therapist can advise the school about strategies that will work with your child in the school and can also be the direct link you need to access technological accommodations, like word prediction software, or voice recognition software to assist with this task. Other areas they can help with are: teaching strategies, sensory recommendations, other assistive technology, etc. Likewise, Speech and Language Pathology can be co-ordinated through the school and services can be provided during the school day. There is often a wait list for these services. To access assistive technologies or devices that your child requires to learn, you should be aware of SEA (Special Equipment Amount) and what equipment is covered under this funding. For more information visit the Ontario Ministry of Education website: http://www.edu.gov.on.ca/eng/funding/1011/2010-11_SEA_Guidelines.pdf You should also know of the SIP (Special Incidence Portion) funding for high needs. School boards may apply for Special Incidence Portion (SIP) funding for additional staff support. This is to ensure the health and safety both of other people in the school and the student who has extraordinarily high needs related to their disabilities and/or exceptionalities. Conflicts sometimes arise while dealing with your school. The Ontario Ministry of Education has documents to help you work within their framework and problem-solve. Parents, schools and school board administrations do not always interpret the directives in the same way. It helps to know what you are advocating for when you engage in problem-solving with your school. It also bears mentioning that you need to be realistic and focus on one need at a time, rather than multiple requests or demands.
Last update: 16-Oct-11
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Navigating The School System (cont’d) A “Special Education Tip Sheet” is provided from People For Education in this section. Another tip sheet prepared by the Waterloo Region District School Board entitled “Communicating With Your School” is also provided in this section. Last, but not least, the Ministry’s document entitled “Shared Solutions – A Guide to Preventing and Resolving Conflicts Regarding Programs & Services for Students with Special Education Needs” is also a great tool. There are a number of useful documents that can be of help to support you in your child’s journey through school on the Ministry of Education’s website. (Please see “The Ontario Ministry of Education- Special Education Resources”). We have provided a chart of related Ontario Ministry of Education resources by the areas of concern you may be experiencing. This is by no means an exhaustive list. The most current source for Ministry of Education information is at http://www.edu.gov.on.ca/
If you have concerns about: Accommodations / Technology / Assistive Devices Bullying (victim or aggressor) Conflicts with school or Board Identification, Placement & Review Committee (IPRC) Individual Education Plan (IEP)
IPRC appeals
Progressive discipline Safety Special Education
Last update: 16-Oct-11
Supporting Ontario Ministry of Education Documentation (under Special Education): www.edu.gov.on.ca
• SEA (Special Equipment Amount) • SIP (Special Incidence Portion) 2010-11 • Bullying: A Guide for Parents of Elementary and Secondary School Students (updated Spring 2011) • Shared Solutions – A Guide to Preventing and Resolving Conflicts Regarding Programs & Services for Students with Special Education Needs • An Introduction to Special Education in Ontario • The Identification, Placement & Review Committee • Resolving Identification or Placement Issues – Procedures for Parent(s)/Guardian(s) • Individual Education Plan (IEP) Samples 2004 • Individual Education Plans - Standards for Development, Program Planning, and Implementation 2000 • The Education Act on Special Education • Regulation 181/98 • The Ontario Special Education Tribunal (for when a parent disagrees on the placement (IPRC) of their child)
• Caring & Safe Schools: Supporting Students with Special Education Needs Through Progressive Discipline, Kindergarten to Grade 12 • SIP (Special Incidence Funding) • Topic headings are: Overview, Policy Direction, Funding, Special Education Advisory Committee, Resource Documents, Special Education Reports/Recommendations, Roles & Responsibilities, Additional Information, Related Information, Advice To Parents, Questions & Answers
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Navigating The School System (cont’d)
If you have concerns about: Suspensions / voluntary withdrawal from school
Teaching strategies Transition Planning (+14 yrs.)
Supporting Ontario Ministry of Education Documentation (under Special Education): www.edu.gov.on.ca (continued) • Caring & Safe Schools: Supporting Students with Special Education Needs Through Progressive Discipline, Kindergarten to Grade 12 • Making Ontario Schools Safer: What Parents Need to Know, click on Parents tab then Safe Schools section • Education for All: The Report of the Expert Panel on Literacy and Numeracy Instruction for Students with Special Education Needs, Kindergarten to Grade 6, 2005 • Transition Planning: A Resource Guide, 2002
If you are still without resolution to your problem after dealing with the administration at your school, you can also try talking to the school superintendent, or directly to the Board office and speak to the Executive Superintendent of Education. (Refer to the “Communicating With Your School” insert in this section.) It is important to maintain a paper trail while communicating with all levels of the school, Board Office and aothers.. At any time, you may also contact your elected school board trustee. Trustees can provide information and direction to parents, but they cannot act as a representative of the parent. Check your local school board website for a listing of trustees. Trustees and representatives of many local parent associations meet monthly during the school year at the school board’s Special Education Advisory Committee meetings. (Please refer to “Special Education Advisory Committee (SEAC)” in this section). Each Board in Waterloo Region has a listing available on their websites. The Ontario Ministry of Education site also provides a list of advocacy and support associations under the heading “Advice to Parents”. If you suspect any of the diagnoses as described in the “WHAT IS” section of this guide, your local parent support group may be able to help you. They may have someone in their membership who has had a similar experience. You may also find someone willing to go along with you to a school meeting to help you with advocacy, or to just to provide moral support or take notes. (Please refer to the links at the bottom of each definition in the “WHAT IS” section for specific support group information, or check the “Website Resource Listing” in the RESOURCE section at the end of the guide). Parents for Children’s Mental Health (PCMH) is an umbrella organization that deals with all of the concerns as they are listed in the “WHAT IS” section. If you cannot find a support group related to your child’s specific needs, PCMH may be the best fit for you.
Links or Useful Resources for NAVIGATING THE SCHOOL SYSTEM: Ontario Ministry of Education: http://www.edu.gov.on.ca/ SEA Funding in the WRDSB: http://www.wrdsb.ca/programs/special-education/special-equipment-amount-qa
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NOTES
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Creating a Supportive Classroom Through Peer Education “Never doubt that a small group
of thoughtful, committed citizens can change the world. In fact, it is the only thing that ever has”. Margaret Mead
Peer education is a popular way of facilitating the process of peers (or equals) talking among themselves and determining behavioural change. There are several ways of facilitating this type of discussion. One way would be for the child or other children to do the training (peer-to-peer). Another way would be for a teacher to facilitate the training (peer education) or a speaker from an organization or support group does the training (in-service).
It is important for students to understand differences in people, in general, to create a supportive classroom environment for students with special needs or exceptionalities. Set the tone in your classroom for acceptance of differences. Remember, for a presentation about an exceptionality, the permission of the student and student's parents is essential before going ahead. Here are a few activities for a classroom setting. They may need to be modified based on your students' age group and the nature of the difference: Have a discussion with how your students are alike and how they are different (green eyes, wear glasses, boys or girls, doesn’t like homework, allergic to bees, have 3 sisters, likes singing, plays chess, plays piano, etc). You could even brainstorm a list of attributes on the board. Then show them a brown egg and a white egg. Discuss the eggs' similarities and differences and list them on the board. Then break the eggs in a bowl and ask if they can tell which was from the brown or white egg. Conclude the discussion that people may look or act differently, but they are similar on the inside. (You could also use a green, brown, and yellow banana for this activity.) Have a discussion with your students about similarities and differences. Using brightly coloured paper cut into strips, have each student write one attribute that makes him or her similar to the other classmates and one attribute that makes him or her different. Once everyone has finished, you could go around the room and ask students to share their similarities and differences. Finish the discussion by talking about how similarities and differences make everyone unique and allow each student to bring a new and interesting perspective and personality to your class. Gather the strips of paper and create a chain with them. This chain can be hung in your classroom as a visual representation of how the students' similarities and differences "link" them together. For a presentation specifically on a child’s exceptionality, ask the students to write down everything they know about that exceptionality and what they would like to learn. If they do not know what it is, have them write down what they think it is. Then gather the papers and ask the children what it means to be different. Write their responses on the board, then discuss how to treat people who have differences and write these responses on the board. There should then be a resource (story or a video or facts) about the exceptionality which specifically explains that exceptionality. Afterwards, you can ask the students to share what they now know about the exceptionality and what they had gotten wrong before they received the information. Do they have any new thoughts on what it means to be different? Any new ideas on how to treat people with differences?
Last update: 18-Oct-11
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Creating a Supportive Classroom Through Peer Education (continued) Give your students a taste of what it feels like to have the exceptionality. An example of someone with a tic disorder could look something like this: Ask the class to pull a book out of their desks. Explain that you will give them a signal to start reading, but that while they read, every time they hear you clap, they must look up and turn their heads to the right. Give them the signal to begin. Over a 2-minute period, clap randomly many times as the children read, then tell them to stop. Discuss how reading with a tic felt. Was it harder to read? Did anyone feel frustrated? How would they react if they were trying to take a test while experiencing frequent tics? Another example to demonstrate what it is like for someone with attention difficulties might be to turn on a television, and play a music CD and have someone flickering the lights. Ask the students to recall the message on the television. Was this difficult? Why? Ask yourself what is the goal or benefit to disclosing this information about the student. What is it that you want the students to feel, to act/behave, or to learn? Why is this important? How will it help the student with the exceptionality? When is it best to disclose all or a little information? Who is the best person to talk with the class (the Student, Teacher, Special Education Teacher, Social Worker, representative from an association, parent)? Remember to tell students that a neurological disorder like ADHD, Anxiety, Tourette Syndrome, or Obsessive-Compulsive Disorders is not a fatal disease and that they can’t catch it from another classmate (we know this, however students often don’t and may get scared). Talk with the child for whom the peer education is being conducted before the presentation to find out what s/he wants the class to understand. Encourage the child to be present at the peer education, however, don’t push it. If the child would like to help teach or run the peer education program, that’s terrific, as it helps them learn to advocate for themselves. But again, never push a child to do that –even if they are in the room. Tell them privately beforehand that you won’t call on them unless they want you to but if they want to add or explain something, you’d love to have their help. If they prefer to not be present, that’s ok too. There are a number of DVDs, videos or books that are well suited to showing the class. Parents or the School Board are often a good resource for this. The message is simple: kids with a difference come in all shapes and sizes, just like every other kid, but they just have this difference that may seem weird if you don’t know what it is. But now that they know what it is, they’ll know that the best thing to do is to just ignore it or be supportive of their peer. Following a peer education, you will probably notice a “honeymoon” effect where peers are nicer to the child for awhile. But keep track over time and see if the peers’ behaviour actually changes towards the child. Is the child now getting included in more activities on the playground? Are they getting invited to more birthday parties? You may need to conduct some “booster” awareness sessions at different points during the school year.
