Psychosocial Needs 4 Hours 1 Smart Seminars 12/28/2017

Psychosocial Needs 4 Hours Instructor: Eric Brotman PHD

A condition is considered a developmental disability when it: Results in a significant mental or physical disability Occurs before the age of 18 Is something that goes on throughout a person's life Substantially affects the individual’s ability to function Often means there is a need for some kind of assistance in daily living

IQ 75 below Limitations in adaptive behavior – difficulty learning from experience Do not seek out novel stimulation Communication - language and speech Poor memory and learning disabilities Problem solving Impaired problem solving Lack of abstract thinking and logical Developmental delays May have behavior e.g. tantrums Onset distinguished as Developmental Disability Functional limitations in three or more of the following areas of major life activity: Self-care Receptive and expressive language Learning Mobility Self-direction Capacity for independent living Economic self-sufficiency

Statistics Vary widely in ID One to three percent of global population ( higher in third world countries) 200 million people in world 6.5 million people in US have ID 16.41 in every 1,000 people

Classification of Intellectual Disability YouTube Uploaded Apr 10, 2012 ADA Videos

https://www.youtube.com/watch?v=80rc4ZAtQ0I

What is Intellectual Disability The ARC Mar 1, 2011 http://www.thearc.org/page.aspx?pid=2448

Psychosocial Needs 4 Hours 2 Smart Seminars 12/28/2017

American Association on Intellectual and Developmental Disability Frequently asked questions on intellectual disability and the AAID definition https://aaidd.org/docs/default-source/sis-docs/aaiddfaqonid_template.pdf?sfvrsn=2

2016 Developmental Disability Statistics Annual Report A Publication of the Rehabilitation Research and Training Center on Disability Statistics and Demographics https://disabilitycompendium.org/sites/default/files/user-uploads/2016_AnnualReport.pdf

Video: 2.2 Minutes What is Intellectual Disability: Video Bethesda Lutheran Communities Youtube Uploaded Jul 5, 2011 Bethesda Lutheran Communities https://www.youtube.com/watch?v=V_mTP9WLdcI Video: 3.38 Minutes Causes of ID

Youtube Uploaded Jul 5, 2011 Bethesda Lutheran Communities

https://www.youtube.com/watch?v=dyjFJ19DF9Y

Video: 2.50 minutes Intellectual and Developmental Disabilities Research Center at Washington University YouTube Uploaded Feb 24, 2011

https://www.youtube.com/watch?v=5oNWnHjAOeI

Down Syndrome Most common cause of intellectual disability One in every 733 births Chromosome damage - risk increases with age of mother Most common is Trisomy 21 - 95% of people with Down Syndrome Developmental delays in walking, talking - facial characteristics Children with Down strengths in vocabulary/pragmatics (social interactive language Good receptive language difficulty with expressive Speech difficult area of Down of all ages. articulation oral-facial muscle tone Physical: hypotonia, vision, heart defects, hearing, gastrointestinal defects and thyroid Behavior challenges are same in general population Down Personality? sociable outgoing and happy - Social perception : Andrea Friedman vs Sarah Palin TV show Family Guy Palins Cry Foul on 'Family Guy' Down Syndrome Episode, Others See 'Sense of Humor ABC News Feb 20, 2010 http://abcnews.go.com/WN/sarah-palin-family-guy-controversy-rages/story?id=9898355 What is Down Syndrome National Down Syndrome Society http://www.ndss.org/about-down-syndrome/down-syndrome/ Video: 5.11 minutes

Psychosocial Needs 4 Hours 3 Smart Seminars 12/28/2017

Down Syndrome 101 Video Youtube Uploaded Utah Down Syndrome Foundati0on https://www.youtube.com/watch?v=nguLcSzN7mM Global Down Syndrome: Research Medical Care, Education and Advocacy https://www.globaldownsyndrome.org/about-down-syndrome/history-of-down-syndrome/research-and-medical-care-timeline/

Medical Conditions Associated with Down Syndrome

Heart Defects (CHD) leads to high blood pressure

Vision Problems – more than 60% have vision problems, cataracts, mear sighted, cross eyed.

