fasd assessment
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Assessing FASD and Complex Developmental Behavioural
Conditions (CDBC)
Interior Health Interior Health Children’s Assessment NetworkChildren’s Assessment Network
Presentation by: Presentation by: Christy Bryceland, Ph.D., R. Psych.Christy Bryceland, Ph.D., R. Psych.Okanagan Ability CentreOkanagan Ability Centrewww.okanaganabilitycentre.comcbryceland@[email protected]
Fetal Alcohol Spectrum DisorderFetal Alcohol Spectrum Disorder Developmental disorder secondary to alcohol Developmental disorder secondary to alcohol
exposure in uteroexposure in utero
Specific neurobehavioural pattern +/- physical signsSpecific neurobehavioural pattern +/- physical signs
Identifiable deficits in at least 3 areas, which may Identifiable deficits in at least 3 areas, which may include cognition, motor skills, executive function include cognition, motor skills, executive function and/or social skillsand/or social skills
Prevalence is estimated at 9.1 per 1000 birthsPrevalence is estimated at 9.1 per 1000 births
Chudley et al., CMAJ, March 1, 2005Chudley et al., CMAJ, March 1, 2005
Impact on Brain FunctionsImpact on Brain Functions
Learning deficitsLearning deficits Poor Impulse ControlPoor Impulse Control Social Skills deficitsSocial Skills deficits Language skills deficitsLanguage skills deficits Poor abstraction/metacognitionPoor abstraction/metacognition Math skills deficitsMath skills deficits Memory/attention/judgment deficitsMemory/attention/judgment deficits
Assessing FASDAssessing FASD Interior Health Children’s Assessment Network Interior Health Children’s Assessment Network
(IHCAN)(IHCAN)
We are an assessment team that provides inter-We are an assessment team that provides inter-disciplinary assessments to children with complex disciplinary assessments to children with complex developmental conditions. developmental conditions.
Children must be referred by a medical Children must be referred by a medical professional and there must be significant professional and there must be significant suspicion/ confirmation of gestational exposure suspicion/ confirmation of gestational exposure to alcohol exposure plus impairment in a number to alcohol exposure plus impairment in a number of domains of functioning (development/ of domains of functioning (development/ learning, mental health/behavioural, learning, mental health/behavioural, adaptive/social skills)adaptive/social skills)
IHCANIHCAN
IHCAN is funded through PHSA, and IHCAN is funded through PHSA, and provides assessments for children 0-19 living provides assessments for children 0-19 living in the Interior Health Authority catchment in the Interior Health Authority catchment area. area.
Children referred for FASD or CCY Children referred for FASD or CCY assessments are seen in 6 sites within the assessments are seen in 6 sites within the health region (Kelowna, Vernon, Kamloops, health region (Kelowna, Vernon, Kamloops, Williams Lake, Nelson and Cranbrook).Williams Lake, Nelson and Cranbrook).
CDBC AssessmentsCDBC Assessments IHCAN completes assessments in 3 different IHCAN completes assessments in 3 different
areas: FASD, Autism Spectrum Disorders and areas: FASD, Autism Spectrum Disorders and other Complex Developmental Conditions (CCY)other Complex Developmental Conditions (CCY)
We have been completing FASD assessments We have been completing FASD assessments since January 2006since January 2006
Families undergoing IHCAN FASD assessment Families undergoing IHCAN FASD assessment can access the Key Worker Agency Program can access the Key Worker Agency Program (partnership with MCFD)(partnership with MCFD)
Complex Children and Youth (CCY)
This is a category designed to catch children who do not meet referral criteria for FASD or autism spectrum disorders, but who present with “complex developmental behavioural conditions.”
The same conditions for intake apply: the child must be showing impairment in multiple areas of functioning, and community resources have not been able to address (e.g. complex medical condition+learning challenges)
Need to access community resources first – has a school psychoeducational assessment been completed (if possible)?
