High Quality Health and Social Care Close to Home 1 Terrific 2 ’ s Gilda Lewis Health Visitor...
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Transcript of High Quality Health and Social Care Close to Home 1 Terrific 2 ’ s Gilda Lewis Health Visitor...
1High Quality Health and Social Care Close to Home
Terrific 2’s
• Gilda Lewis
• Health Visitor Practice Teacher
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What I’m going to cover
• Brief over view of brain development up to age 2
• What that means for behaviour and why• How we assess two year old
development, and the tools we use• What we do if we find something of
concern
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An embryo’s brain produces many more neurons, or nerve cells, than it needs, then eliminates the excess
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Spontaneous bursts of electrical activity strengthen some of these connections, while other (the connections not reinforced by activity) atrophy
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The axons spin out to create connection branches between many targets
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The connections that are used most are now insulated to further speed up connections
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Needs met
Appropriate stimulation/external environmental
factors
Yes
•Reinforcing of desirable pathways
•Secure attachment established
•Concentration skills improve
•Learning takes place
Abusive or stressful situation continues
No
Hyperaroused or dissociated infant
Yes
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The Healthy Child Programme
• The Healthy Child Programme for the early life stages focuses on a universal preventative service, providing families with a programme of screening, immunisation, health and development reviews, supplemented by advice around health, wellbeing and parenting.
• DoH 2009
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The Healthy Child ProgrammeHV Service delivery contacts
Antenatal (targeted)10-14 days post delivery6-8 weeks post delivery2,3,4,12 months and 3yrs 4 months8-12 months2 yearsAdditional support as required on assessment
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• The Health Visitor Implementation plan • levels of service delivery
Universal partnership plus
Universal
Universal plus
Community
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Process:
Health Visitor to oversee process and consider local services and practices alongside.
Type of Contact
Venue Setting
Staff Mix
Type of invitation sent out:
23 Months 24 Months
Letter Birthday card Email Text
Child Health Clinic
GP Surgery Children’s
Centres Home
Community Nursing.
Community Staff Nurse
Health Visitor Family Nurse
Individual
Or Group
LOW MEDIUM HIGH
Content of Reviews Elicit and respond to parental concerns. Assessment of: Raise Awareness of:
General development Healthy Nutrition Growth Immunisation Speech and Language Dental Health Social and emotional development. Injury Prevention
Offer Guidance: Sleep Management Behavioural Management Toilet Training Nutrition and Active Play Language Promotion Personal and emotional development in response to parental concerns
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What are Ages and Stages Questionnaires?
• ASQs are developmental screening tools to identify infants/children in need of further assessment
• ASQs development is the result of careful and thorough research and response to the need for a cost-effective, highly accurate tool for screening young children.
• Tool developed in US
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Why use ASQ?
• Actively involves parents• Researched for sensitivity, specificity,
reliability and positive predictive values.• Parent led questionnaires where parents
answer a series of simple questions regarding child’s behaviour
• Not a pass or fail approach
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• Enables assessment of child’s progress• Can be done by parent or WITH parent• Enables discussion regarding child’s
development• Enables matching of child and parent with
resources
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ASQ as a Parent Education Tool
• Each questionnaire discusses developmental activities tied to the age of the child being screened.
• In completing and reviewing the questionnaire, parents learn about general developmental milestones as well as their own child’s strengths.
• Parents find it helpful to receive suggested learning activities they can work on with their child. (Learning activity sheets can be photocopied from ASQ-3 User’s Guide, and more are available in the Ages & Stages Learning Activities.
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Scoring
• ASQ provides a score in each developmental area
• ASQ: SE provides a total score• LOW scores in ASQ are an indication of
concern• HIGH scores in ASQ:SE are an indication of
concern
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Conclusion
• We now know how the brain develops from birth to three
• How vital this period of brain development is as a basis for future development
• How understanding the services for two year olds can support optimum development through working effectively together