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Parent To Parent: Our Kids And The Schools By: Susan Hess, March 2006, revised October 2006
This Tip Sheet is for PARENTS of children with mental health problems. It includes suggestions and practical advice for helping your child get the services or supports he or she needs. For all children, school is their social and business environment. For kids with mental health challenges, however, it is within the school environment that they often come up against serious or significant frustrations and lack of understanding. Often our youth are categorized as "the behaviour problem...the bad kid...the lazy one. "Children’s mental health is not well understood by most of the population. It is not surprising, therefore, that many (not all, but many) school personnel do not understand. For both parents and youth, dealing with school personnel who do not understand the issue is daunting. It takes consistent and persistent reminders to the school staff (principals and teachers alike), that our child / youth's behaviours are symptoms of an underlying cause, which might happen to be a mental health problem, and that our kids’ behaviours are the result of this underlying cause. BE AWARE [a good rule of thumb] If your child is in a "behaviour modification" program and his/her behaviour does not improve after an eight to twelve week period, then the cause of the behaviour is more deeply rooted. It is important to continue to work at discovering the "root cause" underlying this behaviour, to put in place the appropriate supports and help for your youngster. WHAT CAN YOU DO? 1. Keep a journal This journal is to help you keep personal records so you can have informed discussions with the school personnel. In this journal, document your child's behaviours, what happens prior to the behaviour, what happens afterward, in as much detail as possible, to have the basis for good discussions. Also, in this journal, document every meeting: date, time, location, who is present, the reason for the meeting, the discussion, requests (yours and theirs), expectations, decisions/outcomes, next steps. In the quiet of your own space, review your notes, add further comments or list questions you want to ask next time. Note: You may want to keep a separate journal to record your emotions and feelings. This will keep your emotions separate from the documentation you need to support your child. Having a record of how you felt may also be useful when you are writing letters or briefing notes to describe your child.
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Parent To Parent: Our Kids And The Schools (continued) By: Susan Hess, March 2006, revised October 2006 1. Meetings If you call the meeting, create an agenda and lead the meeting. Be prepared - bring your journal, your records, suspension letters etc. Bring your child's picture and place it at the head of the table, so that everyone in the meeting will be aware of whom this meeting is about. Always bring at least one person with you to the meeting for support. Be sure that this person has a role to play in the meeting, e.g. child psychiatrist, social worker, to be able to clearly explain your child's needs Ask many questions. Do not be afraid to ask for clarifications. Ask permission to record the meetings, so that you can transcribe them for your records. Be sure though that you ask permission to do this first. Remember to record everything in your journal. REMEMBER. . . DO NOT GIVE UP! Trust your intuition. If you have concerns about your child's behaviours in school, keep advocating for your child until you are satisfied that your child is receiving the help that he or she needs in school. There is nothing to be ashamed of if your child has a mental health problem. Continue to speak clearly for your child, and gather a group of "champions" around you who can also be a part of your voice. Remember… you are your child's best advocate!
About Susan Hess: Susan Hess is a speaker, mother, widow, and award -winning volunteer, Susan Hess has the ability to move audiences to both laughter and tears with stories of children and their families who have faced the challenge of mental health problems in children. Past Volunteer President of Parents for Children’s Mental Health, Susan is available to speak to groups of all types about the impact of children’ s mental health problems on the children and their families. For more information please visit: www.pcmh.ca (permission to reproduce granted S.Hess – Nov. 2008)
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Parent To Teacher: Tip Sheet by: Susan Hess, March 2006
Suggestions from a parent to a teacher: how to recognize and handle a child with mental health problems. For all children, school is their social and business environment. For kids with mental health challenges, however, it is within the school environment that they often come up against serious or significant frustrations and lack of understanding. Often our youth are categorized as "the behaviour problem...the bad kid...the lazy one." Children’s mental health is not well understood by most of the population. It is not surprising, therefore, that many (not all, but many) school personnel do not understand either. For both parents and youth, dealing with school personnel who do not understand the issue is daunting. I am a parent of a child with mental health problems. I am also a former teacher. Yet my insights about my child have been dismissed, my suggestions ignored and sometimes not even believed. When my child was in school, I was constantly angry at the injustice that my child experienced and frustrated that she did not receive what she needed to have a positive experience in school. Teachers, please take the time to understand first… For children with mental health problems: Change is a huge roadblock. Often, they do not understand their own behaviour, nor do they have the words to express what is troubling them. Often they see and hear the world around them differently. They may be highly intuitive, hyper-sensitive, and hyper-diligent. This colours how they respond and react to life's situations. They need to feel secure, and they can sense very quickly if there is a change. They often feel like they are "trapped in a corner" with no way out. They really do want to be "regular kids who have friends”. What can teachers do? Here are a few suggestions: Never call our kids "bad" or refer to them as ”lazy." Take the time to find the "root cause" of the behaviours, then be our partner in helping us find the supports and treatments that our youngsters need. Examine the exceptions to the rule. For example, a girl runs away 12 times over a sixmonth period for a total of 20 days. There were 220 days she did not run. The question is: "Why did she not run those 220 days and how can we use this to support her?" Do not focus on an isolated “bad event.” Find the strengths of the youngster and focus on these strengths, building on the positives. Be flexible and patient. Ask yourself these questions in connection with our kids needs and supports Maybe she could…but can she? Maybe he can’t…but should he?
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Parent To Teacher: Tip Sheet (continued) by: Susan Hess, March 2006
NEVER GIVE UP, even if you feel that you have tried all avenues. Begin again. Try a different approach. Understand that it sometimes can take three or four different people to help our kids through distress. Problem-solving needs to take place when the child is ready, not when you are ready. Understand that our kids need to be evaluated on a scale where the assessment of performance is based on their best at the moment, not on someone else's best. Know that our kids need to feel good about themselves before they can be receptive to learning anything. Understand that the living core of our whole life is based on relationships and interpersonal contacts. Develop these connections with our kids .... Work at building trust with our kids. This can take a long time, but it is worth the time and energy. When our kids trust you enough to share their emotions with you, you can begin to work with them. Respect, trust, confidence, genuineness, validation and empathy are the qualities that you need to build these needed connections. The smallest things can make a huge difference and may impact our child's day, week, or even lives. Discipline our kids; do not punish them. Discipline includes teaching, improvement and correction. Our kids need to be accountable for their actions in a way that has meaning for them - this is the important piece - so that positive change will occur.
Most importantly, please like our kids. AS PARENTS WE WOULD ASK YOU TO Recognize the whole person in our child Encourage our kids to believe in themselves even when no one else does. Be compassionate; recognize and acknowledge the struggle that our kids face. Do not be afraid to use your sense of humour. Do not categorize our kids unless it will lead to a better understanding of their needs. Do not separate teaching the child skills from building their self-esteem. Understand our kids’ world: how they see, hear, feel. Understand what it is like to live in their world. Then adjust your plan to meet their need. REMEMBER: A need is not a program. A program is the plan that helps the need be met. Be sure that the program is the right plan to meet the child's need. Recognize how scary it is for our kids to manoeuvre in this world when they do not understand what is happening or why people respond to them the way that they do. Do not put so much distance between yourself and our kids. Take a personalized approach. Teach the whole person. Value the whole person. Do NOT FOCUS ONLY ON THINGS, PRODUCTION and OUTCOMES. Remember the "ripple effect." Whatever happens within the school, no matter how small, can affect our kids even days later.