Hearing Loss – 70 to 75% due to ear structure

Infections – 12 times more likely to die from untreated infections

Hypothyroidism – (Thyroid regulates energy and temperature

Blood Disorders – more likely to develop leukemia – anemia

Spinal Problems – misshapen bone leads to pain

Disturbed sleep patterns and apena breathing

Gum disease and dental problems

Epilepsy – more likely to have seizure disorder

Digestive Problems certain foods and structural deficits

Celiac Disease

Conditions Associated with Down Syndrome NIH https://www.nichd.nih.gov/health/topics/down/conditioninfo/Pages/associated.aspx Understanding Down Syndrome: Capturing Family Experiences through research Telethon Institute for Child Health Research https://www.downsyndrome.org.au/documents/research/understanding_down_syndrome_booklet.pdf Down Syndrome Stigma Historically viewed as unfit and should be warehoused in institutions Labeled imperils, morons and idiots In the early 20th century routinely sterilized People with Down Syndrome vied of incapable of living meaningful lives In one experiment in 195-s fed radioactive oatmeal to see how nutrients absorbed in body

Geraldo Rivera 1960s Expose of Willow Brook brought attention to the mistreatment of people

with Down and ID

Willowbrook, the institution that shocked a nation into changing its laws TimeLine

Psychosocial Needs 4 Hours 4 Smart Seminars 12/28/2017

https://timeline.com/willowbrook-the-institution-that-shocked-a-nation-into-changing-its-laws-c847acb44e0d Video: 2.55 minutes The Last Great Disgrace Trailer Youtube Uploaded Nov 6, 2011 https://www.youtube.com/watch?v=lWDt5IE8RPI Video: 4.4 Minutes Things People With Down Syndrome Are Tired of Hearing Youtube Uploaded BBC Three Aug 2, 2016 https://www.youtube.com/watch?time_continue=1&v=AAPmGW-GDHA Video: 4.28 Minutes A&E Network Original Documentary Series Born This way Youtube Uploaded Nov 30, 2015 https://www.youtube.com/watch?time_continue=105&v=-SJcP5MQ5Ys Down Syndrome and Sexuality Experiences same physical hormonal and emotional changes as other children Interested in sex like everyone else 50 percent of women with Down or fertile Sexuality education is critical in the context of interpersonal relationships William Schwab MD Sexuality and Down Syndrome https://www.kcdsg.org/files/content/Sexuality%20and%20Down%20Syndrome.pdf Down and Aging Accelerated aging due to chromone 21 (associated with aging procews) In down third full or partial copy of 21st chromone Slow down in 40’s and 50’s Sensory loss, early cataracts (cloou9idng of the lnse of the eye. Hearing Loss Alzheimer’s in Down More common in adults with Down than general population Aging and Down Syndrome Health and Well Being Guide Book National Down Syndrome Society http://www.ndss.org/wp-content/uploads/2017/11/Aging-and-Down-Syndrome.pdf Video: 3.54 minutes

Psychosocial Needs 4 Hours 5 Smart Seminars 12/28/2017

Dementia Care For Adults with Developmental Disabilities Youtube Uploaded Nov 29, 2010 Garth Honmer Society https://www.youtube.com/watch?time_continue=100&v=k_x9zJyQzu8

Autism

A neurodevelopmental disorder with difficulties:

Social interaction

Verbal and nonverbal communication deficits

Delay in language or no language

Repetitive or stereotypic behaviors

Rituals

Fixed Interests

Baron - Cohen, Simon

Autism and Asperger’s: The Facts

Oxford Press, 2008

https://www.amazon.com/Autism-Asperger-Syndrome-Facts-Baron-Cohen-

ebook/dp/B001FA0WL6/ref=sr_1_1?ie=UTF8&qid=1517413545&sr=8-

1&keywords=autism+simon+cohen

What is Autism

Autism Science Foundation

http://autismsciencefoundation.org/what-is-autism/

Causes? No link to vaccinations supported in research; original study has been found to be fraudulent Wakefield

