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Fasd assessment

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  • Talk about referral form here and hand outs We do accept referrals from GPs in outlying areas where it is difficulty to access pediatrics. In areas like the Okanagan we tend to accept referrals primarily from peds and psychiatry. If a referral is from a GP family will be encouraged to get a pediatrician.
  • Full time psychologists work in the Okanagan region (Kelowna) as well as out of Kamloops and Nelson. Other areas are covered by outreach clinics combined with local resources where available, or families travelling to assessment centres. Twice a year psychologists travel to Cranbrook for outreach clinics. We recently added Williams Lake outreach clinics – this is in transition.
  • Now at intake social worker calls to provide screening when IHCAN 1 st receives a referral Does the family consent to the assessment? Are they in crisis Inform about the next steps – they will be connected with key worker at this stage if they need support with completing intake paperwork and general support with the assessment processes. In some cases key workers are very involved with supporting referrals. CCY examples: genetic syndrome, developmental delay w/ behavioural problems; FASD type presentation but unconfirmed alcohol exposure; medical condition + learning problems + social emotional/psychiatric problems
  • (Concern re. asking for “a referral to IHCAN” as opposed to outlining the school’s concerns in multiple domains – think about behaviour, social, academic, cognitive, adaptive, etc.
  • Growth impairment defined as at or below 10 th percentile – current and birthweight also included. Growth impairment seems to be the rarest finding (anecdotal).
  • A “brain 2” can sometimes be just as impaired functionally as an individual with a “brain 3” – although in general we are seeing milder symptoms. Brain 2s can grow into Brain 3s (anecdotal) as they age - widening gap in executive functioning, adaptive expectations
  • It may be decided at intake if SLP or OT need to be involved, or the psychologist may decide based on their testing that further testing is warranted in these areas. Limited funding for SLP and OT – about 40 out of 500 assessments (less than 1/12). SLP/OT assessment is generally required if these domains are to be evaluated as impaired (psych does screening measures only).
  • Draw attention to cross over of some domains – e.g. adaptive/social Note – I have yet to do an assessment where imaging results are available – although there is a hope that this can eventually be part of the diagnostic coding in a bigger way. Not sure how functional/ realistic this is?
  • Note re. Woodcock Johnson and American norms – higher scores less comparable to IQ test to diagnose LDs
  • Limited testing of children under the age of 7 or 8 – which is why “ideal time” for FASD assessment is when the child is 8+
  • Interview questions to validate – ask questions about daily living, self care, hygeine, safety, routines, domestic skills, etc.
  • Pattern – often psych testing finds more deficits than SLP testing – may be aspects of the core tests are too visually based or that the problems tend to be with abstraction and higher level language (anecdotal)
  • Key Worker program – run through MCFD but through contracts to many different organizations – key workers have varying qualifications – sometimes are very helpful, not consistently. Intended to help families understand assessment results and apply recommendations.
  • Report needs to meet multiple needs – so a lot of information, not always accessible to all audiences Reporting requirements of our college, needs of school districts for numbers and needs of families/schools to understand the information
  • Note – counterintuitive to the visual verbal discrepancy on IQ testing
  • SD 23 one of the most conservative
  • Window that can include “neurobehavioural” – 2 or more domains (needs to include academics) – not as specific about severity