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Parent To Teacher: Tip Sheet (continued) by: Susan Hess, March 2006
Use all your teaching skill Create a "trusting culture" within the classroom and within the school. Trust that within the kid there is something trustworthy. The kids will then give this trust back to you, the teacher. Teach our kids little ways to reduce their stress and to manage their anxiety. For example: take the word Omaha. Break it down into the syllables O.....Ma.....Ha. Have them say each syllable as loud and as long as they can. This helps release tension, and creates laughter. Instead of "time outs" or “programs,” have "peace circles" or "cool down rooms." Change the focus from negative and punitive to one that is positive and nurturing so that the child has permission to ask for time to take care of themselves. Help our kids explore their behaviours. Help them understand that there is always a reason for these behaviours. Once the reason is discovered, a better understanding will occur for both of you and this will help you relate to our youngster to better be able to help them. For example, my daughter never used her locker at school. She preferred to keep everything boots, coat, books - under her desk. By exploring the reason for this behaviour, we discovered it was a security issue. She needed to have control over a little piece of her world where she had so little control. Having her "treasures" near her gave her comfort and a sense of security. Always find the "teaching moments." Build relationships with the parents and family Nurture the creation of a support network of "champions" for our child and the family, people who have our child's need front and centre. Recognize how frightening it is for the family members who have to fight the stigma, the blame and the shame of the mental health problems that are directing the behaviours and actions of the child. Ask questions in conversation to understand the whole picture. Understand that as parents, we are exhausted and isolated. We know no one who has a child like ours. Understand that this child is just one member of a family, all of whom must be nurtured. Realize that the one thing that we as parents want and that we rarely get is for teachers to listen, to be an empty vessel and just listen to us, without judgment. Keep your learned knowledge in the background. Draw from your wisdom, your intuitive self. Listen to everything we say. Be open to hear not only our words but also our silences. Cradle our anger, frustrations and fears with your perceptions, sensitivity, support and reassurance in a co-operative manner so we know that we are not alone. Be comfortable with our silences and our tears. When we know that you understand, we will trust and begin to build a working relationship with you. Encourage and nurture these relationships with parents. Make us feel part of the solution. Help us all develop into "solution people" not "excuse people." Solutions will help our kids feel connected and grow into their potential, whatever that may be. Teach, guide and encourage parents to become advocates for their child. Lead them to the understanding that they are their child's best advocate and that this will be their lifetime vocation.
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Parent To Teacher: Tip Sheet (continued) by: Susan Hess, March 2006
FINAL NOTES: As parents, we acknowledge that our kids are not easy to have in the classroom. It is also not easy for them. Our kids are worth the extra time and energy. Teachers and parents need to work together, not against each other. They need to be partners in guiding and supporting our youngsters. I believe that most parents love their child and want the best for them. I also believe that most teachers want the best for the children they are teaching. It is important that both sides learn to communicate clearly, so they can be partners in the child's future growth and development. Parents and teachers together need to continue to find ways to help our kids with mental health problems manoeuvre successfully in their school environment and to feel connected.
About Susan Hess: Susan Hess is a speaker, mother, widow, and award -winning volunteer, Susan Hess has the ability to move audiences to both laughter and tears with stories of children and their families who have faced the challenge of mental health problems in children. Past Volunteer President of Parents for Children’s Mental Health, Susan is available to speak to groups of all types about the impact of children’s mental health problems on the children and their families. For more information: www.pcmh.ca (permission to reproduce granted S.Hess – Nov. 2008)
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Special Education Advisory Committee (SEAC) What is SEAC? SEAC is a committee mandated by legislation. This makes it a standing committee of the Board. The members of the committee include representatives of local associations who represent students with Special Needs (defined in the regulation), Senior Special Education Staff and Trustees. The majority of the individuals who represent these Community Associations are volunteers – in many cases parents with their own child who has a special need.
Responsibilities of SEAC To make recommendations to the board in respect of any matter affecting the establishment, development, and delivery of special education programs and services for exceptional pupils of the board; To participate in the board’s annual review of its special education plan; To participate in the board’s annual budget process as it relates to special education; To review the financial statements of the board as they relate to special education. SEAC does not advise parents or school boards on matters involving individual students. They can be available as a resource for parents.
SEAC Meetings All meetings are open to the public. You are welcome to attend and observe any of the ten SEAC meetings held throughout the year (Sept-June). Waterloo Region District School Board - meets the 2nd Wednesday of the month, 7-9pm Waterloo Catholic District School Board - meets the 1st Wednesday of the month, 7-9pm SEAC member associations are available to provide specific information, make recommendations and give assistance to parents/guardians whose children may require additional support. For this reason parents are encouraged to contact the local association that best represents the special needs of the student. The organization may in turn pass on the question or concern to the SEAC representative. Meeting Agendas and Minutes are available on each Board’s website. It may be best to call, email, or visit the websites to confirm meeting dates and location. Have a look at the websites for further information on SEAC and many other resources:
SPECIAL EDUCATION ADVISORY COMMITTEE
SPECIAL EDUCATION ADVISORY COMMITTEE
Waterloo Region District School Board 51 Ardelt Avenue, Kitchener, ON, Canada N2C 2R5
Waterloo Catholic District School Board 35 Weber St. W., Unit A PO Box 91116 Kitchener, ON, Canada N2G 4G2
(519) 570-0003, ext. 4219 www.wrdsb.on.ca
(519) 578-3660, ext. 2285 or e-mail: info@wcdsb.ca (put SEAC in the subject line www.wcdsb.ca
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The Ontario Ministry of Education - Special Education Resources What is the Ministry of Education? The Ministry of Education administers the system of publicly funded elementary and secondary school education in Ontario, in accordance with the directions set by the provincial government. The Minister of Education, through the ministry: Issues curricula Sets requirements for student diplomas and certificates Provides funding to school boards for academic instruction and for building and maintaining schools. The minister may also set policy for student assessment, which is then carried out by the Education Quality and Accountability Office (EQAO).
What is Special Education? Students who have behavioural, communication, intellectual, physical or multiple exceptionalities, may require special education programs and /or services to benefit fully from their school experience. Special education programs and services primarily consist of instruction and assessments that are different from those provided to the general student population. These may take the form of accommodations (such as specific teaching strategies, preferential seating, and assistive technology) and/or an educational program that is modified from the age-appropriate grade level expectations in a particular course or subject, as outlined in the Ministry of Education's curriculum policy documents. The resources outlined below are available on-line or may be requested in print from Publications Ontario at 1-800-668-9938. There is no charge for the documents but there is a charge for shipping the material. Each item listed below is a document with information that parents and educators have found very helpful. We encourage you to visit the Ontario Ministry of Education’s website at www.edu.gov.on.ca/eng/teachers, then click on “Special Education” to view the documents listed below, and many more: Overview An Introduction to Special Education in Ontario The Identification, Placement, and Review Committee (IPRC) The Individual Education Plan Process (IEP) Transition Planning Ministry Support for Special Education Policy Direction The Education Act on Special Education Special Education Regulations Special Education Policy Documents Policy/Program Memoranda Concerning Special Education Funding for Special Education
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The Ontario Ministry of Education - Special Education Resources (continued) Policy Direction (continued) Standards for School Boards' Special Education Plans Individual Education Plans: Standards for Development, Program Planning, and Implementation Funding Special Education Funding Guidelines: Special Equipment Amount (SEA) and Special Incidence Portion (SIP), 2010–11 Special Education Advisory Committee The Special Education Advisory Committee (SEAC) Information Program Resource Documents Caring and Safe Schools in Ontario: Supporting Students With Special Education Needs Through Progressive Discipline, Kindergarten to Grade 12 - sets out a framework that system and school leaders may use to strengthen schools' ability to provide a caring and safe environment with respect to students with special education needs. Resolving Identification or Placement Issues (Procedures for Parents & Guardians) Publications for Parents Individual Education Plan (IEP) Samples Shared Solutions - A Guide to Preventing and Resolving Conflicts Regarding Programs and Services for Students with Special Education Needs Effective Educational Practices for Students with Autism Spectrum Disorders Special Education Transformation: The Report of the Co-Chairs with the Recommendations of the Working Table on Special Education, 2006 Education for All: The Report of the Expert Panel on Literacy and Numeracy Instruction for Students with Special Education Needs, Kindergarten to Grade 6, 2005 Planning Entry to School – A Resource Guide, 2005 Guidelines 2005 – For Approval of Education Programs for Pupils in Government Approved Care and/or Treatment, Custody and Correctional Facilities The Individual Education Plan (IEP), A Resource Guide, 2004 Transition Planning: A Resource Guide, 2002 Special Education, A Guide for Educators, 2001 Older resource documents Special Education Reports/Recommendations Special Education Transformation: The Report of the Co-Chairs with the Recommendations of the Working Table on Special Education, 2006 Education for All: The Report of the Expert Panel on Literacy and Numeracy Instruction for Students with Special Education Needs, Kindergarten to Grade 6, 2005 Early School Leavers: Understanding the Lived Reality of Student Disengagement from Secondary School, 2005
LINKS OR USEFUL RESOURCES: Please refer to “Navigating the School System” in this section for a handy chart to help you decide what to look at first.
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All students will have times when they struggle with schoolwork or with school life. But some students may need extra support from a special education program. Parents may be the first to notice that their son or daughter is having problems in school, or a teacher may suggest to a parent that their son or daughter might need extra and ongoing support.
Some things to remember •
•
•
•
Some issues can be solved by the teacher in the classroom, so speak to the teacher first if you are worried about your child’s progress. Needing Special Education support is not a bad thing—some students just learn differently or need extra support to succeed. Just because your child does not speak English, it does not mean that he/she needs Special Education help. Some problems are a normal part of adjusting to a new language and school. It may help to provide the principal with information about the student’s academic skills in his or her first language.
Ask questions •
Ask your child if there are particular things that are consistently difficult at school.
•
Ask the teacher if he or she thinks your son or daughter needs extra support and if the teacher can provide the extra help
•
Some medical conditions may affect learning (e.g. hearing, vision etc.), so it might help to talk to your child’s doctor.
Meet with the school staff •
If you think your son or daughter needs more help, ask the principal or vice-principal to hold meeting with other school staff (called a School Team Meeting) to talk about your child.
•
Prepare for the meeting. Sometimes it helps to write down questions, such as: o What kinds of supports or programs would help my child succeed? o What is available in the school? o Would my son or daughter have to wait a long time to get into the right program? At the School Team Meeting the school staff may recommend one or more of the following options: o that the teacher continue to provide support in the classroom; o that the teacher develop an Individual Education Plan (IEP) for the student; o that a student be formally “assessed” to find out if he or she has special needs and what those needs are; and/or o that the school hold a more formal Special Education meeting, called an Identification Placement and Review Committee (IPRC).