IH Total FASD Referrals & IH Total FASD Referrals & Assessments Age 0 -19 from 2006- July Assessments Age 0 -19 from 2006- July
20102010
ReferredReferred ~1000~1000
AssessedAssessed ~650~650
Children and Youth Children and Youth diagnosed with an diagnosed with an FASDFASD
~2/3 or >400~2/3 or >400
Current FASD waitlist (July 2010)Current FASD waitlist (July 2010)Region Under 6 6 + TotalEK – E. Kootenay 6 18 24
KB - Kootenay Boundary
2 5 7
OK 1 - South OK 1 11 12
OK 2 – Central OK 3 21 24
OK3 – North OK 2 13 15
OK 4 –S. Arm 1 7 8
OK 5 - Revelstoke 0 1 1
TCS 1 – Merritt 1 5 6
TCS 2 - Kamloops 6 24 30
TCS 3 – Williams Lake
5 18 23
Totals: 27 123 150
Ways for schools to support a referral
Provide documentation for families to take to family doctor and/or paediatrician regarding school’s concerns – be descriptive rather than prescriptive
Assist family in accessing referral – encouraging medical/paediatric referral
Paediatricians decide if it is an appropriate referral for IHCAN
FASD: Canadian Diagnostic Guidelines 2005FASD: Canadian Diagnostic Guidelines 2005
Diagnosis is complex and requires comprehensive Diagnosis is complex and requires comprehensive history, physical and neurobehavioural assessment history, physical and neurobehavioural assessment – an interdisciplinary approach is necessary– an interdisciplinary approach is necessary
In Canada, we utilize the University of Washington In Canada, we utilize the University of Washington Diagnostic Code and Canadian Diagnostic Diagnostic Code and Canadian Diagnostic GuidelinesGuidelines
Chudley et al., CMAJ, March 1, 2005Chudley et al., CMAJ, March 1, 2005
4 Digit Diagnostic Code4 Digit Diagnostic Code
Growth Growth DeficiencyDeficiency
FAS FacialFAS FacialFeaturesFeatures
CNSCNSDamageDamage
PrenatalPrenatalAlcohol Alcohol
44 SevereSevere SevereSevere SevereSevere High RiskHigh Risk
33 ModerateModerate ModerateModerate ModerateModerate Some RiskSome Risk
22 MildMild Mild Mild MildMild UnknownUnknown
11 NoneNone NoneNone NoneNone No RiskNo Risk
FAS Facial FeaturesFAS Facial Features
4 Digit Code & Canadian Diagnostic 4 Digit Code & Canadian Diagnostic GuidelinesGuidelines
Application of the Code + Canadian guidelines results Application of the Code + Canadian guidelines results in multiple variations fitting into or being excluded in multiple variations fitting into or being excluded from one of four diagnostic categories:from one of four diagnostic categories:
1.1. Fetal Alcohol Syndrome (confirmed exposure)Fetal Alcohol Syndrome (confirmed exposure)
2.2. Fetal Alcohol Syndrome (without confirmation)Fetal Alcohol Syndrome (without confirmation)
3.3. Partial FAS (confirmed exposure)Partial FAS (confirmed exposure)
4.4. Alcohol Related Neurodevelopmental Disorder Alcohol Related Neurodevelopmental Disorder (confirmed exposure)(confirmed exposure)
University of Washington guidelines
You will also see diagnoses of:You will also see diagnoses of:
1.1. Static Encephalopathy (alcohol exposure unknown)Static Encephalopathy (alcohol exposure unknown)
2.2. Neurobehavioural Disorder (alcohol exposed)Neurobehavioural Disorder (alcohol exposed) These categories are used to diagnose individuals with
alcohol-related impairments who are not captured by Canadian guidelines.
This includes individuals for whom we cannot confirm alcohol exposure, as well as those who have milder levels of impairment.
Diagnosis needed to access chronic health designation. Some cases of success for categorizing “neurobehavioral disorder” if evidence of school failure.
REMINDER:REMINDER:
The different diagnoses The different diagnoses do notdo not represent represent functional differences or “mild” forms of functional differences or “mild” forms of FASD; they only represent visible, FASD; they only represent visible, physical features – CNS damage is physical features – CNS damage is present with present with allall six diagnostic categoriessix diagnostic categories
Interdisciplinary Team MembersInterdisciplinary Team Members
Core team members:Core team members: Intake CoordinatorIntake Coordinator Assessment CoordinatorAssessment Coordinator PaediatricianPaediatrician PsychologistPsychologist
The team may also include:The team may also include: Psychiatrist (can replace paediatrician)Psychiatrist (can replace paediatrician) Occupational TherapistOccupational Therapist Speech Language PathologistSpeech Language Pathologist
The Interdisciplinary FASD AssessmentThe Interdisciplinary FASD Assessment
Neurobehavioural Assessment: 9 domains
1. Sensory/Motor (“hard and soft signs”)2. If available, imaging results showing differences in
brain structure. 3. Cognition4. Communication5. Academic Achievement6. Memory7. Executive Function8. Attention/Activity Level9. Adaptive Behaviour/Social Communication
A domain is considered “impaired” when on a standardized measure:
Scores are 2 standard deviations or more below the mean
This equates to:
a percentile rank of 2nd or lower
a standard score of 70 or lower (most measures)
The Normal Curve:
Psychology domains: Cognition
Overall intelligence, verbal intelligence, nonverbal intelligence
Common measures:
Wechsler scales – the WAIS-IV, WISC-IV, WPPSI-III
4 Index Scores: Verbal Comprehension, Perceptual Reasoning, Working Memory, Processing Speed (not all within cognition)
Cognition
You are likely to see a broad range of abilities A significant minority will be have an
intellectual disability (IQ below 70) Others will have even, “average” profiles Others will have highly uneven profiles,
usually with visual-spatial skills better than verbal skills
IQ is not highly predictive of function
Psychology domains: Academic Achievement
Standardized assessment by the psychologist plus review of school records
We can accept recent school testing if we have standard scores
Typically we assess with the WIAT-II (Canadian norms)
• Reading• Writing • Math
Academic Achievement
Academic skills may be relatively intact or may be very low.
