National and Michigan Perspectives. Lori Irish Michigan Department of Community Health

Transcription

1 National and Michigan Perspectives Lori Irish Michigan Department of Community Health Barbara LeRoy Developmental Disabilities Institute Wayne State University 1 Introduction Barbara LeRoy, Director, Developmental Disabilities Institute (DDI), Wayne State University Lori Irish, Manager of Services to Children with Intellectual/Developmental Disabilities, Behavioral Health and Developmental Disabilities Administration, Michigan Department of Community Health 2 1

2 Overview Overview of Developmental Milestones Developmental Screening for Young Children Introduction to Early On Michigan Children with Intellectual/Developmental Disabilities Resources for Families Michigan Medicaid and MIChild Autism Benefit Michigan Autism Insurance Law 3 CDC Centers for Disease Control and Prevention Developmental Milestones As children grow, they develop and learn new skills Children develop at their own pace Things most children do by a certain age 4 2

3 Developmental Milestones Four Areas of Development: 1. Social/Emotional 2. Language/Communication 3. Cognitive (learning, thinking, problem solving) 4. Movement/Physical Development 5 What most babies do at this age: 2 Months Social and Emotional Begins to smile at people Can briefly calm himself (may bring hands to mouth and suck on hand) Tries to look at parent Language/Communication Coos, makes gurgling sounds Turns head toward sounds 6 3

4 What most babies do at this age: 2 Months Cognitive (learning, thinking, problem solving) Pays attention to faces Begins to follow things with eyes and recognize people at a distance Begins to act bored (cries, fussy) if activity doesn t change Movement/Physical Development Can hold head up and begins to push up when lying on tummy Makes smoother movements with arms and legs 7 What most babies do at this age: 4 Months Social and Emotional Smiles spontaneously, especially at people Likes to play with people and might cry when playing stops Copies some movements and facial expressions, like smiling or frowning Language/Communication Begins to babble Babbles with expression and copies sounds he hears Cries in different ways to show hunger, pain, or being tired 8 4

5 What most babies do at this age: 4 Months Cognitive (learning, thinking, problem solving) Lets you know if she is happy or sad Responds to affection Reaches for toy with one hand Uses hands and eyes together, such as seeing a toy and reaching for it Follows moving things with eyes from side to side Watches faces closely Recognizes familiar people and things at a distance 9 What most babies do at this age: 4 Months Movement/Physical Development Holds head steady, unsupported Pushes down on legs when feet are on a hard surface May be able to roll over from tummy to back Can hold a toy and shake it and swing at dangling toys Brings hands to mouth When lying on stomach, pushes up to elbows 10 5

6 What most babies do at this age 6 Months Social and Emotional Knows familiar faces and begins to know if someone is a stranger Likes to play with others, especially parents Responds to other people s emotions and often seems happy Likes to look at self in a mirror 11 What most babies do at this age 6 Months Language/Communication Responds to sounds by making sounds Strings vowels together when babbling ( ah, eh, oh ) and likes taking turns with parent while making sounds Responds to own name Makes sounds to show joy and displeasure Begins to say consonant sounds (jabbering with m, b ) 12 6

7 What most babies do at this age : Age 6 Months Cognitive (learning, thinking, problem solving) Looks around at things nearby Brings things to mouth Shows curiosity about things and tries to get things that are out of reach Begins to pass things from one hand to the other Movement/Physical Development Rolls over in both directions (front to back, back to front) Begins to sit without support When standing, supports weight on legs and might bounce Rocks back and forth, sometimes crawling backward before moving forward 13 What most babies do at this age : Age 9 Months Social and Emotional May be afraid of strangers May be clingy with familiar adults Has favorite toys Language/Communication Understands no Makes a lot of different sounds like mamamama and bababababa Copies sounds and gestures of others Uses fingers to point at things 14 7

8 What most babies do at this age : Age 9 Months Cognitive (learning, thinking, problem solving) Watches the path of something as it falls Looks for things he sees you hide Plays peek a boo Puts things in her mouth Moves things smoothly from one hand to the other Picks up things like cereal o s between thumb and index finger Movement/Physical Development Stands, holding on Can get into sitting position Sits without support Pulls to stand Crawls 15 What most babies do at this age : Age 1 year Social and Emotional Is shy or nervous with strangers Cries when mom or dad leaves Has favorite things and people Shows fear in some situations Hands you a book when he wants to hear a story Repeats sounds or actions to get attention Puts out arm or leg to help with dressing Plays games such as peek a boo and pat a cake 16 8