Some parts of the process for getting Special Education support can feel confusing and it may have many unfamiliar names. Always ask
questions if there are things you don’t understand. •
What should you do if you think your child needs Special Education support?
Parents play an important role in Special Education. It is alright to ask for support for your child and it is alright to be persistent.
What is Special Education? Special Education is a term used to describe a wide range of supports and programs for students who need different teaching methods or special equipment to allow them to be successful in school. Sometimes Special Education support involves a different way of teaching, sometimes it means a student will get extra time for writing tests or special equipment to help them with their school work. In a Special Education program, students may be placed in separate classes for all or part of the day, or stay in their regular class with support from an educational assistant. The most important thing to remember is that Special Education is intended to help your child succeed in school.
•
What is a Special Education assessment?
What happens at an IPRC, and do parents have a role?
A Special Education “assessment” is an evaluation of a student by a specialist to determine if a student has special needs and what those needs are. Your principal or vice principal can explain what you need to do to have your child assessed, but you may have to wait for the assessment.
The IPRC meeting usually includes the student’s teacher and/or guidance counsellor, the principal, a psychologist, a school board representative and the parents. Using information from the staff and parents, the committee will recommend a program for the student, and the parents will be asked to sign a document agreeing to the committee’s recommendations. You may take the document home and think it over before deciding whether to sign it.
What is an IEP? The Individual Education Plan, or IEP, describes what the school will do to help your child. A student does not have to be formally assessed in order to have an IEP.
Some tips for your IPRC:
The IEP should include:
•
You can bring a family member or friend who knows the child to the meeting.
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A list of the student’s strengths and needs;
•
•
An outline of the special education services the student will receive, where and when the service will be provided, and who will provide it.
Bring any doctor’s notes or assessments about the student’s medical condition or about his or her learning skills.
•
•
A description of how the student’s progress will be measured and reviewed;
Take a photograph of your child to help the committee remember who they’re talking about.
•
•
A set of goals for the student and teacher to work toward over the year; and
If a particular program is recommended, you may ask to visit it.
•
•
A list of any special equipment to be provided.
If you disagree with the decision of the IPRC, you may appeal it. Your principal can explain how.
An IEP must be completed within 30 school days after your child has been placed in a special program and the principal must ensure that you receive a copy of it.
•
The IPRC process may seem very formal, but it means that you and your child will have a right to request ongoing support, which will help him or her succeed in school.
What is an IPRC?
Will my child’s support change over time?
Sometimes the School Team will recommend the school hold an Identification Placement and Review Committee (IPRC) - which is a meeting to officially identify a student’s special needs (often called “exceptionalities”). An IPRC may be requested by the parents or the school. Once parents have made a request in writing, an IPRC must be held. The school must inform the parents about an IPRC, and it is very important for parents to attend. The IPRC will officially decide: • if a student has special learning needs, • what kind of learning needs the student has, and • the best program for the student.
•
Your child’s program will be reviewed at least once in every school year – you can always ask for changes or for more information when the review comes up.
Where can parents go for help? •
Ask your teacher, principal or guidance counselor for information.
•
People for Education has more information and links to special education organizations at http://www.peopleforeducation.com/links/special_ needs .
•
If you have a school settlement worker, they can help explain the Special Education process.
•
Other parents can be a wonderful resource—talk to the parents in your school about how
Special Education works.
Children and Youth Mental Health Resource Guide Prepared by Parents for Children’s Mental Health – Waterloo Region©
Office of the Provincial Advocate for Children and Youth “If it’s wrong, the Advocacy Office can help you make it right.” The Office of the Provincial Advocate for Children and Youth listens, problem solves, mediates complaints, networks with the community and intercedes on behalf of children and negotiates with service providers or government officials, youth or young adults when they cannot speak for themselves.
...If you’ve tried everything else and no one is listening, call the Office of the Provincial Advocate for Children and Youth…
The Advocacy Office began in 1978. Under the Child and Family Services Act, it is authorized to protect the rights and interests of children and families who are receiving or needing services through the Ministry of Children and Youth Services, in the Province of Ontario. Any student in a residential or special school is also entitled to call for help.
The clients include children and families that may be in conflict with the law, children/youth living in children’s mental health settings, group homes or foster homes, children with intellectual, learning and physical disabilities as well as those that are deaf, blind or hard of hearing. The Advocacy Office makes sure that children/youth in care know and understand their rights and that the laws that protect them are enforced. Advocates empower children and families to make complaints about unacceptable treatment.
LINKS OR USEFUL RESOURCES: Office of the Provincial Advocate for Children and Youth – 1-800-263-2841 or 416-325-3669 (TTY) or www.provincialadvocate.on.ca or email: provincialadvocate.on.ca,
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Article: What The Human Rights Code Guarantees Your Child At School Rights commission says services must meet individual needs, promote inclusion, and protect dignity. In November the Ontario Human Rights Commission released Guidelines on Accessible Education - its interpretation of Ontario Human Rights Code provisions relating to discrimination against students because of disability. Connections asked commission spokeswoman Afroze Edwards to discuss how Guidelines may benefit Ontario parents seeking appropriate school accommodations for their children. Q. How does the Ontario Human Rights Code guarantee the accommodation of students? A. Section 1 of the code guarantees the right to equal treatment in services, without discrimination on the ground of disability. Once a disability has been identified, education providers have a duty to accommodate the needs of students with disabilities in order to allow them to access education services equally, unless to do so would cause undue hardship. Q. How does the code define appropriate accommodation? A. It must involve three factors: dignity, individualization and inclusion. First, services need to be provided in a manner that is respectful of the student's dignity and doesn't marginalize or stigmatize the student. For example, if a student with a disability has to enter the school at the back of the building because the front entrance isn't accessible, that doesn't respect the dignity of the person. Second, the accommodations must meet the unique needs of each student. There's no set formula based on a category of disability and blanket approaches to accommodation aren't acceptable. Each student's individual needs must be assessed and met. Third, before providing separate or specialized services, educators must make efforts to build or adapt their services to accommodate students with disabilities in a way that promotes their full participation. No student should be excluded or singled out. Q. How does the code assess undue hardship? A. In terms of cost, the standard is very high. What the courts have said is that we've got to be careful that we do not put too low a value on accommodating students with disabilities. The onus is on the education provider to show that the cost would be so high as to alter the essential nature of the institution or substantially affect its viability. Detailed financial documentation and evidence, including whether they've looked at their overall budget to determine if the money could come from another area, must be shown. Before claiming undue hardship, organizations have to consider using accommodation funds that are available in the public sector, as well as government grants or loans. Health and safety factors also need to be considered. Q. How can the code ensure accommodation of children whose disabilities cross over a number of designations for exceptionality under the funding process? A. Regardless of what structure is used for funding programs, under the code the education ministry has a duty to accommodate the needs of students with disabilities. The code prevails over the Education Act. Again, each student's individual needs must be assessed and a 'one approach fits all' is not acceptable. One thing I should emphasize is that accommodation is a process. It's not "Here it is, hopefully this works and now we're done." It's part of a continuum. If the education provider can't provide the full accommodation at one point in time, it doesn't mean they don't provide any accommodation. They need to implement interim or "next best" solutions.
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Article : What The Human Rights Code Guarantees Your Child At School (continued)
Q. How can the code protect children whose disabilities are associated with behaviours that may lead to their suspension? A. We heard in our consultation about two student groups that are being adversely affected by the application of the Safe Schools Act: those with disabilities and those from racialized communities. Parents of students with Tourette’s syndrome talked about how their children had been disciplined or suspended because of behaviour that was a manifestation of their disability. Last year we made a submission to the Toronto District School Board and outlined our concern about the possible discriminatory effect the application of the Safe Schools Act was having on students with disabilities. Parents may wish to print the submission and point out to educators that the concerns we've raised apply to their children. (Go to www.ohrc.on.ca, click on news releases and refer to May 14). Q. How does the code protect students who aren't receiving services they need because of funding delays? A. Accommodations must be provided in a timely manner. Unreasonable delays have the potential to impede a student's ability to access the curriculum and may be found to constitute a breach of the code. Parents who believe that time delays have resulted in discrimination may call the commission about filing a complaint. Q. Does the duty to accommodate apply to all school board programs, including alternative schools or French immersion programs, which don't typically offer special education support? A. The Ontario Human Rights Code applies to all educational services that are offered to the public, including alternative schools and French immersion programs. The right to equal treatment also applies to public and private preschools, elementary and secondary schools, colleges and universities, hospital schools, care and treatment programs, provincial schools, separate schools and French language schools. Q. Where can parents get practical advice on the code? A. They can call the commission's information line at (416) 326-9511 or (800) 387-9080 and explain their concerns. To file a complaint, parents need to submit a written complaint on behalf of the student. There are no associated costs. For more valuable information, visit www.ohrc.on.ca.
This article is reprinted with permission from the summer 2005 issue of “Bloom” (formerlyConnections, a practical guide to parenting children with disabilities) produced by Bloorview Kids Rehab, renamed in 2010 to Holland Bloorview Kids Rehab, at www.hollandbloorview.on.ca To be put on the mailing list, call 416-425-6220, ext. 3310. June 20, 2005
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Website Resource Listing The following is an alphabetical listing of resources that we are aware of. They are not necessarily in other areas of this binder. This is not an endorsement by Parents for Children’s Mental Health – Waterloo Region.