Recent research did find a sensitivity to gluten but no relationship with Celiac’s disease. Abnormalities in brain development Brain scans have shown differences in shape and structure Genetic: odds increase if a parent or sibling have ASD

Largest-ever study of autism and celiac disease clarify earlier findings: supports parent reports of gluten sensitivities Autism Speaks Sep 25, 2013 https://www.autismspeaks.org/science/science-news/autism-study-finds-no-link-celiac-disease-gluten-reactivity-real

Vaccination Myth Andrew Wakefield fabricated research results in Lancelet study of Chron’s disease MMR Vaccine contains trace amounts of ethyl mercury in Thermisol Congressman Dan Burton conducts congressional hearings – grandson autism vaccine Jenny McCarthy debates CDC epidemiologists Parents stop having children vaccinated Removed Thermisol in 2002 in California rates continue to climb Herd immunity suffers in affluent communities e.g. Beverly Hills 70% Lower class immigrant communities 98% vaccination rates

Psychosocial Needs 4 Hours 6 Smart Seminars 12/28/2017

Anti Science atmosphere The MMR vaccine and autism: Sensation, refutation, retraction and fraud Indian Journal of Psychiatry Apr-Jun 2011 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/ How Bad Science Confuses the Press and Harms the Public Steven Salzberg MD, Dec 17, 2008 (findings are relevant despite 2008) Youtube Uploaded NCAS Video https://www.youtube.com/watch?v=YPwEdeW10z8 Autism Spectrum and Neurodevelopmental Disorders Psychiatric Times Dec 11, 2012 http://www.psychiatrictimes.com/articles/autism-spectrum-and-neurodevelopmental-disorders Leo Kanner discovered Autism in US 1940s research kids repetitive behaviors and extreme aloneness Studied 11 children for 12 years Autistic Aloneness: The inability to relate in ordinary ways to people and situations from the beginning of life. Extreme autistic aloneness: Disregarding, ignoring and shutting out outside stimulation.

Desire for sameness: Resistance to change.

Unique abilities Strong relation and attachment to objects

“The outstanding feature of autism is the child’s inability to relate in the ordinary way to people and situations for the beginning of life. There is an extreme autistic aloneness, that whenever possible , disregards ignores , shut out anything that comes into the child from the outside”

Kanner L

Autistic disturbances of affective contact

The Nervous Child 2: 217–50. 1943

Leo Kanner’s 1943 paper on autism

Gerald Fischbach

Dec 7, 2007

https://spectrumnews.org/opinion/viewpoint/leo-kanners-1943-paper-on-autism/ The Refrigerator Mother Theory of Autism

Psychosocial Needs 4 Hours 7 Smart Seminars 12/28/2017

Leo Bettelheim MD Kanner observed that parents of children were not warm Pushed view the Autism was caused by cold rejecting mother Spent time in concentration camp and observed behavior of prisoners Common view throughout 1960’s and 1970’s Refuted by Experimental Psychologist Bernard Rimland PHD who had son with autism Psychological vs Biological theory of causation. Early Infantile Autism and The Refrigerator Mother Theory (1943-1970) Embryo Project Encyclopedia https://embryo.asu.edu/pages/early-infantile-autism-and-refrigerator-mother-theory-1943-1970 Rimland, Bernard, PHD Infantile Autism Jessica Kinglsey 1964 https://www.amazon.com/dp/B00OPCRANE?tag=amz-mkt-chr-us-20&ascsubtag=1ba00-01000-org00-win10-other-nomod-us000-pcomp-feature-scomp&ref=bit_scomp_sav0 Hans Asperger 940s same time higher IQ impaired social - little professors Identifying characteristics Autism: low to high IQ, repetitive behaviors, impaired social interaction Fixed interests, always a delay in language