Math problems are very common. Those who have language problems are also
likely to have poor reading comprehension. May do better with more concrete skills (word
reading, spelling) but have more challenges with abstract skills (comprehension, math reasoning)
Psychology domains: Memory
Includes standardized assessment by the psychologist plus interview questions to parent/caregiver
Testing such as the WRAML-2, NEPSY, Children’s Memory Scale, WMS-III
Measures of:• Visual memory• Verbal memory• Working memory• May include: immediate, delayed, recognition
Memory Many have poor functional memory – however, you
may see a variety of reasons for this.• Some won’t be able to pay attention to what they’re
supposed to learn.• Some won’t be able to actively search their memory,
but can recognize info in a multiple choice framework.
• Problems with working memory are often distinct from problems with short/long term memory.
Those with language problems may have better visual than verbal memory.
Psychology domains: Executive Functioning
A set of high-level thinking skills responsible for organizing and directing the brain’s activities in order to meet long-term goals
Very sensitive Difficult to assess – use a combination of
standardized testing, parent/teacher report, observation, and history
Very difficult area in younger children – harder to do valid and reliable testing
Executive functioning:
Very common area of weakness – however, standardized tests for children are relatively new and are not always sensitive.
Clinical manifestations may include severe problems with safety awareness, inability to learn from consequences, denying wrongdoing even when caught “red handed,” inability to multitask, inability to improvise when something goes wrong, perseveration or “sticky thinking”
Executive Functioning
Our test guidelines mandate: Parent and/or teacher report of executive
functions in daily life Direct testing of:• Inhibition• Working Memory• Planning/cognitive flexibility/
organizing/abstract reasoning (some of these domains covered in other tests, e.g. WISC)
Psychology domains: Attention and Activity Level
Another sensitive indicator Some standardized testing may be possible, but most
crucial information is probably parent and teacher report on formal questionnaires (e.g. Conner’s, Stony Brook) + observation
Teacher reports are very important Many children and youth seen in the system already
have an ADHD diagnosis – if it is considered ‘trustworthy’ then that alone may constitute evidence of impairment
Psychology domains: Adaptive functioning/social
communication Tests in many of the other areas are intended
to measure what the child can do under the best possible circumstances (“ideal” testing environment)
Adaptive functioning tests are intended to measure what the child does do in his/her own environment – at school and at home
Adaptive functioning
Adaptive behaviour is measured by parent/teacher report – and also through clinical interview with caregiver
Common measures: Vineland, ABAS, SIB-R (we most typically use ABAS)
Includes real-life communication, self-care, self-direction, home living and social skills
Time, money, safety, social vulnerability are key areas
Adaptive functioning
Adaptive behaviour is often very low in this population, even when intelligence is average
In interpreting questionnaires we have to consider the literacy, analytical skills and possible bias of the informant, particularly parents with FASD – in this case teacher reports are crucial (they are generally helpful collateral information)
Additional domains: sensory/motor
Psychologist does screening of visual motor integration, fine motor coordination and visual perception (Beery VMI) and by interview
Can refer to OT if significant concerns Sensory concerns are evaluated qualitatively –
by interview/observation
Additional domains: language and social communication
Psychology testing looks at verbal reasoning skills
Consideration of “higher level language” and abstraction through some measures of executive functioning
Further assessment by SLP can be recommended
Adjunct Assessment: SLP and OT
Limited resource: approx 40 out of 500 assessments or 1/12
Need evaluated on a case by case basis – can be decided at intake or by psychologist after testing completed
Sometimes OT or SLP assessment has already been completed by community – especially in younger children. We can use this info.
