Vol 1 • Issue 5 • Sep 2010

Last December, Grafton was chosen as the lead agency for Infant & Toddler Connection (ITC) of Shenandoah Valley. This program is extremely unique in its approach, seeking to address a child’s entire circle of support by:

• Teaching, coaching, and mentoring families of children up to the age of three with a developmental delay or diagnosed disabling condition
• Providing early intervention services in homes and other natural environments to help families understand what they can do to meet their child’s needs within existing daily routines
• Addressing any delays in development early in a child’s life and, in so doing, helping to eliminate or minimize the necessity for more intensive services later on

This unique public-private partnership between Grafton, Winchester City, and the Commonwealth of Virginia will serve six different localities, meeting a critical need within the region. The new services offered by ITC fit squarely into Grafton’s expanding system of integrated care: staff members specializing in cognitive, physical, communication, social, emotional, adaptive and atypical development will work in tandem with parents to improve their child’s development by setting specific goals and service delivery levels.

As a state run and federally funded program, Infant & Toddler Connection of Shenandoah Valley required a public education campaign, increasing awareness among both parents and referral sources about the early intervention services available to children. I am excited to share with you that we officially launched the campaign in September 2010, which included:

• An ITC website complete with an informational toolkit (including fact sheets, forms and presentations) for families and referral sources
• Brochures and posters for placement in doctors’ offices and with referral agencies
• A developmental checklist(available online), designated for children between the ages of zero to three

While our campaign has only just been introduced, already it is having a positive impact on the community. When Grafton was first awarded Infant & Toddler Connection of Shenandoah Valley in December 2009, 129 children were enrolled in the program. Thanks to the hard work of our ITC team, that number has since risen to 191 children. Health and social service providers have also begun to take note of the program, requesting information and presentations from ITC staff members.

It is estimated that up to seventeen dollars can be saved for every one dollar invested in early intervention services. Though not surprising to those of us in the behavioral health care field, this represents a staggering return on investment. Every dollar invested represents the best seventeen dollars taxpayers won’t have to spend in the future. “Treatment that works”, works for all.

As a celebration for our newly launched campaign, this issue of Continuums will have a keen focus on Infant & Toddler Connection. Cole, who you will meet later, is one of the many children that have received early intervention services. Although he is too young to know what the future has yet in store for him, Cole’s progress has been amazing. Infant & Toddler Connection affords many other children the same bright future. For more information about this service or to refer a child to the program, please contact a Shenandoah Valley service coordinator at 540-636-4520 or visit our newly launched website www.itcshenvalley.org.

Jim Gaynor

Success Story

HISTORY:

Cole* is a one-year-old toddler, born four months prematurely at John Hopkins in June of 2009. He weighed only one pound and one ounce at birth and had to spend the first five months of his life in the hospital. For the majority of this, he was connected to oxygen and feeding tubes as well as apnea and heart monitors that kept him from being able to move around. Because of Cole’s premature birth, and the various diagnoses and disorders that came with such an early delivery, it was immediately evident to his parents and doctors that he would need early intervention services after being discharged.

DIAGNOSIS:

Cole’s premature birth led to his development of reflux, retinopathy of prematurity (an abnormal blood vessel development in the retina of the eye), cerebellar hypoplasia (a developmental disorder characterized by the under developmental of the cerebellum.), failure to thrive, chronic lung disease and anemia. As a result of all of his diagnoses, and due to the amount of time he spent in an incubator as an infant, he also suffered from reduced motor skills. Cole’s level of retinopathy also continues to be an unknown factor for his doctors. It is uncertain what and how much he can see. As Cole’s condition stabilized, he was transferred from John Hopkins in October and brought home on November 5. On that very day, a doctor at the Winchester Medical Center made the initial referral to Infant & Toddler Connection of Shenandoah Valley.

ASSESSMENT:

Initially, a staff member from Infant & Toddler Connection of Shenandoah Valley met with Cole and his parents for an intake meeting. During these discussions, families are first given a Child and Family Safeguard rights document, their priorities and concerns are talked about and the child’s health and medical history is assessed.

ITC staff members present for Cole’s assessment included the Shenandoah Valley service coordinator, a developmental specialist and a physical therapist. A member of the Department for the Blind and Visually Impaired was also present. The initial assessment was made around Cole’s crib, as he was hooked up to both oxygen tubes and apnea monitors. He was tested on a number of different profiles to gauge his developmental levels. Staff members administered the Early Learning Accomplishment Profile (E-LAP), Hawaii Early Learning Profile (HELP) and a Vision and Hearing screening. Staff also involved Cole’s parents in the assessment, asking them questions and getting a sense of the goals they had for the next 6-12 months of his development.

