Assignment: Meeting the Needs of

Children And Families

March, 31st 2015

Student: Elizabeth Malik, 300742227

Professor: Lisa McCaie

Introduction to Summer and her family

• Summer is a three year old girl

• Summer has had a stroke which left her paralyzed on the left side of her body

• She lives at home with her father and mother

• Summer’s father works overtime to pay for her expenses and needs.

• Summer’s mother is her primary caregiver, she has recently hurt her back trying to carry Summer who has been getting heavier and harder to carry.

Pediatric Stroke

• “A stroke is caused by the interruption of normal flow of blood to the brain, either by a blockage or a rupture in the blood vessels.” http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

• When the brain does not receive blood it can cause brain cells to die.

• “Children may experience two types of strokes: hemorrhagic stroke (rupture of blood vessels), or ischemic stroke (blockage caused by a blood clot).”http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

Informative Video On Stroke’s

• https://www.youtube.com/watch?v=PY8EszDP3jY

Possible effects of pediatric strokes

• Weakness on one side of the body

• Paralysis on one side of the body

• Difficulty with speech and language

• Vision problems

• Loss of emotional control/ mood changes

• Problems with memory, judgment and problem-solving

• Trouble swallowing

• Inability to control urine and bowel movements

• http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

Treatment for pediatric stroke

• “Treatment for hemorrhagic stroke: focuses on stabilizing the child and treating the hemorrhagic itself. Kids who have had a hemorrhagic stroke will be looked after by the vascular neurosurgery team. Surgical options may include a clip in the aneurysm or remove the abnormal vessel” http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

• “Treatment for ischemic stroke. The goal of treatment is to reduce damage to the brain and prevent another stroke. If child has been diagnose with an ischemic stroke, doctors will most likely prescribe blood thinners.” http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

Summer’s Stroke

• Summer is paralyzed on the left side of her body, which means the stroke affected “The right side of her brain” The right side of the brain controls skills such as “memory, organization, social communications (pragmatics), orientation, reasoning and problem solving, perception and attention”

Wheel Chair

• Providing Summer with a wheelchair will allow her to become independent with movement and will help her mother by not needing to carry Summer as much which might help with her back pain.

Electric wheelchair, allows for Summer to use her right hand to control the wheelchair movements, Rather than non electric wheelchairs which both hands are needed to spin the wheels.

Will allow Summer to participate in sports activities with peers being active is an important part the health and well being of children!

Wheel Chair Poncho to stay dry!

Rolling Walkers

• Although Summer is paralyzed on the left side of her body, her right side is still functioning we do not want to lose the muscles on this side so we will gradually introduce her to using rolling walkers.

Summer will be at her peers eye level unlike when in the wheel chair. She can still use wheelchair when needed, depending on her ability!

Will assist with poor balance, decreased weight bearing and decreased endurance

Promotes inclusion of children with special needs

Cane

• Depending on Summers ability providing her the chance to maneuver with a cane will give her the independence of relying less on a bulky mobility device and will help improve balance and coordination.

Seat cane will allow for Summer to sit whenever she feels she is tired or in needs to sit.

Will allow for peers to be at eye level and maneuver around similar pace!

Wheel Chair Ramps

• Ensuring that our centre is wheelchair accessible will provide Summer the independence of getting in and out of the centre on her own.

Under supervision of parents of RECE and centre staff !

Railings

• Having railings within the centre will allow Summer to help balance herself while maneuvering around, getting up, sitting down, etc.

Can play with peers and independently move around or

stand up with help from railings!

Push Buttons

• Push buttons on all the doors within the centre will allow Summer to move freely room to room without the help from others.

This push button would be best to have in child care because Summer will be able to look at the pictures to help her understand what to do!

Under supervision of parents,RECE, centre staff

Elevator

• Having an elevator within the centre will help Summer maneuver around the building freely and independently.

Under supervision of parents, RECE, or centre staff

Wheel Chair Accessible Washroom

• Having wheelchair accessible washrooms in the centre will allow Summer the independence to go to the washrooms alone and whenever needed.

•Washrooms equipped with handlebar grips!

Low sinks and high toilets

With supervision from RECE, parents, centre staff

Classroom Layout

• Having the classroom laid out in a way that will accommodate access for Summer and her wheelchair to maneuver anywhere at anytime. This will provide independence for Summer to move anywhere within the room or centre freely.

Ensure to keep pathways clear!

Hardwood or tiled floors throughout centre!

High tables, adaptable furniture

Adequate space to maneuver through each activity centre independently!

“Safety can be reinforced with books and pictures” class notes week 7

Names

• Adding names and pictures to cubby's, materials, activity centers and object within the room will help Summer remember where certain things are in the room!

Name tag and picture room for cubby's and materials

Soft Seats

• Providing soft seating for gathering time, reading centre etc, will help Summer feel

comfortable rather than having to sit on a hard floor.

Bed Raiser

• Summer will be able to move in and out of her bed during nap time with little to no assistance needed, which will allow her independence like peers.

Higher off the ground to make for easy transfer in and out of bed from wheelchair, walker, and canes!