Speech Language Assessment
Standardized testing of core language (receptive and expressive language) – assessment tools such as Clinical Evaluation of Language Fundamentals - 4
Additional testing of “higher level language” and social communication – these measures seem less standardized/more qualitative. Example: Test of Narrative Language. Test of Problem Solving (TOPS) is standardized measure of abstract language
Occupational Therapy Assessment
Standardized assessment of fine motor skills and visual motor integration
Often: Bruininks-Oseretsky Test of Motor Proficiency
May also assess gross motor skills and sensory sensitivities – sensory assessment is more qualitative and thus difficult to quantify severity in our ranking system
Team Deliberation and Family Team Deliberation and Family ConferenceConference
After all appointments are completed, the team spends After all appointments are completed, the team spends time reporting their findings, agreeing upon diagnoses time reporting their findings, agreeing upon diagnoses and discussing the most appropriate recommendations.and discussing the most appropriate recommendations.
The team then sits down with the family and shares The team then sits down with the family and shares this information with them and with the support this information with them and with the support people they may choose to invite.people they may choose to invite.
We leave it up to families to invite school We leave it up to families to invite school professionals. Sometimes this is more sensitive (e.g. professionals. Sometimes this is more sensitive (e.g. birth mothers) and we may do parts with family only birth mothers) and we may do parts with family only even if professionals have been invited.even if professionals have been invited.
Assessment Goals:Assessment Goals: To ascertain if there is a Fetal Alcohol Spectrum To ascertain if there is a Fetal Alcohol Spectrum
Disorder Disorder
To discover what is making it difficult for this To discover what is making it difficult for this child/youth to be successful, and what child/youth to be successful, and what interventions we can recommend to assist the interventions we can recommend to assist the child and family with overcoming barrierschild and family with overcoming barriers
To ensure that recommendations are specific, To ensure that recommendations are specific, reasonable and achievable while focusing on reasonable and achievable while focusing on identified needs and taking into account strengths identified needs and taking into account strengths and personal/community resourcesand personal/community resources
Assessment Summary
The multidisciplinary team will produce a short report on the day of feedback (sometimes hand written).
This summarizes diagnosis and key assessment findings as
well as key recommendations.
This is the only report signed by all professionals, and is needed to support designation under chronic health (given multidisciplinary guidelines).
We encourage families to share the report with schools but all documentation is owned by families.
Key Recommendations
Tailored to the individual, but often recommend: An individualized learning plan at school (we do not
direct schools how to designate children – rather we describe difficulties in a way to facilitate this should schools feel it would be helpful)
Support of the “key worker” – this is a family advocate rather than someone who can work directly with the child or youth. Limited mandate, variable service.
Possible medication recommendations Possible mental health follow up
Psychology Report
Comes out several weeks after the team feedback. Shared directly with families and medical
professionals. Families are encouraged to provide a copy to schools and if there is sensitive personal information, we may provide a “school version” to facilitate this.
Summarizes findings in much more detail. Additional specific recommendations for families as
well as schools.
Psychology Report: A consumer’s guide
Key components of report: Reason for Referral Identifying/Background information Behavioural Observations Tests used Results: review of test findings – correspond to
FASD domains Summary and diagnostic conclusions Detailed recommendations
Psychology Report: A consumer’s guide
1. Flip to the summary/conclusions section – look for the diagnoses as well as an overall description of the concerns – what are the strengths and weaknesses? What is the level of difficulty in different areas?
2. Look at the recommendations – many of these are aimed at schools to assist with developing an IEP/school plan, understanding the child’s learning style and providing appropriate accommodations
3. If desired, you can review test findings in more detail.
Case example: How do you get a “brain 3”?
John Smith example:- 16 year old- In utero alcohol, LSD, cocaine and marijuana in first 14 weeks of
pregnancy – stopped when she knew she was pregnant - mom is adopted and believes she may have FASD herself
- History of learning problems as well as attachment disruption- Has ADHD diagnosis – tried meds but couldn’t tolerate side effects- School avoidant in the last year (so school reports less available) –
choosing to attend shop class only- Viewed as bright and capable and previous academic testing
revealed low average to above average skills (Woodcock Johnson) but weak visual motor skills
- Has been identified as having LD in writing – some accommodations provided
Case example: How do you get a “brain 3”?