Initial assessment showed, that despite being seven months old, Cole’s developmental age was still at three months, and his motor skills were at one month. This was used as the baseline to write his service plan. It was decided that he would receive physical therapy twice a month to work on his motor skills and mobility. He would also receive developmental services twice a month. The outcome and goals that were set for Cole were to get him to sit without support behind him and to increase his awareness of his surroundings.

PROGRESS:

Although Cole has received services for less than a year, his progress has been significant. He now has the mobility to roll onto his back, sit up with minimal support and touch objects in his surrounding environment. He is able to recognize his name, turning towards the source of the sounds when hearing it. He is also playing with toys appropriate for his age and can pay attention to different colors shown to him. While doctors are still unsure of how much he can see, the fact that he is able to identify items in his surroundings is positive.

Collaboration and partnership with Cole’s family members and service providers has been the most crucial element of his progress. Both parents have been incredibly supportive throughout the process, working closely with ITC members during each visit and even thinking of new strategies to use on Cole in between visits. They also interact with him extensively on a daily basis and engage him in all activities suggested by the professional staff. The family is responsive to suggestions and recommendations, providing valuable feedback to the team on what has and has not worked with Cole.

Although it is still unknown what services Cole will need throughout his life, he is eligible to continue receiving early intervention services until his third birthday. After that, he will be transitioned into Part B school services. His parents will continue to work with the Department for the Blind and Vision Impaired on an ongoing basis to address his vision problems. The ultimate goal is for Cole to be a happy, healthy and independent child, teen, and adult.

Cole’s mother recently said, “I am so happy that Cole is a part of this program. Everyone is so helpful, kind, and very knowledgeable. It’s very obvious how much they care about helping children with special needs and their families.”

*Client’s name has been changed to protect his privacy

• “If Safety is Your Priority, Physical Restraint is Not Your Option” – presented at the 41st annual Autism Society conference in Dallas, Texas on July7th by Allyson Bateman, educational administrator, Jason Craig, assistant educational administrator and Kim Sanders, executive director, Winchester facility.
• “Data – A Good 4-Letter Word: Increasing Goal Mastery through Data-Based Decision-Making” – presented by Lisa Marshall, director of clinical services, at Opening Doors—Unlocking Potential 2010—Invigorating Instruction for Students who are Deaf or Hard of Hearing on August 3rd & 4th in Charlottesville, Virginia.
• Infant & Toddler Connection of Shenandoah Valley – launched program website www.itchshenvalley.org and communications toolkit (including brochure, poster, presentation and fact sheet).
• “The Effects of an Action Plan, Staff Training, Management Support and Monitoring on Restraint Use and Costs of Work-Related Injuries” – an article published in the Journal of Applied Research in Intellectual Disabilities was one of the top 50 articles downloaded from Wiley InterScience. Wiley InterScience is one of the world’s premiere resources for study, teaching and advanced research and provides access to over 3 million articles across 1,500 journals.
• Substance Abuse and Mental Health Services Administration (SAMHSA) – recognized Grafton’s clinical best practices in restraint and seclusion reduction in Issue brief #4 of “Promoting Alternatives to the Use of Seclusion and Restraint.” Click here for brief.
• “Comfort vs Control—A Proactive Approach to Supporting Individuals with Intellectual Disabilities” – a webinar presented by Shweta Adyanthaya, director of communications and Kim Sanders, executive director, Winchester facility, at The Virtual Learning Institute, a Substance Abuse and Mental Health Services Administration (SAMHSA) funded online learning forum developed to support behavioral health treatment facilities in their efforts to prevent the use of coercive practices and to develop alternatives to the use of seclusion and restraint on August 12th.
• “Treating Individuals with Intellectual Disabilities” – a web based open forum presented by Janelle Hyson, teacher, Julia Pyles, instructional assistant and Buster Willingham, residential instructor and Kim Sanders, on behalf of the National Association of State Mental Health Program Directors (NASMHPD), a non-profit organization dedicated to serving the needs of the nation’s public mental health system through policy development, information dissemination and technical assistance on August 26th.

• “Best Practices in Reducing Workers’ Compensation Costs” – presented by Tony Sanders, director of risk management at the Partlow Insurance Agency Worker’s Compensation Seminar on October 7th in East Brunswick, New Jersey.

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