Difficulty understanding gestures and facial expressions Normal to high IQ Repetitive stereotypical behaviors and fixations Clumsy movements. One sided conversation. Talk about favorite topic in detail. Little Professors. Clarify difference between autism and Asperger’s Hans Asperger Definition Autism UK Independent https://www.autismuk.com/home-page/history-of-autism/hans-asperger-definition/ What is Asperger’s Syndrome Autism Speaks https://www.autismspeaks.org/what-autism/asperger-syndrome Early Detection Autism Reliable diagnosis by age 3 Parents first to identify major signs: Not Responding to sound of own name (powerful sign) Fascination with mechanical objects Lack of interest in people and social play Lack of joint attention Silent withdrawn Repetitive behaviors without purpose

Psychosocial Needs 4 Hours 8 Smart Seminars 12/28/2017

Head banging and other SIB Delay in language – lack of babbling Brown, Phyllis Early Intervention lesson autism symptoms University of California News Sept 9, 2014 https://www.universityofcalifornia.edu/news/early-intervention-lessens-autism-symptoms Video: 9.02 minutes Early Signs of Autism Video Tutorial Youtube uploaded Jun 11, 2013, Kennedy Krieger Institute https://www.youtube.com/watch?v=YtvP5A5OHpU Temple Grandin Autism grew up with autism grew up in 50’s Mother educated her in social skills Fascination with animals Leading word speaker on autism Work with animals designed cattle yards Leading world speaker on autism Keen sensitivity to understanding social skills aspects and non verbal IQ over verbal Grandin, Temple Thinking in Pictures: My Life with Autism Vintage Books 2006 https://www.amazon.com/Thinking-Pictures-Expanded-Life-Autism/dp/0307275655/ref=pd_sim_14_1?_encoding=UTF8&pd_rd_i=0307275655&pd_rd_r=EG0FK9ZTRN0271YYQ7VJ&pd_rd_w=JO4Kb&pd_rd_wg=xoFdY&psc=1&refRID=EG0FK9ZTRN0271YYQ7VJ Video: 8 minutes Stairway to Heaven Temple Grandin Part 1 Uploaded Sept 9, 2009 Mindtrick https://www.youtube.com/watch?v=8QCWeMHU6y0&list=PLCAE833A19175EA80 Video: 3.54 minutes HBO Original Film with Clare Dane Youtube Uploaded Feb 5, 2010, American Humane https://www.youtube.com/watch?v=bnI_Y8PyTHM Simon Baron Cohen Theory of Mind: Mind Blindness Extreme Male Theory of Autism

Psychosocial Needs 4 Hours 9 Smart Seminars 12/28/2017

MIND-BLINDNESS:

an inability to know what others are thinking

Synapse: Connecting Lives

http://www.autism-help.org/communication-mind-blindness.htm

Cohen, Simon Baron

The Essential Difference: Male And Female Brains And The Truth About Autism

Preuss Book Group 2004 New York

https://www.amazon.com/dp/B009K48144/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

World renown researcher discusses his ground breaking theories of autism support services and educational products Autism Speaks https://www.autismspeaks.org/science/science-news/qa-autism-pioneer-simon-baron-cohen Video: 3.53 minutes The False Belief Test: Theory of Mind Uploaded Jam 7, 2010 https://www.youtube.com/watch?v=8hLubgpY2_w Residential Care with Autism Clients Learn to look at world from point of view of resident Behavior intervention discussed in Non Violent Intervention section Fragile X Most common form of intellectual disability (100,000 in US) one in 3500 males Gene mutation/ cause of autism - up to 30% have autism Leaning problems, delays, high rate of epilepsy and sensory difficulties Physical characteristics: large ears and long face - develop at puberty Good memory for pictures and visual patterns Poor concept formation and problem solving Social anxiety and behaviors: tantrums hitting biting repetitive behaviors Up to 40% also have epilepsy May suffer from severe deficits in language and speech (many in social context) National Fragile X Foundation Fragile X Foundation https://fragilex.org/learn/ What Is Fragile X CDC https://www.cdc.gov/ncbddd/fxs/facts.html Video: 7.37 minutes

