Dr. Roy Wade's Presentation from Childhood Adversity & Poverty: Creating a Co...SaintA
Dr. Roy Wade, a pediatrician from Children’s Hospital of Philadelphia, specializes in the connection between adverse childhood experiences and urban issues such as poverty, violence and health problems. This presentation was made during our community conversation on urban ACES and trauma informed care in Milwaukee.
CONDITION OF ADHD: AND HOW WITHOUT SEAMLESS TRANSITION INTO ADULT CLINICS AFFECTS ADULT LIFE OUTCOMES & HOW IT COULD BE PROPERLY FACILITATED HAVING CREATED AND SUCCESSFULLY CONDUCTED ONE FOR TWO YEARS - PRESENTED AT A UNITED KINGDOM NATIONAL CONFERENCE
The presentation will discuss use of focus groups to obtain data to tailor sexual health program approaches. We conducted 4 focus groups of middle and high school-aged youth in our program areas to identify prevalent sexual beliefs, attitudes and behaviors of Hispanic border community adolescents Each focus group comprised 8-12 participants. Such data were used to tailor the sexual heath education program implementation and evaluation and make them relevant to our program populations.
“Condoms are not a family planning Method”: Why efforts to prevent HIV have failed to comprehensively address adolescent sexual and reproductive health
Dr. Roy Wade's Presentation from Childhood Adversity & Poverty: Creating a Co...SaintA
Dr. Roy Wade, a pediatrician from Children’s Hospital of Philadelphia, specializes in the connection between adverse childhood experiences and urban issues such as poverty, violence and health problems. This presentation was made during our community conversation on urban ACES and trauma informed care in Milwaukee.
CONDITION OF ADHD: AND HOW WITHOUT SEAMLESS TRANSITION INTO ADULT CLINICS AFFECTS ADULT LIFE OUTCOMES & HOW IT COULD BE PROPERLY FACILITATED HAVING CREATED AND SUCCESSFULLY CONDUCTED ONE FOR TWO YEARS - PRESENTED AT A UNITED KINGDOM NATIONAL CONFERENCE
The presentation will discuss use of focus groups to obtain data to tailor sexual health program approaches. We conducted 4 focus groups of middle and high school-aged youth in our program areas to identify prevalent sexual beliefs, attitudes and behaviors of Hispanic border community adolescents Each focus group comprised 8-12 participants. Such data were used to tailor the sexual heath education program implementation and evaluation and make them relevant to our program populations.
“Condoms are not a family planning Method”: Why efforts to prevent HIV have failed to comprehensively address adolescent sexual and reproductive health
Self-esteem is defined as how one feels about oneself.1 It may be either high or low depending upon a personal assessment of self. Healthy self-esteem is essential for success in every area of life. It is one of the most dynamic variables in youth development.
Size of the Problem:
It has been observed that children experience a decline in self esteem during adolescence years which is a critical transition period for them. Girls experience this decline at age 12 whereas in boys the decline generally begins at age 14.2 Youth with high self-esteem consider themselves worthy, and view themselves as equal to others. Those low in self-esteem generally experience self-rejection, self-dissatisfaction, self-contempt, and self-disparagement. Direct estimates of the level of self-esteem in Kentucky youth are not available but there are some indirect indicators that can help us understand this problem in our young population.
Interview Tips: What you say vs. What is heardShawn Kinard
Job interviews can be intimidating and down right nerve wracking. While the interviewer is asking you questions: each of your answers are clouded by internal questioning: What answers are they expecting? Do they like me? Is this a place I can see myself working at? The key to a successfull interview is to keep these questions from circling in your head. Try not to say things that can be misunderstood.
Self-esteem is defined as how one feels about oneself.1 It may be either high or low depending upon a personal assessment of self. Healthy self-esteem is essential for success in every area of life. It is one of the most dynamic variables in youth development.