Flexibility

• Providing flexibility in routines, schedules and activities will allow for Summer to feel confident and

comfortable throughout her day at the centre!

• More warning before transitions will help assist Summer with the effects of memory due to her stroke, reminders will help Summer understand and allow for

Summer to remember what’s to come!

• RECE’s, Parents and centre staff must remember to be as flexible as possible!

Social Communication

• When speaking to Summer a way we can make it easier for her to understand due to the

effects the stroke may have caused on her social communication will be to avoid sarcasm,

and metaphors.

Stabilizing

• “Stabilizing involves securing toys or materials” (Class notes, week 7)

• Having toys and materials stabilized will allow Summer to independently use the toys and materials with her right arm

only which will contribute to a much greater rate of success!

Observations

• Contentious informal, formal, and non-verbal observations made on Summer will help in determining her needs, ways to help, and things to change!

Development

Modeling

• Modeling social interactions will help Summer with her social communication which may have been effected during the process of her stroke.

• Children can model each other! –Class notes week 7

Ask 3 before me!!

Peer modeling

Buddy System

Asking Questions

• Finding out information from parents, staff etc will help in determining which steps to take to help Summer feel comfortable and safe in the environment!

Ways to help child achieve milestones!

Consistency

• Having a consistency schedule will help assist Summer in remembering what is to come throughout the day. Having

enlarged schedules , schedules posted everywhere (at children's level), and schedules Summer can keep with her, will all benefit her with memory that may be a struggle for

her due to the stroke.

Labeling Systems/PECS

• Summer may experience problems with concentrating, speech and language, and memorizing. Having visuals will help support confidence and reduce frustration that may be caused!

• PECS is a great system to use to help Summer with language and speech difficulty's she may face due to the stroke. It will help her gain confidence and self-esteem by allowing her to make choices and understand what is happening throughout the day!

Large font

Brail if vision is a problem

Prompting and fading less steps over time

Prompting and fading smaller pictures over time

Books and Toys

• Having a variety of books that promote inclusion of children with special needs will educate all children on diversity, acceptance, and inclusion! It will promote self-esteem and confidence for Summer to not be singled out on her special need rather educate all children including Summer on all types of special needs!

•

Staff

• Staff must be aware of Summer’s special need to help support her.

• Staff must be knowledgeable in the training needed in the event Summer or any child suffers from a stroke at the centre.

• On-going documentation and observations to help support Summer

• Private space for ECE and parents to communicate with one another.

• Caring, nurturing, sensitive, dedicated and loving staff members !

Teamwork

Relationships

Giving Instructions

• Summer may need extra time to process information she is receiving due to her stroke, allow 10 seconds before repeating an instruction which will allow Summer the ability to process the information without distractions!

• “Set realistic expectations” for Summer so she can achieve success

• Communicating at Summers eye level at all times will help her focus and also raise self-esteem.

Working With Parents

• Warm welcome

• Parent meetings held in quiet confidential area.

• Extra time made to communicate

• Celebrate success with families

• Provide resources

Sick Kids Family Centre• Summer’s Father is working overtime to pay for her expenses, the program at Sick Kids Family Centre will

enable help for filling out documents and forms to receive a drug coverage plan, this program also assists patients and families a range of other private and government programs. The program can share

information about accommodations, parking rates and other local resources

• There is a children’s library which provides a comfortable place for inpatient and outpatient families to relax, health information and services, education instruction through the TDSB teachers program

• Open Monday- Friday 9:30am-4:30 pm (Excluding weekends and Holidays), No cost

• Appointments are not necessary available walk in at anytime during the open hours, you can talk or email a trained volunteer to find out information about parents support groups, be referred to other information services etc.

• Family Centre, The Hospital for Sick Children 555 University Avenue Main floor, Room M200, Black Wing Toronto, ON M5G 1X8 Phone: 416-813-7903 email: family.centre@sickkids.ca

Resources

http://www.sickkids.ca/ProgramsandServices/centre-for-innovation-and-excellence/Family-Centre/index.html

Holland BloorviewRehabilitation Hospital

Provides programs and services for outpatient, early learning and development, swimming, respite, music and arts, therapeutic recreation and life skills, which will be very beneficial for Summer to take part in.

New clients are require a physician or dentist referral to access the programs and services. (Form is online at http://hollandbloorview.ca/programsandservices/Referrals#) and if you have any questions you can call 416-424-3804 for assistance

Holland Bloorview Kids Rehabilitation Hospital ,150 Kilgour Road Toronto, Ontario, Canada M4G 1R8

Tel: 416-425-6220 Toll Free: 1-800-363-2440

http://hollandbloorview.ca/Aboutus/ContactUs

Canadian Stroke Network

• A great online resource to help gain a deeper understanding regarding pediatric strokes.

• http://www.strokebestpractices.ca/wp-content/uploads/2011/10/PEDSGuide-EN.pdf

Family Caregiver Connections

• Family Caregiver Connections provide services to help support family care in the home! This service will be beneficial to Summer’s mother because she is the primary caregiver for Summer at the moment as may need assistance.