Psychosocial Needs 4 Hours 10 Smart Seminars 12/28/2017

What is Fragile X Youtube Uploaded Oct 9, 2017, Fragile X Society UK https://www.youtube.com/watch?v=pgUZsOGOlfk Fetal Alcohol Syndrome (FAS) FASD is a catch all term to describe various effects of prenatal alcohol exposure. Leading cause of ID – most have normal IQ Characteristics of FAS Abnormal facial features, smooth ridge between nose and upper lip (ridge is philtrum) FAS Diagnostic Prevention Network https://depts.washington.edu/fasdpn/htmls/fas-face.htm

Small head size Shorter-than-average height Low body weight Poor coordination Hyperactive behavior

Difficulty with attention

Poor memory

Difficulty in school (especially with math)

Learning disabilities

Speech and language delays

Intellectual disability or low IQ

Poor reasoning and judgment skills

Sleep and sucking problems as a baby

Vision or hearing problems

Problems eating and sleeping

Impaired hearing and vision and speech

Difficulty following directions and learning how to do simple things

Trouble paying attention and learning in school

Difficulty getting along with others and controlling their behavior

Trouble regulating their emotions

Need for medical care all their lives

Case Study FAS Matthew B Fetal Alcohol Community Resource Center http://www.come-over.to/FAS/VocRehabMatthew.htm Case Study FAS A Child With Fetal Alcohol Syndrome Interdisciplinary Clinical Assessment of Young Children with Developmental Disabilities Clarren et al. 2000 https://depts.washington.edu/fasdpn/pdfs/child.pdf Fetal Alcohol Spectrum Disorder Case Studies

Psychosocial Needs 4 Hours 11 Smart Seminars 12/28/2017

Worcestershire Early Years and Childcare Services https://www.choiceforum.org/docs/fasdcasest.pdf Common Misinterpretations of Normal Responses in Students with FASD Understanding Fetal Alcohol Spectrum Disorders (FASD) Duke University https://sites.duke.edu/fasd/chapter-6-the-fasd-student-and-behavioral-issues/ Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): ND-PAE was first included as a recognized condition in the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013 (1) thinking and memory, trouble planning or may forget material already learned, (2) behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another (3) trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children. (4) the mother of the child must have consumed more than minimal levels of alcohol before the child’s birth, which APA defines as more than 13 alcoholic drinks per month of pregnancy (that is, any 30-day period of pregnancy) or more than 2 alcoholic drinks in one sitting. End to Alphabet Soup: FASD and Changes in the DSM5 Psychology Today Individuals affected by exposure to alcohol have a diagnostic code in the DSM 5. https://www.psychologytoday.com/blog/aristotles-child/201403/end-alphabet-soup-fasd-and-changes-in-the-dsm5 Video: 2.57 Minutes Fetal Alcohol Syndrome YouTube Uploaded Apr 24, 2013 Calgary TV https://www.youtube.com/watch?v=8nzxwWJw0vI CDC Facts About Fetal Alcohol Syndrome https://www.cdc.gov/ncbddd/fasd/facts.html Epilepsy (catch all term to describe seizures) Brain Disorder in which neurons are firing in brain Many famous people had or have epilepsy: name some One of oldest conditions of humans Types of seizures Generalized Seizures Entire Brain is effected

Psychosocial Needs 4 Hours 12 Smart Seminars 12/28/2017

Tonic Clonic (Grand Mal) Partial Seizures Absence Seizures (petit mal) Focal Seizure Types of Seizures Epilepsy Foundation https://www.epilepsy.com/learn/types-seizures Treatment Deep Brain stimulation Vegas Nerve Stimulation Surgery Medications and treatment Keeping seizure logs When to Call 911 Seizures lasts more than 3 minutes or in water Status Epilepticus Video: 2.37 minutes Seizure Response First Aid Youtube Uploaded Sep 19, 2013, Synapse https://www.youtube.com/watch?time_continue=6&v=MKAhD4xO0FY Childhood Epilepsy Dravet Syndrome: hundreds of seizures in one day – die by age 6 or 7 Charlette Fiji first child with Dravet treated with CBC Cannibis Medical Marijuana to Treat Epilepsy https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/other-treatment-approaches/medical-marijuana-and-epilepsy What is Epilepsy https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy Prader Willie Syndrome Rare disorder - constant sense of hunger. not inherited: mutation of gene Begins at age 2 suffer from hypotonia Want to eat constantly - they never feel full (hyperphagia) One in 10,000 Chronic overeating leads to obesity, diabetes Mild to moderate intellectual impairment and learning disabilities Temper outbursts, stubborn, compulsive behaviors such as picking skin Interventions - Prader Willie Homes -Food must be locked Move away from focus on food.