Size of the Problem:
It has been observed that children experience a decline in self esteem during adolescence years which is a critical transition period for them. Girls experience this decline at age 12 whereas in boys the decline generally begins at age 14.2 Youth with high self-esteem consider themselves worthy, and view themselves as equal to others. Those low in self-esteem generally experience self-rejection, self-dissatisfaction, self-contempt, and self-disparagement. Direct estimates of the level of self-esteem in Kentucky youth are not available but there are some indirect indicators that can help us understand this problem in our young population.
Interview Tips: What you say vs. What is heardShawn Kinard
Job interviews can be intimidating and down right nerve wracking. While the interviewer is asking you questions: each of your answers are clouded by internal questioning: What answers are they expecting? Do they like me? Is this a place I can see myself working at? The key to a successfull interview is to keep these questions from circling in your head. Try not to say things that can be misunderstood.
Autism and Life Transitions: Hard Lessons Learned & Taught as a Person-Center...Cheryl Ryan Chan
In December of 2015, I presented this webinar to members of the National Association for Dual Diagnoses (thenadd.org). I've been conducting Person-Centered Plans for 4 years, and over that time I've seen a number of disturbing trends around the lack of understanding and planning for preparedness in transitioning students; in particular, in the areas of independent skill building specific to the anticipated environment, and personal safety skills. I feel it's important to talk about what I've observed and how my team of co-facilitators and I have identified and tackled these issues within the PCP process. I hope that the "lessons learned" will assist people in planning for IEP/ISP goals that can help maximize success. I offer it free to anyone who would like to attend.
The Invisible Child: Understanding the Experiences of Siblings in the World of Chronic Illness was presetned at Akron Children's Hospital on July 6, 2011. The presentation is part of a monthly Pediatric Palliative Care Curriculum Series.
Putting Children First: Session 3.1.C Mokhantso Makoae - Young adolescents se...The Impact Initiative
Putting Children First: Identifying solutions and taking action to tackle poverty and inequality in Africa.
Addis Ababa, Ethiopia, 23-25 October 2017
This three-day international conference aimed to engage policy makers, practitioners and researchers in identifying solutions for fighting child poverty and inequality in Africa, and in inspiring action towards change. The conference offered a platform for bridging divides across sectors, disciplines and policy, practice and research.
Wekerle CIHR Team - Child Sexual Abuse & Adolescent Development: Moving from ...Christine Wekerle
Child Sexual Abuse & Adolescent Development: Moving from Trauma To Resilience - Findings from The Maltreatment and Adolescent Pathways (MAP) Research Study
Slides from an event held on December 17, 2016 to investigate the potential uses in healthcare for cognitive computing technologies. Janet McDonagh asking specifically which issues affect young people with longterm health conditions, with a view to understanding how cognitive computing could help.
1. 7/9/2014
1
Informing the content development
of a relationship curriculum for
teenagers with Trisomy 21:
A survey of parents and healthcare
professionals
Kristy Palmer
MPH candidate
JSPH, Thomas Jefferson University
Outline
• Background
• Purpose
• Methods
• Results
• Recommendations
Background
• Trisomy 21
• Living longer, full lives
• Physical development same as typical teens
• Emotional development may be delayed
• Same risks: pregnancy, STIs
• Increased risk of abuse
Background
• T21 Program Aware of Need
• Incorporate relationship/sexual health session