ADDICTIONS/SUBSTANCE ABUSE American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Centre of Substance Abuse Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Children’s Mental Health Ontario Drug and Alcohol Registry of Treatment (DART) Here to Help Mayo Clinic Narcotics Anonymous National Institute on Drug Abuse Science and Management of Addictions Waterloo Region Police Service ADVOCACY Child Advocacy Project Office of the Provincial Advocate for Children and Youth Parents for Children’s Mental Health Waterloo Region Family Network ADVOCACY-EDUCATION Ontario Ministry of Education Parent’s Advocacy in the School Parents for Children’s Mental Health People for Education Waterloo Region Family Network ANGER/AGRESSION Anger Management Tips.com Kids Help Phone Offord Centre for Child Studies
Last update: 16-Oct-11
www.aacap.org www.ccsa.ca www.cmha.ca www.camh.ca www.kidsmentalhealth.ca www.dart.on.ca www.heretohelp.bc.ca www.mayoclinic.com www.glana.ca www.nida.nih.gov www.samafoundation.org www.wrps.on.ca www.childadvocacy.ca www.provincialadvocate.on.ca www.pcmh.ca www.waterlooregionfamilynetwork.com www.edu.gov.on.ca www.parentsadvocacy.com www.pcmh.ca www.peopleforeducation.com www.waterlooregionfamilynetwork.com www.angermanagementtips.com/children and www.angermanagementtips.com/teens www.kidshelpphone.ca www.knowledge.offordcentre.com
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Website Resource Listing (continued) ANXIETY DISORDER ABCs of Mental Health American Academy of Child and Adolescent Psychiatry (AACAP) Anxiety BC Anxiety Disorders Assoc. of Ontario Anxiety Disorders Association of America Canadian Mental Health Association Child and Parent Resource Institute (CPRI) Children’s Mental Health Ontario Hamilton Health Sciences Here to Help KidsAbility Centre for Child Development kidsLink Mayo Clinic McMaster University Mind your Mind Mood Disorders Association of Ontario (MDAO) OCD Ontario Offord Centre for Child Studies Shyness and Social Anxiety Treatment Australia Social Phobia/Social Anxiety Association The Social Anxiety Network Tourette Syndrome Plus
www.brocku.ca/teacherresource/ABC/ www.aacap.org
www.anxietybc.com
www.anxietyontario.com www.adaa.org www.cmha.ca www.cpri.ca www.kidsmentalhealth.ca www.macanxiety.com www.heretohelp.bc.ca www.kidsability.ca www.kidslinkcares.com www.mayoclinic.com www.mcmaster.ca www.mindyourmind.ca www.mdao.ca www.ocdontario.org www.knowledge.offordcentre.com www.socialanxietyassist.com.au www.socialphobia.org www.social-anxiety-network.com www.tourettesyndrome.net
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) Attention Deficit Disorder Association (ADDA) www.add.org ABCs of Mental Health www.brocku.ca/teacherresource/ABC/ Dr. Daniel G. Amen’s Clinic www.amenclinics.com American Academy of Child and Adolescent Psychiatry (AACAP) www.aacap.org Canadian Mental Health Association www.cmha.ca CanChild Centre for Childhood Disability Research www.canchild.ca Centre for ADHD/ADD Advocacy, Canada www.caddac.ca Child and Parent Resource Institute (CPRI) www.cpri.ca Children and Adolescents with A.D.D. www.chaddcanada.org Children’s Mental Health Ontario www.kidsmentalhealth.ca Here to Help www.heretohelp.bc.ca Lifes A Twitch, Dr. Duncan McKinlay www.lifesatwitch.com Mayo Clinic www.mayoclinic.com Last update: 16-Oct-11
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Website Resource Listing (continued) ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) cont’d McMaster University’s Canchild Centre for Childhood Disability Research www.canchild.ca Offord Centre for Child Studies www.knowledge.offordcentre.com The Canadian Attention-Deficit/Hyperactivity Disorder Resource Alliance www.caddra.ca The Learning Disabilities Association of Canada www.ldac-taac.ca Tourette Syndrome Foundation of Canada www.tourette.ca Tourette Syndrome Plus www.tourettesyndrome.net AUTISM American Academy of Child and Adolescent Psychiatry (AACAP) Autism Ontario Autism Society of America Autism Spectrum Connection Autism Web Child and Parent Resource Institute (CPRI) Developmental Services Access Centre (DSAC) Erinoak Geneva Centre for Autism KidsAbility Centre for Child Development Mayo Clinic
www.aacap.org www.autismontario.com www.autism-society.org www.autismspectrumconnection.com www.autismweb.com www.cpri.ca www.dsac-wr.com www.erinoak.org www.autism.net www.kidsability.ca www.mayoclinic.com
BIPOLAR DISORDER American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Child and Adolescent Bipolar Foundation Child and Parent Resource Institute (CPRI) Children’s Mental Health Ontario Fyreniyce – Australian Bipolar Website Juvenile Bipolar Research Foundation Mayo Clinic Mood Disorders Association of Ontario (MDAO) Pendulum Resources The Organization for Bipolar Disorders Tourette Syndrome Plus
www.aacap.org www.cmha.ca www.camh.ca www.bpkids.org www.cpri.ca www.kidsmentalhealth.ca http://members.iinet.net.au www.bpchildresearch.org www.mayoclinic.com www.mdao.ca www.pendulum.org www.obad.ca www.tourettesyndrome.net
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Website Resource Listing (continued) BORDERLINE PERSONALITY DISORDER About.com American Academy of Child and Adolescent Psychiatry (AACAP) BPD Demystified Canadian Psychiatric Research Foundation Keeping Kids Healthy
http://bpd.about.com/od/forfamilyandfriends /a/bpdchild.htm www.aacap.org www.bpddemystified.com www.cprf.ca www.keepingkidshealthy.org
BULLYING Schools Strategy Kids Help Phone Line Notice of Harassment Kit for School Bullying
www.ontario.ca/safeschools www.kidshelpphone.ca www.documatica_forms.com/bullying
COMPLEMENTARY/ALTERNATIVE HEALTH CARE Canadian Association of Naturopathic Doctors (CAND) Brain Gym Government of Canada Mood Disorders Association of Ontario (MDAO) Integrated Centre for Optimal Learning Information about Indigo Children Right Brained Learners
www.cand.ca www.braingym.org www.canadabusiness.ca www.mooddisorders.on.ca www.ICOLsolutions.com www.indigochild.com www.visualspatial.org
COGNITIVE BEHAVIOUR THERAPY Child and Parent Resource Institute
www.cpri.ca
CONDUCT DISORDER American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association ConductDisorders Mental Health America
www.aacap.org www.cmha.ca www.conductdisorders.com www.nmha.org
COUNSELLING Ontario Psychological Association The Therapy Directory
www.psych.on.ca www.therapists.psychologytoday.com
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Website Resource Listing (continued) CUTTING/SELF HARM ABCs of Mental Health American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Kids Help Phone Mayo Clinic The Helpline USA DEPRESSION ABCs of Mental Health A Guide to Depression Treatments (incl. Myths/Facts about Depression) American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Children’s Mental Health Ontario Depression Guide Dr. Ivan’s Depression Central Families for Depression Awareness Here to Help Mayo Clinic Mental Health Assoc. of Greater St. Louis Mood Disorders Association of Ontario (MDAO) Offord Centre for Child Studies Shyness and Social Anxiety Treatment Australia University of Michigan Depression Centre DUAL/CONCURRENT/CO-MORBID DIAGNOSES Canadian Mental Health Association Child and Parent Resource Institute (CPRI) Children’s Mental Health Access Centre Developmental Services Access Centre (DSAC) KidsAbility Centre for Child Development kidsLink Mayo Clinic Tourette Syndrome Plus
Last update: 16-Oct-11
www.brocku.ca/teacherresource/ABC/ www.aacap.org www.cmha.ca www.kidshelpphone.ca www.mayoclinic.com www.helpguide.org/mental/self-injury.htm www.brocku.ca/teacherresource/ABC/ www.cmha.bc.ca/resources/bc_resources/de ptreat www.aacap.org www.cmha.ca www.camh.ca www.kidsmentalhealth.ca www.depression-guide.com www.psycom.net/depression.central.html www.familyaware.org www.heretohelp.bc.ca www.mayoclinic.com www.mhagstl.org www.mdao.ca www.knowledge.offordcentre.com www.socialanxietyassist.com.au www.depressioncenter.org www.cmha.ca www.cpri.ca www.lutherwood.ca - click “access centre” www.dsac-wr.com www.kidsability.ca www.kidslinkcares.com www.mayoclinic.com www.tourettesyndrome.net
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Website Resource Listing (continued) DEVELOPMENTAL DISABILITY Ministry of Community and Social Services Child and Parent Resource Institute (CPRI) Children’s Mental Health Access Centre Developmental Services Access Centre (DSAC) KidsAbility Centre for Child Development kidsLink Mayo Clinic DIALECTIC BEHAVIOUR THERAPY About.com American Academy of Child and Adolescent Psychiatry Centre for Addiction and Mental Health DBT Self Help Portland Dialectic Behaviour Therapy EATING DISORDERS ABCs of Mental Health American Academy of Child and Adolescent Psychiatry (AACAP) Bulimia Anorexia Nervosa Association Canadian Mental Health Association Children’s Mental Health Ontario Eating Disorders Awareness and Prevention Inc. Eating Disorders Awareness Coalition Mayo Clinic National Eating Disorders Information Centre Overeaters Anonymous Trellis Mental Health & Developmental Services Regional Eating Disorder Services
Last update: 16-Oct-11
www.mcss.gov.on.ca/mcss/english/pillars/de velopmental/questions/general/faqs-general www.cpri.ca www.lutherwood.ca and click on access centre www.dsac-wr.com www.kidsability.ca www.kidslinkcares.com www.mayoclinic.com http://depression.about.com/od/psychotherap y/a/dialectical.htm www.aacap.org www.camh.net www.dbtselfhelp.com www.portlanddbt.com www.brocku.ca/teacherresource/ABC/ www.aacap.org www.bana.ca www.cmha.ca www.kidsmentalhealth.ca www.edap.org www.edacwr.com www.mayoclinic.com www.nedic.ca www.oa.org www.trellis.on.ca