9 What most babies do at this age: Age 1 year Language/Communication Responds to simple spoken requests Uses simple gestures, like shaking head no or waving bye bye Makes sounds with changes in tone (sounds more like speech) Says mama and dada and exclamations like uhoh! Tries to say words you say 17 What most babies do at this age: Age 1 year Cognitive Explores things in different ways, like shaking, banging, throwing Finds hidden things easily Looks at the right picture or thing when it s named Copies gestures Starts to use things correctly; for example, drinks from a cup, brushes hair Bangs two things together Puts things in a container, takes things out of a container Lets things go without help Pokes with index (pointer) finger Follows simple directions like pick up the toy 18 9

10 What most babies do at this age : Age 1 year Cognitive (learning, thinking, problem solving) Watches the path of something as it falls Looks for things he sees you hide Plays peek a boo Puts things in her mouth Moves things smoothly from one hand to the other Picks up things like cereal o s between thumb and index finger 19 What most babies do at this age : Age 1 year Movement/Physical Development Gets to a sitting position without help Pulls up to stand, walks holding on to furniture ( cruising ) May take a few steps without holding on May stand alone 20 10

11 What most babies do at this age : Age 18 Months Social and Emotional Likes to hand things to others as play May have temper tantrums May be afraid of strangers Shows affection to familiar people Plays simple pretend, such as feeding a doll May cling to caregivers in new situations Points to show others something interesting Explores alone but with parent close by 21 What most babies do at this age : Age 18 Months Language/Communication Says several single words Says and shakes head no Points to show someone what he wants 22 11

12 What most babies do at this age : Age 18 Months Movement/Physical Development Walks alone May walk up steps and run Pulls toys while walking Can help undress herself Drinks from a cup Eats with a spoon 23 Developmental Milestones If you do not see your child reaching these milestones Act Early Talk to your child s doctor or nurse Screen Your Child Now! The M CHAT R's primary goal is to detect as many cases of ASD as possible. Contact Early On Michigan Early On offers early intervention services for infants and toddlers, birth to three years of age, with developmental delay(s) and/or disabilities, and their families Early On or

13 Individuals with Disabilities Education Act (IDEA) The Individuals with Disabilities Education Act (IDEA) is a United States federal law that governs how states and public agencies provide early intervention, special education, and related services to children with disabilities. Part C = birth to 3 years Part B = 3 to 21 years 25 Early On A statewide system of early intervention services mandated by federal legislation (Part C of IDEA) Designed to help families find the social, health and educational services that will promote the development of their infants and toddlers with special needs 26 13

14 Early On Strengths based Family Centered Based on parent/professional partnerships Based on interagency collaboration 27 Early On Eligibility: Any infant or toddler with an established condition (i.e., a physical or mental condition likely to lead to a delay) Developmental Delay Under 2 months of age: any delay 2 to 36 months of age: 20% in one or more areas 28 14

15 Early On Categories of Established Conditions Chromosomal Anomalies Chronic Illnesses Congenital Anomalies Developmental Delay Endocrine/Metabolic Disorders Exposures Affecting Fetus Hearing Deficiency Infectious Conditions Mental Health Conditions Other Disorders/Diseases Other Fetal/Placental Anomalies 29 Early On Developmental Delay in one or more categories Physical (including hearing and vision) Gross and Fine Motor Development Communication Development Cognitive Development Social/Emotional Development Adaptive (self help) 30 15

16 Early On Referral: Early On or Finding Out if My Child is Eligible for Early On After your child has been referred to Early On, your family will receive a written notice within 10 calendar days. This notice will include a form to ask for your permission to evaluate (or screen if appropriate) and an initial copy of your family rights. 31 Early On Service coordinator will be in charge of setting up the appointment for an evaluation. Evaluation will look at a child s growth and learning It can be completed in the child s home or child care If eligibility is determined, an Individualized Family Service Plan is developed 32 16

17 Early On Services Provided Assistive Technology Services Audiology Services Family Training, Counseling & Home Visits Health Services Medical Services Nursing Services Nutrition Services Occupational Therapy Signed/Cued Language Services Speech Therapy Physical Therapy Psychological Services Special Instruction Social Work Service Coordination Transportation Vision Services 33 Screening The American Academy of Pediatrics (AAP) recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months

18 Screening The AAP recommends using evidence based developmental screening tools including but not limited to: Ages and Stages Questionnaires (ASQ) Ages and Stages Questionnaires: Social Emotional (ASQ SE) Modified Checklist for Autism in Toddlers Revised (M CHAT R) 35 Screening M CHAT R Modified Checklist for Autism in Toddlers Revised A scientifically validated tool for screening children between 16 and 30 months of age that assesses risk for autism spectrum disorder (ASD). The American Academy of Pediatrics (AAP) recommends that all children receive autism screening at 18 and 24 months of age, and the M CHAT R is one of the AAP s recommended tools. The M CHAT R's primary goal is to detect as many cases of ASD as possible