into larger “transition” curriculum
• Hundreds of Sexual Health Curricula
• Case Study – the Pittsburgh trial
Study Purpose
• Prioritize Topics
• Better Understand Teen Access
Methods
• REDCap Surveys
▫ Qualitative Healthcare Professionals
▫ Quantitative Parents
• Safety features of REDCap
2. 7/9/2014
2
Methods - Quantitative
• Recruitment via CHOP T21 Listserv
▫ Phone Calls
• 73 Parents of Patients Ages 12-22
• Data Analysis by SPSS
▫ Stratified by Child Age, Gender, Older Siblings
• 6 Sexual Health Topics from SIECUS National
Guidelines
Parent Survey Instrumentation
• 12 Questions
▫ Q1-Q3 Demographic
▫ Q4-Q8 Communication/Access
▫ Q9 Priority Topics
▫ Q10-Q12 Planning Purposes
Methods Qualitative
• 15 Healthcare professionals affiliated with CHOP
T21 Program
• Analyzed by hand
▫ Tallying keywords based on SIECUS topic list
• 2 independent MPH reviewers
Professional Survey Instrumentation
• 8 Open-Ended Questions
▫ Professional Role, Experience
▫ Priority Topics
▫ Teen Access to Information
▫ Common ?s – Teens/Parents
▫ Resources
Results – Professional Demographics
• 7/15 Professionals – 47%
Health Care Professional Qualitative Survey Respondents
Professional Role
Years of Experience with
Trisomy 21
Educational Consultant 4
Research Coordinator 5
Physician 11
Occupational Therapist 1-2 intermittently
Physical Therapist (Mother) 11
Physical Therapist 5
Social Worker 41
Results – Parent Demographics
• 49/73 Parents
= 67%
• Older Siblings
54.8% Yes
45.2% No
Demographics for Children with Trisomy 21 of
Parent Survey Respondents
Age of Child n %
Under 12 7 14.3
12-13 6 12.2
14-15 15 30.6
16-17 8 16.3
18 + Over 13 26.5
Totals 49 100
Child Gender n %
Male 15 35.7
Female 27 64.3
Totals 42 100
3. 7/9/2014
3
Professional Opinion of Parent
Discussions
• 1 Positive:
▫ “I do feel most parent’s do a good job at preparing
and educating their child. They want to see their
child mature and develop and along with that
come the questions regarding relationships and
sexual health.” (Educational Consultant, 4 years)
Professional Opinion of Parent
Discussions
• Mostly Negative – Lack of Comfort/Preparation/Skills
• “I feel that topics that are difficult to discuss are often
skipped over or ignored. I also feel that patients with T-
21 are typically thought of as much younger than reality
which impedes appropriate conversations and learning.”
(Occupational Therapist, 1-2 years)
• “Most times they have no idea how or what to talk about,
and would rather not think of their children/young
adults as sexual beings… Kids with DS [Down syndrome]
often have ‘boy friends’ or girl friends, but parents do not
see these relationships as in need of guidance like they
would be providing with a typical child” (Physician, 11
years)
Parent Self-Reports
Child Age
12-13 14-15 16-17 18+ Totals X2
No 2 7 3 5 17 0.877
Yes 4 7 5 8 24
Totals 6 14 8 13 41
Child Gender
Male Female Totals X2
No 10 7 17 0.021
Yes 5 19 24
Totals 15 26 41
Older Siblings
No Yes Totals X2
No 4 13 17 0.025
Yes 15 9 26
Totals 19 22 41
Have you started discussing relationships/sexual health?
Parent Self-Reported Preparedness
• 0-100 sliding scale
• Mean score = 51.89
• Standard deviation = 29.846
Parent Resources
• 21 (51.2% of n=41) Parents answered “Yes” they
have found useful resources
Inclusion in School Health/SexEd
• “School programs rarely offer sex ed to kids
with disabilities and if they do, parents are not
aware of the curriculum.”
Physician (11 years)
4. 7/9/2014
4
Inclusion in
School Health/
SexEd
• Parent Responses
▫ Gender, Age
Not Signficant
Will your child be included?
n %
Yes 16 39
No 14 34.1
I Don't Know 11 26.8
Totals 41 100
Of those Yes Responses, Will information be presented in a
way your child will understand?
n %
Yes 4 25
No 4 25
I Don't Know 8 50
Totals 16 100
Healthcare Provider
Age of Child
Total Χ212-13 14-15 16-17 18+
Did your child's
healthcare provider
discuss relationships/
sexual health?