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Website Resource Listing (continued) FETAL ALCOHOL SYNDROME DISORDER Canadian Centre on Substance Abuse KidsAbility Centre for Child Development Mayo Clinic St. Michael’s Hospital – Toronto The Hospital for Sick Children, Mother Risk Program – Toronto
www.ccsa.ca www.kidsability.ca www.mayoclinic.com www.stmichaelshospital.com www.motherisk.org
FINANCIAL Canada Revenue Agency Government of Ontario – Attorney General information on Power of Attorney J.E. Arbuckle Kenneth C. Pope
www.cra.qc.ca www.attorneygeneral.jus.gov.on.ca/english/f amily/phy/poa.pdf www.finplan.net www.kpopelaw.ca
INDIGO & CRYSTAL CHILDREN Integrated Centre for Optimal Learning Information about Indigo & Crystal children
www.ICOLsolutions.com www.Indigochild.com
(IEP) INDIVIDUAL EDUCATION PLAN ****SAMPLES!!**** Council of Ontario Directors of Education (CODE) www.ontariodirectors.ca/IEP-PEI/en.html LEARNING DISABILITIES American Academy of Child and Adolescent Psychiatry (AACAP) Children’s Mental Health Ontario Coordinated Campaign for Learning Disabilities Learning Disabilities Assoc. of Canada Learning Disabilities Assoc. of Ontario
www.aacap.org www.kidsmentalhealth.ca www.ldonline.org www.ldac-taac.ca www.ldao.ca
LEGAL Community Legal Education Ontario Government of Ontario J.E. Arbuckle Kenneth C. Pope
www.cleo.on.ca www.attorneygeneral.jus.gov.on.ca www.finplan.net www.kpopelaw.ca
Last update: 16-Oct-11
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Website Resource Listing (continued) MENTAL HEALTH – GENERAL ABCs of Mental Health All Psych Online American Academy of Child & Adolescent Psychiatry American Psychiatric Association Canadian Mental Health Association Canadian Psychiatric Research Foundation Caring for Kids Children’s Mental Health Ontario Front Door Here to Help kidsLink Mayo Clinic Mental Health Service Information Ontario Mood Disorders Association of Ontario (MDAO) Offord Centre for Child Studies Parents for Childrens Mental Health Psychiatry Online Teen Mental Health The Jack Project Trellis Mental Health & Developmental Services Regional Eating Disorder Services
www.brocku.ca/teacherresource/ABC/ www.allpsych.com www.aacap.org www.psych.org www.cmha.ca www.cprf.ca www.caringforkids.cps.ca www.kidsmentalhealth.ca www.kidslinkcares.com www.heretohelp.bc.ca www. kidslinkcares.com www.mayoclinic.com www.mhsio.on.ca www.mooddisorders.on.ca www.knowledge.offordcentre.com www.pcmh.ca www.psychiatryonline.com www.teenmentalhealth.org www.thejackproject.org www.trellis.on.ca
MOOD DISORDERS (see also Depression, Bipolar, etc.) ABCs of Mental Health www.brocku.ca/teacherresource/ABC/ American Academy of Child and Adolescent Psychiatry (AACAP) www.aacap.org Canadian Mental Health Association www.cmha.ca Centre for Addiction and Mental Health (CAMH) www.camh.ca Child and Parent Resource Institute (CPRI) www.cpri.ca Children’s Mental Health Access Centre www.lutherwood.ca - click on access centre Children’s Mental Health Ontario www.kidsmentalhealth.ca Family Association for Mental Health Everywhere (FAME) www.familyaware.org Mayo Clinic www.mayoclinic.com Mood Disorders Association of Ontario (MDAO) www.mdao.ca Offord Centre for Child Studies www.knowledge.offordcentre.com Tourette Syndrome Plus www.tourettesyndrome.net
Last update: 16-Oct-11
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Website Resource Listing (continued) OBSESSIVE COMPULSIVE DISORDER ABCs of Mental Health American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Child and Parent Resource Institute (CPRI) Children’s Mental Health Ontario Hamilton Health Sciences Mayo Clinic Tourette Syndrome Plus OPPOSITIONAL DEFIANT DISORDER ABCs of Mental Health American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Child and Parent Resource Institute (CPRI) Mayo Clinic Tourette Syndrome Plus PSYCHOSIS Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Child and Parent Resource Institute (CPRI) Children’s Mental Health Access Centre Psychosis Sucks Trellis Mental Health & Developmental Services Regional Eating Disorder Services RE-ACTIVE ATTACHMENT DISORDER (RAD) Attachment Disorder Site Child and Parent Resource Institute (CPRI) Institute for Attachment Mayo Clinic
Last update: 16-Oct-11
www.brocku.ca/teacherresource/ABC/ www.aacap.org www.cmha.ca www.camh.ca www.cpri.ca www.kidsmentalhealth.ca www.macanxiety.com www.mayoclinic.com www.tourettesyndrome.net www.brocku.ca/teacherresource/ABC/ www.aacap.org www.cmha.ca www.cpri.ca www.mayoclinic.com www.tourettesyndrome.net www.cmha.ca www.camh.ca wwwcpri.ca www.lutherwood.ca , click on access centre www.psychosissucks.ca www.trellis.on.ca www.attachmentdisorder.net www.cpri.ca www.instituteforattachment.org www.mayoclinic.com
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Website Resource Listing (continued) SCHIZOPHRENIA American Academy of Child and Adolescent Psychiatry (AACAP) Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Child and Parent Resource Institute (CPRI) Children’s Mental Health Ontario Mayo Clinic Mood Disorders Association of Ontario (MDAO) See also Mood Disorders SCHIZOAFFECTIVE DISORDER Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Mood Disorders Association of Ontario (MDAO) See also Schizophrenia and Mood Disorders
www.aacap.org www.cmha.ca www.camh.ca www.cpri.ca www.kidsmentalhealth.ca www.mayoclinic.com www.mdao.ca
www.cmha.ca www.camh.ca www.mdao.ca
SELF-ADMINISTERED TESTS Canadian Mental Health Association Centre for Addiction and Mental Health (CAMH) Dr. Daniel G. Amen’s Clinic (for ADD/ADHD) Juvenile Bipolar Research Foundation Mood Disorders Association of Ontario (MDAO)
www.cmha.ca www.camh.ca www.amenclinics.com www.bpchildresearch.org www.mdao.ca
SENSORY INTEGRATION/DYSFUNCTION Apraxia Kids Child and Parent Resource Institute (CPRI) Kidpower KidsAbility Centre for Child Development Tourette Syndrome Plus Waterloo Region Family Network
www.apraxia-kids.org www.cpri.ca www.kid-power.org www.kidsability.ca www.tourettesyndrome.net www.waterlooregionfamilynetwork.com
STRESS B.C. Partners for Mental Health & Addiction Information Families for Depression Awareness
Last update: 16-Oct-11
www.heretohelp.bc.on www.familyaware.org
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Website Resource Listing (continued) SUICIDE Befrienders International Canadian Health Network Canadian Mental Health Association Centre for Suicide Prevention Mood Disorders Association of Ontario (MDAO) Ontario Assoc. for Suicide Prevention (OASP)
www.suicideinfo.org www.canadian-health-network.ca www.cmha.ca www.suicideinfo.ca www.mdao.ca www.ospn.ca
TEACHING and or STUDENT and or PARENT TIPS/STRATEGIES ABCs of Mental Health www.brocku.ca/teacherresource/ABC/ Access To Learning Canada (ATLC) www.accesstolearning.ca Brain Gym www.braingym.org Integrated Centre for Optimal Learners www.ICOLsolutions.com Mood Disorders Association of Ontario (MDAO) www.mdao.ca Parents for Children’s Mental Health (PCMH) www.pcmh.ca Raising Small Souls, Ellen C, Braun www.Raisingsmallsouls.com Right Brained Learners www.visualspatial.org Ten Suggestions for Positive Parenting www.energyconnectiontherapies.com Iris the Dragon Series – books and units of study Email – info@iristhedragon.com TOURETTE SYNDROME American Academy of Child and Adolescent Psychiatry (AACAP) Child and Parent Resource Institute (CPRI) Children’s Mental Health Ontario Life’s A Twitch, Dr. Duncan McKinlay Tourette Syndrome Foundation of Canada Tourette Syndrome Plus Tourette Syndrome Association of Ontario TRANSLATION/MULTICULTURAL SERVICES American Academy of Child and Adolescent Psychiatry (AACAP) Cambridge YMCA Cross Cultural and Immigration Services Canadian Mental Health Association Centre for Addiction and Mental Health Cultural Profiles Project Kitchener-Waterloo Multicultural Centre
Last update: 16-Oct-11
www.aacap.org www.cpri.ca www.kidsmentalhealth.ca www.lifesatwitch.com www.tourette.ca www.tourettesyndrome.net www.tourettesyndromeontario.ca
www.aacap.org www.ymcacambridge.com wwwcmha.ca www.camh.ca www.cp-pc.ca www.kwmc.on.ca
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Website Resource Listing (continued) TRANSLATION/MULTICULTURAL SERVICES cont’d Kitchener-Waterloo YMCA Cross Cultural and Immigration Services National Institute of Drug Abuse Tourette Syndrome Plus TRANSITIONS Aspire Ministry of Education www.edu.gov.on.ca Parents for Children’s Mental Health Waterloo Region Family Network TRAUMA Australian Child and Adolescent Trauma, Loss and Grief Network (ACARLGN) Child Trauma Academy kidsLINK Klinic Community Health Centre The National Child Traumatic Stress Network The Association of Chief Psychologists with Ontario School Boards Trauma Center at Justice Resource Institute
www.kwymca.org www.nida.nih.gov www.tourettesyndrome.net www.aspirewory.org www.pcmh.ca www.waterlooregionfamilynetwork.com
www.earlytraumagrief.anu.edu.au www.childtrauma.org www.kidslinkcares.com www.clinic.mb.ca www.nctsnet.org www.acposb.on.ca www.traumacenter.org
NOTES
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Glossary of Terms Advocate – ad vo cate To speak or write in favour of; support or urge by argument; recommend publicly. A person who speaks or writes in support or defense of a person, cause, etc. Accommodation - ac·com·mo·da·tion as used in psychology this is the process of changing or modifying existing behaviours and routines to new ones. as used in education are changes made in the classroom to assist a child with a disability – learning or physical.
