Hidden Disabilities 101
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Dr. Grcevich's presentation from Key Ministry training, Cuyahoga Valley Church, Broadview Heights, OH, October 17, 2010

Dr. Grcevich's presentation from Key Ministry training, Cuyahoga Valley Church, Broadview Heights, OH, October 17, 2010

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Hidden Disabilities 101 Hidden Disabilities 101 Presentation Transcript

  • Hidden Disabilities 101:Tips and tools for including children withHidden Disabilities and their families at church Stephen Grcevich, M.D. President, Key Ministry Presented at Cuyahoga Valley Church Broadview Heights, OH October 17, 2010 ©Key Ministry
  • What are Hidden Disabilities?A hidden disability (HD) is a serious emotional, behavioral, developmental or neurological disorder with no outwardly apparent symptoms
  • Examples of Hidden Disabilities:• Autism, autistic spectrum disorders• Developmental disabilities• Attention-Deficit Hyperactivity Disorder (ADHD)• Learning disabilities• Anxiety disorders• Mood disorders (depression, bipolar disorder)• Attachment disorders (common among adopted, foster children)• Fetal Alcohol Effects (FAE)• Brain injury: resulting from trauma, epilepsy, stroke Stephen Grcevich, MD, Case Western Reserve University School of Medicine
  • “Rethinking” disability and church• An individual with a disability is defined as a person who has a mental or physical impairment that substantially limits one or more major life activities, a record of such impairment, or is regarded as having such an impairment. Taken from www.joniandfriends.org
  • “Rethinking” disability and church• If a mental or physical impairment substantially limits a person’s ability to actively pursue spiritual growth and fully participate in the ministry of a local church, is that person “disabled?”
  • The Ultimate Low-Hanging Fruit for Evangelism, Outreach? • 9% of U.S. kids ages 6-17 received Rx for ADHD meds • Prevalence of anxiety disorders-U.S. youth: 8-20% • 1/91 kids born in 2008 will be diagnosed with autism • 22% of U.S. kids entering first grade meet criteria for one or more psychiatric disorders • What about siblings and church? • Who equips parents to shepherd their kids in the faith? • Key Ministry estimate: families of children with HD at least 50% less likely to be involved with a local churchJ Am Acad Child Adolesc Psychiatry - July 2010 (Vol. 49, Issue 7), Pages 686-698
  • • What strategies are useful when a child exhibits inappropriate behavior at church?
  • Increasing positive behavior• Know the A,B,Cs (Antecedents, Behaviors, Consequences)• Understand the function of his/her behavior (obtain/avoid)• Be preventive – look for antecedents to behaviors• Be consistent• Keep kids busy• Teach appropriate behaviors• Use of Social Stories
  • Strategies: Behavioral ApproachesFinding Solutions for Problem Behaviors: ABC Analysis• ABC Analysis is a process for gathering information about the environmental stimuli that are controlling the behavior.• Antecedents (A) Antecedents are things or situations which happen before the target behavior. Examples of antecedents are asking a question, time of day, loud noise, a particular toy, etc. Certain behavior may regularly follow each of these antecedents.• Behavior (B) This is the target behavior we are studying. It is very important to be specific in our descriptions so that others could easily recognize it.• Consequences (C) Consequences are things or situations which immediately follow a particular behavior. They serve two purposes: to increase the behavior or to decrease the behavior that just happened. From Olson & Marker (2000) In-service Training Manual – Pine Grove School.
  • Strategies: Behavioral ApproachesAnalysis of Function• Two main functions of behavior: – To OBTAIN something desirable or communication – To AVOID/ESCAPE something undesirable• By identifying the variables that maintain a behavior, we can also identify more adaptive ways of obtaining the same function.Always teach a more appropriate behavior!From Olson & Marker (2000). In Service Training Manual – Pine Grove School.
  • Strategies: Behavioral Approaches . A = Antecedent B = Behavior C = ConsequencesTeacher reads paragraph A = Antecedent Danny draws on worksheet B = Behavior Teacher redirects verbally C = ConsequencesaloudA stands for antecedent or what happens before the B stands for behavior. Behaviors are functional, C stands for consequences or what happensbehavior. Antecedents can be a person, place, time, meaning they serve a purpose. Behaviors most often immediately following the behavior. command, object, smell, noise, etc. are used to obtain or avoid something. Behaviors should be described in detail.Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.)Function: To obtain or avoid: Avoid listening to storyAppropriate Behavior to Teach:Appropriate Behavior to Teach: On-task behavior, listeningFunction: To obtain or avoid –Appropriate Behavior to Teach: - From Olson & Marker (2000). In-service Training Manual – Pine Grove School.
  • Strategies: Behavioral Approaches A = Antecedent B = Behavior C = Consequences .Teacher asks question to J. Danny calls out Teacher ignores A = Antecedent B = Behavior C = ConsequencesTeacher asks question to R. D. Stamps foot. “I NEVER Teacher puts hand on D’s get called on.” shoulder A stands for antecedent or what happens before the B stands for behavior. Behaviors are functional, C stands for consequences or what happensT. says, “I like how T. is time,behavior. Antecedents can be a person, place, D. Puts serve a purpose. desk most often T. says, “Good job calming meaning they head on Behaviors immediately following the behavior.waiting. object, smell, noise, etc. command, are used to obtain or avoid something. Behaviors should be described in detail. down.”Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.)Function: To obtain or avoid:Appropriate Behavior to Teach:A turn in the lesson, attentionAppropriate Behavior to Teach: turn-takingFunction: To obtain or avoid –Appropriate Behavior to Teach: - From Olson & Marker (2000). In-service Training Manual – Pine Grove School.
  • Be sure that reinforcement is:• Clear• Fair• Honest• Positive• Systematic (ratio of behavior/reinforcer)• ManageableAlberto and Troutman, 1986
  • Strategies: Behavioral ApproachesINCREASING DESIRABLE BEHAVIORS• Reinforcement: Something serves as reinforcement if 1) it immediately follows a behavior and 2) it increases the frequency of that behavior in the future.• If it does NOT increase the behavior, it is NOT a reinforcement for that child.• It is always better to reinforce (increase) a desirable behavior than to punish (decrease) an undesirable behavior. Doing so teaches good behavior! You should be giving at least 6 positives to your child for every negative you give. Make sure the reward is motivating for your child and is realistic for you to give the child!From Olson & Marker (2000). In Service Training Manual – Pine Grove School.Courtesy of Cara Marker-Daily, Ph.D.
  • Strategies: Behavioral ApproachesDECREASING BEHAVIORWe can decrease unwanted behaviors through a variety of methods. The following list ranges from least to most intrusive. – Extinction/Ignoring – Differential reinforcement of others (DRO) – Response cost – Time Out – Physical restraintFrom Olson & Marker (2000). In-service Training Manual – Pine Grove School.
  • Key Ministry: How Can We Serve You?Key Ministry: www.keyministry.org provides resources to churches free of charge: Best Practices Resource Kit “Key Ring Binder” Web-based resources (Blogs, Twitter, Facebook) Opportunities to network with other churches Phone consultation On-site consultation, training Celebrating your successes Local and National conferences Praying for you
  • Please Stay in Touch! Key Ministry Foundation Rebecca Hamilton, Executive Director 8401 Chagrin Road, Suite 14B Chagrin Falls OH 44023 Phone: 440/708-4488 rebecca@keyministry.org katie@keyministry.org steve@keyministry.org Web: www.keyministry.org Steve’s blog: http://drgrcevich.wordpress.comKatie’s blog: http://katiewetherbee.wordpress.com