• They Provide, caregiving services, educational workshops, educational materials, group education and support, transportation services, In-Home respite care, Individual counseling and support, Information and referral services.

• They also help connect families with day programs, Financial Assistance, Health, wellness and fitness services, Friendly visitors and phone pal programs

• To speak to a Family Caregiver Coordinator and learn more about our programs, call our Information Line at 416-373-4093 or email us at: care@supportingfamilycare.com

• Mailing Address: 4211 Yonge Street, 4th floor. Toronto, ON M2P 2A9.

• Fax: 416-635-1692Business Hours:

• Monday-Thursday 8:30am-4:30pm and Friday 8:30am-3:30pm

• http://www.supportingfamilycare.com/

Telehealth Ontario• Telehealth is a free, confidential telephone service you can

call to get general health information 24/7 from a Registered Nurse.

• You can call in and describe at symptoms, seek information or resources to help you or a loved one.

• Telephone: 1-866-797-0000

• This service will help Summer and her family with any extra support they may need at any time of the day or night!

• http://www.health.gov.on.ca/en/public/programs/telehealth/

•

Bibliography

• ECEP-233-062, Class notes, week 1-9

• http://www.cpssa.org/resources.htm

• http://www.asha.org/public/speech/disorders/RightBrainDamage/

• http://www.nursingassistanteducation.com/site/courses/eng/nae-para-eng.php

• http://www.heartandstroke.com/site/apps/kb/cs/contactsearch.asp?c=ikIQLcMWJtE&b=8598311&raw=

• http://www.supportingfamilycare.com/brochures.php

• http://www.sickkids.ca/Neurology/Research-activities/index.html

• http://www.specialneedsbookreview.com/2014/05/18/childrens-book-friendships-cerebral-palsy-friend-suhana-shaila-abdullah-aanyah-abdullah/

Bibliography

• http://www.fireflyfriends.com/special-needs-blog/specific/three-fantastically-awesome-childrens-books-that-explain-special-needs-to-o

• https://www.autismspeaks.org/what-autism/treatment/what-treatments-are-available-speech-language-and-motor-impairments

• https://www.wheelfreedom.com/products/paediatric_wheelchair_hire/childrens_wheelchair_hire

• http://www.accessaudits.com/access-audits-service-providers/

• http://lathropdentalcenter.com/setting-positive-tone-for-family-dental-visits/

• http://hollandbloorview.ca/Aboutus/WelcometoHollandBloorviewhttp:/

• /www.123rf.com/photo_10132512_illustration-of-kids-listening-to-a-story.html

• http://babytoys.en.alibaba.com/product/60117937227-212749096/Cheeky_Monkey_Knitted_Toy_Knitted_stuffed_Monkey_toy_secured_and_safe_for_all_age_certificated_toys.html

Bibliography

• http://www.dreamstime.com/stock-images-happy-children-holding-hands-image20586204

• http://www.laeliasky.com/2009/09/09/cartoon-us/

• http://cjengo.blogspot.ca/2012/05/its-stroke-awareness-month-and-jude.html

• https://www.youtube.com/watch?v=PY8EszDP3jY

• http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5458215/k.250D/Stroke__Stroke_in_children_Pediatric_stroke.htm

• http://www.123rf.com/photo_18875646_cartoon-of-nurse-and-child--vaccination.html

• http://cliparts.co/heart-cartoon

• http://cliparts.co/cartoon-pictures-of-little-girls

• http://www.windowoncyprus.com/self_catering_disabled_friendly.htm

Bibliography

• http://www.sadtoraw.com/innovative-and-various-classroom-table-inspiring-design-ideas/high-quality-classroom-tables-from-my-school-furniture-for-innovative-and-various-classroom-table-inspiring-design-ideas/

• http://www.disabilitysystems.com/ramps/modular-ramp-original.html

• http://www.just-good-prices.co.uk/acatalog/child-wheelchair-clothing.html

• http://www.aliexpress.com/push-button-door-opener_reviews.html

• http://dhbc.ky.gov/bce/elevators/Pages/Elevator-Continuing-Education.aspx

• http://www.multiage-education.com/multiagen-b/classlayout.html

• http://www.qualityclassrooms.com/classroom-decorations/award-name-plates/handprints-name-tags.html

• http://www.beanbag.com/0neatstu.asp

• (Reading Package) Inclusion Of Children with Special Needs- Centennial College- Earlychildhood education 2011

Bibliography

• http://galleryhip.com/hemi-rolling-walker.html

• http://www.mayoclinic.org/healthy-living/healthy-aging/multimedia/canes/sls-20077060

• http://www.futonland.com/index/page/product/product_id/17911/product_name/Bed+Risers+(Set+of+4)+by+Comfort+Pure

• http://workingcapitalreview.com/2014/12/proof-youre-wasting-time-meetings/

• http://dancarman.blogspot.ca/2013_02_01_archive.html

• http://www.jobinterviewtools.com/blog/job-interview/interview-questions/

• http://highergrade.ca/resources/parent-resources/effective-parent-teacher-conference/