Apprehension – ap·pre·hen·sion a fearful emotion.
Behaviour modification - be·hav·iour + mod·i·fi·ca·tion A method of therapy that is concerned with the treatment of behaviours that are unacceptable or undesirable and teaches substitution of appropriate responses.
Binge – binge is any behavior indulged to excess. As used in an eating disorder; binge eating is a pattern of eating which consists of uncontrollable overeating.
Bio-chemical -bio·chem·i·cal This involves chemical reactions or a defect in the brain.
Biofeedback – bio feed back is a technique that uses monitoring instruments to measure and feed-back information about muscle tension, heart rate, sweat responses, skin temperature, or brain activity. Blasphemy - blas·phe·my is the disrespectful use of the name of one or more gods. It may include using the names of these gods when swearing. Chronic or chronically – chron·ic continuing a long time or recurring frequently: a chronic state of civil war. having long had a disease, habit, weakness. Cognitive Behavioral Therapy (CBT) - cog ni tive + be ha viou r al + ther a py is a term for a therapy system that deals with cognition, interpretation, beliefs and the person’s responses, with the aim of changing undesirable emotions and behaviours. Complex - com·plex complicated – many things to look at. Communication – com mun i ca tion an attempt to express and understand one’s own ideas as well as others. Comorbid – co·mor·bid This refers to two conditions that are usually found together in the same person.
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Glossary of Terms Compensation - com·pen·sa·tion is a strategy whereby one covers up, consciously or unconsciously, weaknesses, frustrations, desires, feelings of inadequacy or incompetence in one life area through striving for excellence in another areas.
Compulsions – com pul sions is a repetitive, excessive, meaningless activity or mental exercise that a person performs in an attempt to avoid distress or worry.
Concurrent – con cur rent Simultaneous; occurring at the same time or together.
Conduct Disorder - con duct + dis or der describes a pattern of repeated behaviours where the rights of others or the current social norms are violated. Symptoms include verbal and physical aggression, cruel behaviour toward people and pets, destructive behaviour, lying, truancy, vandalism, and stealing.
Confrontational – con fron ta tion al Strongly expressing ideas that are in opposition of another person’s (which may result in conflict).
Congenital - con·gen·i·tal A congenital disorder involves damage to the fetus while it was being developed. As a result certain conditions are then present at birth. Consequences- con·se·quence the effect, result, or outcome of something occurring earlier
Co-occurrence – co oc cur rence Happening at the same time. two conditions that the same person may have.
Counsellor – coun sel lor is a person who is involved in counselling. It refers to a person who is concerned with the profession of giving advice on various things such as academic matters, vocational issues and personal relationships. He is generally a professional and an expert in his field of functioning. There are different types of counsellors such as rehabilitation counsellor, Marriage and Family counsellor, School counsellor, Mental Health counsellor, online counsellor and Legal counsellor.
Curricula – cur-ric-u-la Course(s) offered by an educational institution
Debilitating - de bil i tat ing to weaken or to impair the strength of.
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Glossary of Terms Delusion - de lu sion A false belief based on an incorrect assumption about external reality that is firmly sustained despite what almost everybody else believes and even with proof to the contrary.
Dependency – de pen den cy as used in Addiction/Substance Abuse, the need for a substance is so strong that it becomes necessary to have this substance to function properly. Developmental disability – de vel op men tal + dis a bil i ty is a term used to describe life-long disabilities attributable to mental and/or physical or a combination of mental and physical impairments, Diagnosis - di·ag·no·sis, has two distinct dictionary definitions: The recognition of a disease or condition by its outward signs and symptoms. The analysis of the underlying physiological/biochemical cause(s) of a disease or condition.
Disinhibition - dis·in·hi·bi·tion a term in psychology used to describe conditions of a person being unable (rather than disinclined) to control their immediate impulsive response to a situation.
Dopamine - do·pa·mine is a hormone and neurotransmitter in the brain that activates certain actions.
Dysfunction – dys·func·tion relates to abnormal behaviour.
Dyslexia - dys·lex·ia a learning disability that manifests primarily as a difficulty with written language, particularly with reading and spelling with reversals of characters.
Dysthymia – dys thy mia is a mood disorder that falls within the depression spectrum. It is considered chronic depression, but with less severity than major depression.
Empathy - em pa thy is the ability to recognize or understand someone else’s state of mind or emotion.
Eccentric – ec·cen·tric unusual or odd behaviour on the part of a person
Extraneous stimuli – ex tra ne ous + stim u li outside influences
Global – glob·al applying to a whole person or all parts of
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Glossary of Terms Glorification – glor i fi ca tion The act of raising to a high position or status or the condition of being so raised The honoring of a deity, as in worship
Hallucination - hal·lu·ci·na·tion defined as perceptions while you are awake which have the qualities of reality but are not.
Heart palpitations – heart + pal pi ta tions are an abnormal awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency.
Holistic – ho·lis·tic holistic medicine attempts to treat both the mind and the body. Hyper-arousal
- hy.per+a.rous.al
To stir to greater degrees of action or strong response than most people
Hyper-vigilant – hy per + vig i lant above or beyond the normal watchfulness or alertness. Impact
- im·pact The influence or effect of something
Impulsive, Impulsivity (or impulsiveness) - im·pul·siv·i·ty is acting on an idea without thinking it through.
Inattentive – in at ten tive not attentive; not paying attention.
Inclusion – in clu sion children with disabilities in natural environments with peers who do not have disabilities. a sense of belonging – being part of a community, valued as a contributing member. accepting differences and making accommodations for individual needs and differences.
Inhalants - in·hal·ant are a broad range of drugs in the forms of gases, aerosols, or solvents which are breathed in and absorbed through the lungs.
In-service – in ser vice Training conducted on-site and in-house during school/work time either by staff or contracted trainer.
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Glossary of Terms Isolation - iso·la·tion as used in Cutting/Self Harm means no longer seeking to be with friends and family and to prefer being alone.
Lethargy - leth·ar·gy also called exhaustion, is a weariness caused by exertion. It can describe a range of illnesses and can be both physical and mental.
Mandated - man·date a command or authorization to act in a particular way on a public issue given by the electorate to its representative
Manipulative – ma·nip·u·la·tive the ability to handle and/or alter some object or information or to convince someone of something else.
Manipulation - ma·nip·u·la·tion a means of gaining control or social influence over others by methods which might be considered unfair.
Metabolism - me·tab·o·lism is the set of chemical reactions that occur in a living body in order to maintain life.
Mis-interpreting – mis-int-er-pret-ing to understand wrongly
Multiaxial – mul ti·ax ial looks at multiple domains/areas of a person’s functioning.
Multidimensional – mul ti·di men sion al The understanding of a person through examination of their various domains/areas of functioning. Multidisciplinary – mul ti·dis cip lin ary is a non-integrative mixture of disciplines in that each discipline retains its methodologies and assumptions without change or development from other disciplines within the multidisciplinary relationship. Myths - myth a traditional or legendary story, usually concerning some being or hero or event, often without a determinable basis of fact or a natural explanation. Neurobehavioural – neu·ro·be·hav·ior·al of or relating to the relationship between the action of the nervous system and behaviors such as learning disabilities.
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Glossary of Terms Neurobiology - neu·ro·bi·ol·o·gy the branch of biology that is concerned with the anatomy and physiology of the nervous system. Neurology - neu·rol·o·gy is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. Neuorological disorder - neu rol o gic al + dis or der Disturbance in structure or function of the nervous system resulting from developmental abnormality, disease, injury, or toxin Obsession – ob-ses-sion A persistent pre-occupation with an idea or feeling. Occupational therapy – oc cup a tion al + ther a py Skilled treatment that helps people return to ordinary tasks around school, home and at work by maximizing physical potential through lifestyle. Oppositional - op·po·si·tion·al is described as an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior. Palpitation - pal·pi·ta·tion is an abnormal awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. Palpebral fissures – pal·pe·bral + fis·sures separation between the upper and lower eyelids Perception - per·cep·tion is the process of attaining an awareness or understanding of sensory information Pervasive developmental disorders (PDD) – per va sive + de vel op men tal + dis or der as opposed to specific developmental disorders (SDD), refers to a group of five disorders characterized by delays in the development of multiple basic functions including socialization and communication. Pervasive impairment - per va sive + im pair ment (everywhere), intractable (not easily relieved or cured) loss of normal function of part of the body due to disease or injury Philtrum - phil·trum is the vertical groove in the upper lip.