19 Children with Intellectual and Developmental Disabilities (I/DD) 37 Children with I/DD 38 19

20 Children with I/DD Over the last 12 years, the Prevalence of DDs has increased 17.1% that's about 1.8 million more children with DDs in compared to a decade earlier Prevalence of DDs has increased 17.1% Prevalence of ADHD increased 33.0% Prevalence of autism increased 289.5% Prevalence of hearing loss decreased 30.9%. 39 Family Resources Local Community Mental Health Service Programs _4868_ ,00.html Children s Special Health Care Services (CSHCS) _4911_35698,00.html Michigan Alliance for Families

21 Wayne State University Developmental Disabilities Institute AIDD/ACL/HHS Core funded University Center of Excellence in Developmental Disabilities (UCEDD) 3 prong State Network Began at UM 1960 s; moved to WSU % funded on grants and contracts Report to the Office of the Provost Located in Leonard Simons building 4809 Woodward Mandated State Advisory Council 41 DDI Mission and Values Community inclusion Self determination Quality of life individuals and families Cultural sensitivity Participant empowerment 42 21

22 Developmental Disabilities Institute National network of 67 UCEDDs 43 UCEDD Mandates Statewide, all developmental disabilities, lifespan focus Pre service Education Graduate certificate program SSW Disability Modules for Academic Units Empowerment Education Student Field Placements 44 22

23 UCEDD Mandates Community Support and Services Training/TA State Taskforces System Change Initiatives Inclusion education Transition Supported employment Demonstration Projects Minority family support Monitoring Healthy Relationships 45 UCEDD Mandates Dissemination Website (ddi.wayne.edu) Special Interest Forums Spanish speaking families Sibling Network FASD Network Dual Diagnosis (DD/MI) Possibilities Video series Social Media: Facebook, Twitter, YouTube 46 23

24 Michigan Autism Insurance Law Senate Bills (SB) 414/415, Law became effective October 15, 2012 Bills for private insurers and all other HMO s insurers Includes all insurers covered under state regulated laws Does NOT include ERISA (self insured, federally regulated) companies (larger companies): overrides state mandates Does NOT include Medicaid & MI Child eligible children Is limited to services for children MEDICALLY diagnosed with an ASD (classic autism, PDD NOS, Asperger s) Does not cover co pays or deductibles 47 Michigan Autism Insurance Law Autism Bill Specifics: What s Covered Covers ABA, Speech and Occupational Therapies, Psychiatric and Psychological Care Dollar Limits/Caps With the Affordable Care Act (ACA), a dollar cap is not allowed for ABA. Some carriers have converted to maximum days or units per year for ABA

25 Medicaid and MIChild Autism Benefit Applied Behavior Analysis The science of analyzing and improving socially significant human behavior. 49 Medicaid and MIChild Autism Benefit Applied Behavior Analysis (ABA) services for ASD Focuses on increasing language acquisition, communication, peer interactions and social skills, responding to group instruction, academic/cognitive skills, following typical classroom routines, play skills, self help and daily living skills, learning in and from the natural environment, and reducing inappropriate behavior(s)

26 Medicaid and MIChild Autism Benefit Medicaid/MIChild Autism Benefit launched April 1, 2013 Services provided through the Prepaid Inpatient Health Plans /Community Mental Health Service Programs (PIHPs/CMHSPs) Added Board Certified Behavior Analysts (BCBAs) to the provider network 51 Medicaid and MIChild Autism Benefit Families now have access to Applied Behavior Analysis (ABA) Services for children aged 18 months up to 6 years of age children are eligible for ABA services Children also eligible for other CMHSP services, i.e., Family Support and Training, Occupational Therapy, Speech Therapy, Respite 52 26

27 Michigan Department of Community Health Autism Program Michigan Autism Program is located within the Behavioral Health and Developmental Disabilities Administration within the Michigan Department of Community Health The Michigan Autism Program was established in 2013 to support the: Medicaid and MIChild Autism Benefit Michigan Autism Spectrum Disorders State Plan Autism Council Autism services provided throughout Michigan Manage all MDCH autism related contracts with Universities and other stakeholders Michigan Autism Program Website 53 Autism Alliance of Michigan AAoM is dedicated to enhancing the lives of individuals and families affected by Autism Spectrum Disorders through education, comprehensive services, coordinated advocacy, and cutting edge research. website

28 Resources Learn the Signs Act Early 18mo.html Early On Michigan Michigan Department of Community Health: Developmental Disabilities Institute Wayne State University Autism Alliance of Michigan Michigan Alliance for Families 55 Lori Irish Barbara LeRoy