Psychosocial Needs 4 Hours 13 Smart Seminars 12/28/2017

Prader Willie Syndrome Foundation For Prader Willi Research https://www.fpwr.org/about-prader-willi-syndrome/?gclid=CjwKEAjwpMLOBRC9mb-H_c6q4VISJAD4hnmQZiO3aBRpx116TG6uHk-nid-SoqYnuXgpFAtLH22OgxoCwJTw_wcB Video: 6.44 Minutes Prader Willie Syndrome Uploaded Youtube Aug 5,2010, UNC-TV https://www.youtube.com/watch?v=JDmvqLK7S_0 Case Study Actual case from day program. Julie suffered from PW. Tantrums when food schedule was late by less than a minute and steals scavenge food trash. Screamed for hours. Interventions developed restaurant obsession. Alzheimer’s Disorder Memory impairment and loss Confusion Mood swings Personality changes Behaviors Difficulty with language No treatment to address cause drug treatment may temporality improve symptoms some evidence that exercise and lifestyle change may prevent Down Syndrome prone to develop in 50’s Other types of dementia Vascular Subcortical dementia Most Common Forms of Dementia Alzheimer’s Association http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp Chronic Degeneration of Brain NIH https://www.nia.nih.gov/health/alzheimers What is Alzheimer’s CDC https://www.cdc.gov/aging/aginginfo/alzheimers.htm Schizophrenia – Broken Mind Thought disorder Perceptual impairment Hallucinations Auditory: hearing voices that are often consistent with delusion Visual: seeing things that are not there – more serious break

Psychosocial Needs 4 Hours 14 Smart Seminars 12/28/2017

Olfactory: smelling things Tactile: feeling things in skin or brain Delusions False Beliefs can be organized or fleeting Describe examples from case experience and movie Beautiful Mind (story Johnathan Nash) Poverty of thought Confusion Loss of motivation – negative symptom Depression Poverty of Thought Treatment Medications – first and second generation anti psychotics Social therapeutic Schizophrenia NIMH https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml Schizophrenia Overview National Association of Mental Illness https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia Bipolar Disorder Mood swings must have manic episode Mania characterized by psychosis that is grandiose often with hallucinations Extreme energy, omnipotence, drug use, promiscuity, power and self-importance Depression is severe with vegetative symptoms and suicide Different types of cycles: over weeks, months and mixed Medications: anti convulsant and lithium Bipolar Disorder https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder Kay Jamison discusses mental illness symptoms, overcoming stigma at Chancellor’s

Lecture

https://news.vanderbilt.edu/2017/02/02/jamison-discusses-mental-illness-symptoms-overcoming-stigma-at-chancellors-lecture/ Video: 5.5 minutes Descent into Madness Kay Redfield Jamison Uploaded BigThink Apr 22, 2012 https://www.youtube.com/watch?v=LhzbAzSPWQ4 Depression Chronic