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Glossary of Terms Phonological – pho·no·log·i·cal is the science of speech sounds including the phonetics and phonemics of a language at a particular time the ability to use sound to determine the meaning of spoken language. Physiological – phys·i·o·log·i·cal characteristic of, or appropriate to, our healthy or normal functioning , based in the mechanical, physical, and biochemical functions of the person. Predispose - pre·dis·pose to have a tendency towards something Preferential - pref·er·en·tial showing or giving preference. Preoccupation – pre·oc·cu·pa·tion worrying about or thinking about something more than what is considered normal. Prognosis - prog·no·sis is a medical term for the doctor's prediction of how a patient's disease will progress, and whether there is a chance of recovery. This word is often used in medical reports to call attention to the doctor's view on a case. Proprioception – pro·pri·o·cep·tion is the reaction to bodily sensations. Psychiatrist - psy·chi·a·trist is a physician who specializes in psychiatry and is certified in treating mental disorders. Psycho-educational - psy·cho·edu·ca·tion·al assessment and intervention target a student's function within his or her educational setting. Psychological assessment - psy·chol·o·gic·al + as·sess·ment is a process that involves the integration of information from multiple sources, such as psychological tests, and other information such as personal and medical history, description of current symptoms and problems by either self or others, and collateral information (interviews with other persons about the person being assessed). Psychologist - psy·chol·o·gist is a practitioner of psychology, the scientific investigation of the mind, including behaviour, cognition, and affect. Psychotherapy – psy·cho·ther·a py treatment of mental or emotional disorder or of related bodily ills by psychological means.
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Glossary of Terms Psychometry - psy·chom·e·try measuring psychological attributes through a variety of tools and techniques which includes standardized testing. Psychosis - psy·cho·sis People experiencing psychosis may report hallucinations or delusional beliefs, and may exhibit personality changes and disorganized thinking. This may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out the activities of daily living. Psycho-social - psy·cho·so·cial refers to ones psychological development in and interaction with a social environment. The individual is not necessarily fully aware of this relationship with his or her environment. Recreation therapy – re·cre·a·tion + ther·a·py the broad spectrum of health care through treatment, education, and the provision of adapted recreational opportunities — all of which aid in improving and maintaining physical, cognitive, emotional, and social functioning. Recurrent – re·cur·rent the same issue returning after a period of absence. Remorse - re·morse is an emotional expression of personal regret felt by a person after he or she has committed an act which they deem to be shameful, hurtful, or violent. Repetitive – re·pet·i·tive repeating something over and over again. Sensory – sen·sory of or relating to the senses or sensation. Transmitting impulses from sense organs to nerve centers. Serotonin - se·ro·to·nin is a neurotransmitter in the central nervous system. Spectrum – spec·trum means that it is not limited to a specific set of values but can vary infinitely within a disability. Socio-economic - so·cio·eco·nom·ic one’s standing in society based on a variety of factors including income, education, etc. Social skills – so·cial + skills are a group of skills which people need to interact and communicate with others in a positive way. This is done using verbal and nonverbal ways.
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Glossary of Terms Spatial – spa·tial relating to the ability to perceive relations of objects in space Specific - spe·cif·ic particular. Stigma – stig·ma the feeling of shame or disgrace because of a disease/diagnosis/appearing different from others around you or others reaction to your diagnosis Stimulants - stim·u·lants are substances that are eaten or swallowed (coffee, medication) that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness and can be misused. Substitute Decision Maker – sub·sti·tu·tion + de·ci·sion + ma·ker anyone who makes care decisions for another person when that person is unable. Transitions - tran·si·tion movement, passage, or change from one position, state, stage, subject, concept, etc., to another; ex. the transition from adolescence to adulthood. Transposes – trans·po·ses to change the position of Traumatic – trau·mat·ic as used in Conduct Disorder means an emotional or psychological injury, usually resulting from an extremely stressful or life-threatening situation. Triage - tri·age the process of determining medical Truant - tru·ant is an intentional unauthorized absence from compulsory schooling. The term typically describes absences caused by students of their own free will. Vestibular - ves·tib·u·lar affecting how the body perceives position and movement. Vulnerability - vul·ner·a·ble open to moral or physical attack, criticism, temptation, etc.:
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NOTES
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Glossary of Acronyms AACAP ACSD ADD ADHD ARND ASD ASO BPD CAMH CAP CBT CD CMH CMHA CMHO CPRI CRA CYMHIN CYW DBT DID DSAC DSM-IV EA EAP EDAC EIEI EQA FACE FASD FCS GAD GRH HBHC IEP IF IPRC LD MDAO NEDIC NIMH OAEA OCD ODD ODSP PCL PCMH Last update: 16-Oct-11
American Academy of Child and Adolescent Psychiatry Assistance for Children with Severe Disabilities Attention Deficit Disorder Attention Deficit Hyperactivity Disorder Alcohol Related Neurological Disorder Autism Spectrum Disorder Autism Society Ontario Borderline Personality Disorder Centre for Addiction and Mental Health Child Advocacy Project Cognitive Behaviour Therapy Conduct Disorder Cambridge Memorial Hospital Canadian Mental Health Association Children’s Mental Health Ontario Child and Parent Resource Institute Canada Revenue Agency Child and Youth Mental Health Information Network Child and Youth Worker Dialectic Behaviour Therapy Dissociative Identity Disorder Developmental Services Access Centre Diagnostic and Statistical Manual Educational Assistant Employee Assistance Program Eating Disorders Awareness Coalition Early Identification, Early Intervention Education, Quality and Accountability Families for Awareness, Change and Education Fetal Alcohol Syndrome Disorder Family and Children’s Services Generalized Anxiety Disorder Grand River Hospital Healthy Babies, Healthy Children Individual Education Plan Inclusion Facilitator Identification, Placement & Review Committee Learning Disability Mood Disorder Association of Ontario National Eating Disorders Information Centre National Institute on Mental Health Ontario Association of Education Awareness Obsessive Compulsive Disorder Oppositional Defiant Disorder Ontario Disability Support Plan Parents for Community Living Parents for Children’s Mental Health Page 169
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Glossary of Acronyms PDD-NOS PTSD RAD RMHC SAD SEAC SSAH SSRI’s TS WRCSB WRDSB WRP YMCA
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Pervasive Developmental Disorder – Not Otherwise Specified Post Traumatic Stress Disorder Reactive Attachment Disorder Regional Mental Health Care Seasonal Affective Disorder Special Education Advisory Committee Special Services At Home Selected Seratonin Re-uptake Inhibitors Tourette Syndrome Waterloo Region Catholic School Board Waterloo Region District School Board Waterloo Regional Police Young Mens Christian Association
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How Can You Help? Parents for Children’s Mental Health is a non-profit, parent run organization that provides a voice for children and their families who face the challenges of mental health. We work with families, the general public, mental health professionals and agencies, schools and government to provide education, support and advocacy. We are all volunteers, and we do not receive any financial compensation for our work. We do not receive any government funding for our operations.
Our Goals To advance the unique needs of children with emotional and behavioural disorders and their families To dissolve the stigma attached to children’s mental illness To advocate for research, prevention, early intervention, family support, education and other services needed by these children and their families To work with mental health agencies and government to ensure that children with emotional and behavioural disorders have access to community-based services to help them reach their full potential To provide volunteer support to families (for a listing of affiliated support groups, please see
listing under Finding Support).
You can help us to achieve these goals by providing your support in the following ways: Financial Donations: Monetary donations are most welcome and very much needed for us to continue to operate. Some examples: Individual donations, donations received from a child’s birthday party or event, fundraising activities, corporate donations, community grants Follow the easy step-by-step directions to donate @pcmh.ca website, click the “Donate Now” button. Scrolll down to the “Donate Now through CanadaHelps.org icon. If you mention the Waterloo Chapter in the message section, our chapter receives the money and it stays in the community.
In-kind Donations: Donating a product or service is as meaningful as a monetary contribution Some examples are: office supplies, materials for workshops, gifts for speakers, educational materials such as books and DVDs, meeting rooms, gift cards
Volunteer Donations: Give the gift of time! Some examples are: help plan or attend events, organize workshops, join a committee, set up a display, fundraise, and there’s more….
TO DONATE in any of these ways, PLEASE contact us by email at parent.advocacy@hotmail.com.
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Feedback Page PCMH Waterloo Region resource guide committee has tried to bring up-to-date and pertinent information to parents to the best of their ability. The scope of the material here is only what we have experienced or accessed ourselves. We recognize that such a resource can get outdated over time. If there is something not quite right, or if you would like to see additional information added, please let us know! Our resource guide is now available on line. Please feel free to access this guide at www.PCMHwaterloo.com to print a copy. For permission to reproduce the Guide in whole or part, please contact us. Some of our content is the intellectual or copyright property of others.
Feedback Form: How did you find out about our resource?
What did you find most helpful in this guide?
What would you change or improve in this guide?
Any additional suggestions for us?
Would you be interested in joining PCMH? Please call (519) 746-KIDS (5437) and ask for the PCMH representative.
Mail to:
E-mail: parent.advocacy@hotmail.com Website: www.PCMHwaterloo.com
1855 Notre Dame Drive St. Agatha, ON
N0B 2L0
Attention: PCMH Representative
Last update: 16-Oct-11
www.PCMHwaterloo.com
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