Yes-
with me
in the
room
0 1 0 1 2
0.482
Yes- 1
on 1
with my
child
0 2 2 0 4
No 6 11 6 12 35
Total 6 14 8 13 41
If YES, 83.3% (5/6) thought their child
understood
16.7% (1/6) did not think their child
understood
Professionals on Common Discussions
• “They rarely ask questions, but I would say I
don’t give them the opportunity.”
Physician, 11 years
• “…because I have minimal rapport with patient’s
I feel as though I get a lot of surface questions
but not in depth discussions. Those topics
typically revolve around work, school, camp,
etc.” Occupational Therapist 1-2 years
Media/TV
• “The problem with getting this information from
the media is that it is often unrealistic.
Individuals with T21 sometimes have difficulty
separating reality from TV, so by receiving
information from TV and not from an honest
source, individuals with T21 may form skewed
perceptions of relationships/sexual health.”
(Research coordinator, 21 years)
SIECUS Topics
Key Concept 1: Hum an Development
T opic 1: Reproductive and Sexual Anatomy
and Physiology
T opic 2: Puberty
T opic 3: Reproduction
T opic 4: Body Image
T opic 5: Sexual Orientation
T opic 6: GenderIdentity
Key Concept 2: Relationships
T opic 1: Families
T opic 2: Friendship
T opic 3: Love
T opic 4: Romantic Relationships and Dating
T opic 5: Marriage and Lifetime Commitments
T opic 6: Raising Children
Key Concept 3: Personal Skills
T opic 1: Values
T opic 2: Decision-making
T opic 3: Communication
T opic 4: Assertiveness
T opic 5: Negotiation
T opic 6: Looking for Help
Key Concept 4: Sexual Behavior
Topic1: Sexuality Throughout Life
Topic2: Masturbation
Topic3: Shared SexualBehavior
Topic4: Sexual Abstinence
Topic5: Human SexualResponse
Topic6: Sexual Fantasy
Topic7:Sexual Dy sfunction
Key Concept 5:Sexual Health
Topic1: Reproductive Health
Topic2: Contraception
Topic3: Pregnancy and Prenatal Care
Topic4: Abortion
Topic5: Sexually Transmitted Diseases
Topic6: HIV and AIDS
Topic7:Sexual Abuse, Assault,Violence,and Harassment
Key Concept 6: Society and Culture
Topic1: Sexuality and Society
Topic2: Gender Roles
Topic3: Sexuality and the Law
Topic4: Sexuality and Religion
Topic5: Div ersity
Topic6: Sexuality and the Media
Topic7:Sexuality and the Arts
Prioritizing Topics
Healthcare Professionals Parents
1. Personal Skills
2. Relationships
3. Sexual Behavior
4. Human Development
5. Sexual Health
6. Society & Culture
1. Personal Skills
2. Relationships
3. Human Development
4. Sexual Behavior
5. Sexual Health
6. Society & Culture
5. 7/9/2014
5
Recommendations
• Main concern: Personal Skill Building
• Second concern: Relationships
• Parent involvement necessary
• Human Development/Basics covered at home
▫ Pre-test to guide facilitator
• Provide Parent Resources
• Discuss Clinic Time with Providers
Acknowledgements
Amy Leader, DrPH, MPH
Symme Trachtenberg, MSW
Natalie Stollon, MSW
Krissy Cellary, MPH
Caren Steinway
References
Barrett, K.A., O’Day, B., Roche, A., Lepidus Carlson, B. (2009). “Intimate Partner Violence, Health Status, and Health
Care Access Among Women with Disabilities” Women’s Health Issues, 9:94-100.
Benson, S., Brannen, D.E., Valentine, R. (2009). "Disability Rights Movement." UXL Encyclopedia of U.S. History, 2:
444-446. Detroit, MI.
Brownridge, D.A. (2006). “Partner Violence Against Women with Disabilities: Prevalence, Risk and Explanations”
Violence Against Women, 12(9): 805-822.