Overall IQ not meaningful, large discrepancy between IQ domains – visual skills are 75th percentile, verbal 16th, working memory 5th, processing speed 1st
Significant academic problems – history of written output challenges, on testing reading is average, but written math and spelling/writing are below 1st percentile
VMI 9th percentile, fine motor 4th percentile (note OT assessment would have been helpful, but not available on outreach in small community)
Case example: How do you get a “brain 3”?
Memory testing showed visual memory at the 2nd percentile, verbal memory scores scattered from below average to average
Executive functioning: reported difficulties in all areas – testing shows weak scanning as well as working memory/cognitive flexibility and multi-tasking, and poor inhibition (not all testing is low)
Very compliant and focused during testing – ADHD not outwardly visible – now qualifies for inattentive subtype
Case example: How do you get a “brain 3”?
Adaptive functioning at the 1st percentile Strengths in communication and community
use Weaknesses in health and safety, home living,
self care, self direction, social and leisure
Case example: How do you get a “brain 3”?
Weaknesses in language reasoning and related academic problems suggest a language-based learning disability
Also a specific LD: Disorder of Written Expression, complicated by fine motor/visual motor challenges and problems with visual scanning
Meets criteria for ADHD, inattentive subtype
Case example: How do you get a “brain 3”?
Multiple impaired domains: cognitive (scatter), achievement, visual memory, executive functions, attention and adaptive meet the “severe” criteria
No findings of growth impairment or facial features Diagnosis is 1134 or Alcohol Related
Neurodevelopmental Disorder For John who appears high functioning and has
generally average to high average cognitive (especially visual strengths) – this is truly an “invisible disability”
Case Study: Recommendations
Strengths based learning program – e.g. good at mechanics – find a way to build program around strengths
Visual and hands-on learner Reduce verbal demands Adjust for slower processing speed Adaptations for written output challenges Recognize and support memory impairment Structured, predictable environment – lots of support
as “external brain”
Assessment Outcomes
Better understanding of the child or youth’s learning profile, challenges, strengths and needs
Hopefully impacts to school planning and provision of supports
Limited access to intervention programs outside of school context (not like ASD programming)
In adulthood, may have access to disability services such as Persons With Disabilities funding or Personal Supports Initiative through Community Living BC
Family may be eligible for Disability Tax Benefit
Designation of students for Special Education Services
FASD is most often designated under “chronic health impairments”
IHCAN covers 16 different school districts and each has their own policy and interpretation of assessment information with regards to designation of students under Ministry of Education guidelines
A diagnosis seems to be a requirement (not just a description of challenges) and needs to include medical assessment (multidisciplinary)
From the policy manual:
In some cases, students diagnosed through the Complex Developmental BehaviouralConditions (CDBC) Network as children and youth with complex needs may beincluded in this category. Regionally, the CDBC Network has been established toassess children and youth with complex needs, including children and youth whomay have fetal alcohol spectrum disorder (FASD). A clinical diagnostic assessment bythe CDBC Network or by qualified specialists (psychiatrist, registered psychologistwith specialized training, or medical professional specializing in developmentaldisorder) is required. The assessment must include and integrate information frommultiple sources and various professions from different disciplines that indicates thestudent with FASD or the complex developmental behavioural conditions is exhibitingan array of complex needs, with two or more domains being impacted (social
emotionalfunctioning, communication, physical functioning, self determination/independence, and academic/intellectual functioning).