Psychosocial Needs 4 Hours 15 Smart Seminars 12/28/2017

Reactive -adjustment disorder with recovery Self esteem Energy Medications and therapy NIH https://www.nimh.nih.gov/health/publications/depression/index.shtml Alcohol and Drug Abuse Common in mentally ill population Lower SES higher risk One half to one third of severe mentally ill abuse alcohol and drugs Drugs often used to self-medicate Anxiety and depression less painful when high Alcohol and drugs can worsen underlying mental illness Use of drugs and alcohol makes for worse prognosis for mental illness Severe cases of alcohol intoxication my require emergency treatment Amphetamine, crack cocaine can result in heart attacks stroke and or death Resistance to admitting problem National Institute of Drug Abuse https://www.drugabuse.gov/ Alcoholics Anonymous https://www.aa.org/ Narcotics Anonymous https://www.na.org/ Bereavement Severe stressor Everyone reacts differently. normal grieving is acute painful period of dealing with loss with recovery Complicated bereavement becomes chronic Intense sorrow that is ongoing Becomes persistent preoccupation and longing Numbness and detachment from others Suicidal ideation and possible attempt Therapy ideal intervention Developmentally disabled with limited language and resources important to convey empathic response and listen. Bereavement Juneau Alliance For Mental Health http://www.jamhi.org/poc/view_links.php?lt=Videos&cn=58 Client Rights JFK and Sargent Shriver catalyst for recognition of DD population Special Olympics single most important event to bring attention to DD

Psychosocial Needs 4 Hours 16 Smart Seminars 12/28/2017

Move away from viewing DD as limiting or disorder in itself People like everyone else who have challenges JFK and People with Intellectual Disability JFK Presidential Library https://www.jfklibrary.org/JFK/JFK-in-History/JFK-and-People-with-Intellectual-Disabilities.aspx Bernard Rimland, PHD 60s debated Bruno Bettelheim on Autism Strong voice for the idea that DD population out of institutions into community and jobs Client centered or person-centered planning. The old medical model of the doctor on top is out. People have a right to fail. Regional Center System outgrowth of LPS ACT in 1973 http://www.arf35.com/residents-and-regional-center/ Family Involvement - DD B age 10 most children with DD have visited more health care professionals than all the people they know Self-concept quickly developed that there is something wrong with me Most kids with DD form strong relationship with family member who functions as their primary guide. Negative attitudes effect self-concept and esteem Most families experience myriad of emotions and issues: shame, guilt, denial over protective is obvious common dynamic Understanding Disability Chapter 1 World Heath Report http://www.who.int/disabilities/world_report/2011/chapter1.pdf Developmental Disability and Culture Different cultures respond differently Hispanic culture in general values support and interdependence American culture tends to value independence and autonomy Asian cultures often experience heightened shame associated with DD Middle Eastern tend to emphasize independence as well as strong ties and support Developmental Disability Across Culture Caring for Kids https://www.kidsnewtocanada.ca/mental-health/developmental-disability

Psychosocial Needs 4 Hours 17 Smart Seminars 12/28/2017

Employment with DD population Often little concern or emphasis on matching consumer with job that maximizes abilities and preference - jobs are boring Jobs may be limited to contracts Time analysis often results in consumer receiving tiny income Job coaching and work in retail and other venues option but often limited availability, HCBS Guidelines Consumers involved in community Payroll jobs in businesses Meaningful volunteer work in government or nonprofit Deadline extended to 2022 Regulatory Guidelines for Home and Community Based Settings

Medicaid

https://www.medicaid.gov/medicaid/hcbs/downloads/requirements-for-home-and-community-

settings.pdf

Microenterprise is a small entrepreneurial activity. Small investment to produce products and provide services ay programs can support this activity Microenterprise Options for People with Intellectual and Developmental Disabilities: An Outcome Evaluation http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.627.4059&rep=rep1&type=pdf Sexuality Curriculum Planned Parenthood Myths about sexuality and developmentally disability intimacy and social skills Contraception STDs Sexual orientation Consent Developmental Disability Sexuality Curriculum Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-northern-new-england/local-education-training/development-disabilites-sexuality Sexuality and Disability Sexuality and People With ID and Other Disabilities https://ici.umn.edu/products/impact/232/232.pdf%20IMPACT Sex Life and Sexuality of Individuals with Developmental Disabilities: A Critical Review of The Literature Research Paper Denise Zirke Brouillard Graduate School University of Wisconsin-Stout Menomonie, WI 2006 http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.390.5484&rep=rep1&type=pdf

Psychosocial Needs 4 Hours 18 Smart Seminars 12/28/2017