Bryen, D.N. & Wickman, C.H. (2011). “Ending the Silence of People with Little or No Functional Speech: Testifying in
Court” Disability Studies Quarterly, 31(4).
Casale-Giarnnola, D. & Kamens, M.W. (2006). “Inclusion at a University: Experiences of a Young Woman with Down
Syndrome” Mental Retardation, 44(5): 344-352.
Casteel, C., Martin, S.L., Smith, J.B., Gurka, K.K., Kupper, L.L. (2008). “National Study of Physical and Sexual Assault
Among Womenwith Disabilities” Injury Prevention, 14: 87-90.
Centers for Disease Control. (2013). Facts about Down Syndrome. Retrieved from
http://www.cdc.gov/ncbddd/birthdefects/DownSyndrome.html.
References
Children’s Hospital of Philadelphia. (2012). Trisomy 21 Program Brochure. Retrieved from
http://www.chop.edu/export/download/pdfs/articles/trisomy-21/trisomy-21-brochure.pdf
Colker, R. (2000). "Disability Discrimination." Encyclopedia of the American Constitution. Ed. Leonard W. Levy and
Kenneth L. Karst. 2nd ed. Vol. 2. Detroit, MI: Macmillan Reference.
Couwenhoven, T. (2007). Teaching Children with Down Syndromeabout Their Bodies, Boundaries, and Sexuality.
Bethesda, MD: Woodbine House.
Fergus, S. & Zimmerman, M.A. (2005). “Adolescent Resilience: A Frameworkfor Understanding Healthy
Development in the Face of Risk” Annual Review of Public Health,26: 399-419.
Iarocci, G., Yager, J., Rombough, A., & McLaughlin, J. (2008). The Development of Social Competence among
Persons with Down Syndrome across the Lifespan: From Survival to Social Inclusion.
Jones, R.K. & Biddlecom, A.E. (2011). “Is the Internet Filling the Sexual Health Information Gap for Teens? An
Exploratory Study” Journal of Health Communication: International Perspectives, 16(2): 112-123.
Martinez, G., Abma,J., & Copen, C. (2010). “Educating Teenagers About Sex in the United States” NCHS Data Brief,
44 Retrieved from http://www.cdc.gov/nchs/data/databriefs/db44.pdf
References
Mazurek, M.O., Shattuck, P.T., Wagner, M., & Cooper, B.P. (2012). “Prevalence and Correlates of Screen-Based Media Use
Among Y ouths with Autism Spectrum Disorders” Journal of Autism Developmental Disorders, 42:1157-1167.
National Center on Birth Defects and Developmental Disabilities. (2013). Annual Report: Fiscal Year 2012. Retrieved from
http://www.cdc.gov/ncbddd/aboutus/annualreport2012/documents/ncbdddannualrepor2012-full-report.pdf.
Presson, A.P., Partyka, G., Jensen, K.M., Devine, O.J., Rasmussen, S.A., McCabe, L.L., McCabe, E.R.B. (2013). “Current
Estimate of Down Syndrome Population Prevalence in the United States” The Journal of Pediatrics,163(4):1163-8.
Sexuality Information and Education Council of the United States (SIECUS) National Guidelines Task Force. (2004). Guidelines
for Comprehensive Sexuality Education: Kindergarten-12th Grade, Third Edition.
Sexuality Information and Education Council of the United States (SIECUS) SexEd Library (2014). “Curricula Bibliography”
Retrieved from http://www.sexedlibrary.net/
Sirlopú, D., González, R., Bohner, G., Siebler, F., Ordóñez, G., Millar, A., Torres, D., et al. (2008). Promoting Positive Attitudes
Toward People With Down Syndrome: The Benefit of School Inclusion Programs. Journal of Applied Social
Psychology,38(11),2710–2736.
Sullivan, P. M. (2000). Violence and abuse againstchildren with disabilities.Centerfor Abused Children with Disabilities. Boys
Town National Research Hospital.
Questions???