See: http://www.bced.gov.bc.ca/specialed/special_ed_policy_manual.pdf
FASD district partners
SD 23: Sue Thompson (Central Okanagan) –[email protected]
SD 22 (Vernon): Cheryl Turner [email protected]
For other partners see: http://www.fasdoutreach.ca/about-us/district-partners/district-partners
Where are services accessed?Where are services accessed? Ministry of EducationMinistry of Education Ministry of Children and Family Development Ministry of Children and Family Development
(Keyworker, CYSN, CYMH, Probation)(Keyworker, CYSN, CYMH, Probation) Adults- CLBC, Mental HealthAdults- CLBC, Mental Health Ministry of Housing and Social DevelopmentMinistry of Housing and Social Development Interior Health AuthorityInterior Health Authority Community AgenciesCommunity Agencies
Ministry of EducationMinistry of Education In B.C., children/youth identified with an In B.C., children/youth identified with an
FASD FASD maymay qualify for additional supports in qualify for additional supports in their educational settingtheir educational setting
http://www.bced.gov.bc.ca/independentschools/bc_guide/spec_edgrants.htm
www.fasdoutreach.ca
MCFD – Keyworker programMCFD – Keyworker program
Key Worker Agency Program and Parent to Key Worker Agency Program and Parent to Parent Support Groups funded by MCFD Parent Support Groups funded by MCFD (Ministry of Children and Family (Ministry of Children and Family Development) and contracted out to various Development) and contracted out to various private agency around the provinceprivate agency around the province
http://www.mcf.gov.bc.ca/fasd/kw_support.htm
MCFD – continued…MCFD – continued…
Child and Youth Mental Health (CYMH)Child and Youth Mental Health (CYMH) – – child/youth with an FASD may qualify for child/youth with an FASD may qualify for counselling and support if they have additional counselling and support if they have additional mental health concerns mental health concerns
Child and Youth with Special NeedsChild and Youth with Special Needs (CYSN)(CYSN) – may provide supports if child/youth – may provide supports if child/youth has an FASD and an intellectual disabilityhas an FASD and an intellectual disability
Victoria Foundation Funded Pilot Victoria Foundation Funded Pilot Projects for 2010Projects for 2010
http://www.victoriafoundation.bc.ca/web/files/Sept2009_FASD_nr.pdf
Gateway Program at the John Howard Society (South Central Gateway Program at the John Howard Society (South Central Okanagan)Okanagan)
Pacific Community Resources Society (Vancouver-to-Pacific Community Resources Society (Vancouver-to-Chilliwack)Chilliwack)
Women’s Health Research Institute (Vancouver area)Women’s Health Research Institute (Vancouver area) Alberni Valley FASD Community Action Group (Port Alberni Valley FASD Community Action Group (Port
Alberni)Alberni) Fetal Alcohol Spectrum Disorder Society of BC (Asante Fetal Alcohol Spectrum Disorder Society of BC (Asante
Centre, Vancouver)Centre, Vancouver)
Community Living British ColumbiaCommunity Living British Columbia Adults with an FASD may now qualify for Adults with an FASD may now qualify for
life-long supports IF they have significant life-long supports IF they have significant impairment in adaptive functioning (below the impairment in adaptive functioning (below the 0.1 percentile)0.1 percentile)
Supports may include supported living, Supports may include supported living, respite, employment support, skill respite, employment support, skill development, homemaker support and development, homemaker support and development of support networksdevelopment of support networks
http://www.communitylivingbc.ca/individuals-families/personalized-supports-initiative/
Trouble with the Law/ForensicsTrouble with the Law/Forensics
Forensic involvement opens service doorsForensic involvement opens service doors Specialized programs for youth who commit Specialized programs for youth who commit
sexual and violent offensessexual and violent offenses General and specialized mental health services General and specialized mental health services
for eligible youthfor eligible youth Community treatment and supervision of Community treatment and supervision of
youth who have received a conditional youth who have received a conditional dischargedischarge
Ministry for Housing and Social Ministry for Housing and Social DevelopmentDevelopment
For some older youth (18+)/adults with an For some older youth (18+)/adults with an FASD and an inability to work full time, FASD and an inability to work full time, financial support may be available via MHSD financial support may be available via MHSD through the Persons with Disabilities or PWDthrough the Persons with Disabilities or PWD
http://www.hsd.gov.bc.ca/PUBLICAT/bcea/pwd.htm
Interior Health AuthorityInterior Health Authority
IHA funds Alcohol and Drug counselling for IHA funds Alcohol and Drug counselling for youth. Many of the counsellors have received youth. Many of the counsellors have received specific training regarding necessary specific training regarding necessary modifications when treating youth with an modifications when treating youth with an FASDFASD
Developmental Disability Mental Health – Developmental Disability Mental Health – trained youth mental health therapists trained youth mental health therapists (generally youth also have an intellectual (generally youth also have an intellectual disability to qualify) disability to qualify)
Summary – Community Services for Summary – Community Services for individuals with an FASDindividuals with an FASD Without additional diagnoses or forensic Without additional diagnoses or forensic
involvement, individuals with an FASD do not involvement, individuals with an FASD do not generally qualify for specialized services in BC generally qualify for specialized services in BC
In our region, there are no services that work directly In our region, there are no services that work directly with the person affected by FASDwith the person affected by FASD
The Key Worker Agency Program is the only The Key Worker Agency Program is the only provincial program for FASD and its mandate is to provincial program for FASD and its mandate is to work with families and other professionalswork with families and other professionals