Vasha was at the end of her rope. After CPS found that she was being neglectful of Terrance, she didn't know what to do. On the one hand, she felt anger at "the system" -- what did they know about her son? What did they know about her? She resented such interference into her life, and she had half a mind to take Terrance and leave the state - but she knew that would put her in much more trouble than she was already in.
Vasha had limited social support - her friend Sarah was still a close confidant - and she wasn't sure how she was going to deal with the pressure she perceived from the social worker. It was like she was the enemy of this person, even though all she was doing was trying her best to care for her son. Sarah was the only one who understood.
Terrance continued to be a challenge, even after the mandated counseling. The counselor even came to the home. Vasha was both skeptical of this person and rather annoyed. The counselor was a young girl who didn't even have kids of her own! What did she know? How could she help? For Vasha, such a presumption that someone so unlike her could provide assistance was another slap in the face. Terrance seemed to like the counselor, but he didn't do anything differently - in fact, he really threw a tantrum after each time the counselor left the house.
Terrance was able to enjoy himself sometimes - usually when he had some kind of video device nearby. He would sit for hours in front of the TV - and Vasha would let him - and watch reruns of old shows. It wasn't the content that captured him as much as the movement, the colors, and the sounds. He loved it when the TV would just go to static.
Vasha learned from the counselor that Terrance ceased to qualify for the intensive in-home service under which he was being served, so the counselor would have to stop coming to the home after only 6 months. Vasha didn't care - it's not like it was helping anyhow. The social worker set up regular meetings with Vasha to check in on her, and Vasha kept going to see her counselor.
Vasha continued on this way until Terrance was 4. He was old enough to get around, and he was tall enough to get into heaps of trouble around the house. It was one sleepy Sunday morning that proved to be the last straw for Vasha - and for CPS. Terrance got hold of a book of matches and set some paper on fire. By the time Vasha smelled the smoke and ran into the room when Terrance was, the fire was slowly spreading. She grabbed Terrance and got out of the house.
The fire department came and was able to save most of the home. Vasha still had a place to live even though it was in need of great repair. For his part, Terrance didn't seem affected by the incident whatsoever. CPS was called again, and the social worker gave Vasha the choice to place Terrance with a relative or to have him go into the care of the state. Vasha made contact with her mother who begrudgingly agreed to care for Terrance.
* Describe typical developmental milestones for a four year old.
* What is "intensive in-home" as a Medicaid-provided service? Who typically provides this service? What is the level of training required? How ethical is it to cease serving someone because their insurance runs out?
* Hypothesize as to Vasha's various negative responses to her involvement in the child welfare system.
* Describe the manner in which a family transitions from
Part B of IDEA to Part C. What are the major differences between the services
provided under Part B vs Part C?
In addition to the questions above, please also answer the
following questions posed to you by the other groups (not all questions are
included from all groups) :::
From the Lisa Yoo group :::
1) Where can Vasha go/who can she talk to about her concern about the
services Terrance is receiving? Are there any other services that are
available for Terrance, other than those offered in IDEA and if so what
are they?
From the Thomas Mahoney group :::
1) What is Vasha’s relationship with her parents like? With the babies’ father? Can any of these relationships be affecting the way that she is raising Terrance or the way she is reacting to motherhood?
From the Ahmad Nassar group :::
1) Is there any information available about the success rates of
community services overall? Have they actually been proven to be
effective?
2) If CPS suspects that the child is being abused or neglected, why was he not taken out of the home?
* Describe typical developmental milestones for a four year old.
ReplyDeleteTypical developmental Milestones for a 4 year old child in the area of movement and physical and motor skills are as follows:
• “Gains weight at the rate of about 6 grams per day
• Grows to a height that is double the length at birth
• Shows improved balance
• Hops on one foot without losing balance
• Throws a ball overhand with coordination
• Can cut out a picture using scissors
• May not be able to tie shoelaces
• May still wet the bed (normal)
• Running is more controlled; can start, stop, and turn
• Can easily catch and bounce a ball
• Can brush teeth, comb hair, wash, and dress with little assistance
• Prints some letters (Medline Plus, 2012)”
• “Uses table utensils skillfully
• Copies crosses and squares
• Learn best when they participate in hands-on, tactile and real experiences, walk down steps, alternating feet (Destefanis & Firchow, 2009)”
• “Begin to coordinate movements to climb on jungle gyms and begin trying to jump rope (Clayton County Public Schools, 2012).”
Typical Developmental milestones for an 4 year old child in the area of cognitive and sensory skills (which include learning, language, thinking, and problem-solving) are as follows:
• “Has a vocabulary of more than 1,000-1,500 words
• Easily puts together sentences of four or five words
• Can use the past tense
• Can count to four
• Will ask the most questions of any age
• May use words that aren't fully understood
• May begin using vulgar words
• Learns and sings simple songs
• Tries to be very independent (Medline Plus, 2012)”
• “May show increased aggressive behavior
• Talks about personal family matters to others
• Commonly has imaginary playmates
• Has an increased understanding of time
• Is able to tell the difference between two objects based on things like size and weight
• Lacks moral concepts of right and wrong (Destefanis & Firchow, 2009)”
• “Rebels if too much is expected of him or her
• Begins to understand the difference between reality and fantasy
• Begins to think literally—starting to develop logical thinking
• Begins to grasp that pictures and symbols can represent real objects
• May try to write their own name
• Use verbal commands to claim things.
• Can control volume of voice for periods of time if reminded.
• Can retell a three to four step sequence in a story or directive (Clayton County Public Schools, 2012).”
Typical Developmental milestones for an 4 year old child in the area of social and play skills are as follows:
• “Begin to understand taking turns, sharing, and cooperating (may still show difficulty here)
• Expresses anger verbally rather than physically
• Can feel jealousy
• May sometimes lie to protect himself, but understands the concept of lying
• Enjoys pretending and has a vivid imagination.
• Still engage in associative play most of the time, but begin the first steps in true give and take cooperative play (Medline Plus, 2012)”
• “At times become angry (but no more temper tantrums) if things don’t go their way and quickly justify an aggressive act such as “he hit me first.”
• Show difficulty following through on a task and become easily sidetracked.
• Can get their own snacks and clean up without constant supervision, but still are unable to wait very long regardless of the promised outcome (Destefanis & Firchow, 2009)
• “Enjoy a variety of group experiences such as large group, small group, and some partners.
• May begin to start teasing others (Clayton County Public Schools, 2012).”
* What is "intensive in-home" as a Medicaid-provided service? Who typically provides this service? What is the level of training required? How ethical is it to cease serving someone because their insurance runs out?
ReplyDeleteAccording to the Institute for Family Centered Services, “intensive in-home services are designed to keep families together that are at risk for one or more of the family members leaving home as a result of their or other family member’s behaviors in the home or community” (Institute for Family Centered Services, 2007). In terms of possibly losing their child to social services, parents now have the “intensive in-home” opportunity to improve their lifestyles and their child’s well-being. An important concept of this Medicaid-provided service is that providers recognize the potential of some children being in truly loving homes. This service really strives to work in the child’s best interest, while also genuinely improving upon the family’s issues at home rather than “quick-fixing” the issue and taking the child away from his/her family. The “intensive in-home” service is specifically used to “develop, support, and empower the family unit by teaching problem solving skills, assisting parents in becoming advocates for themselves, and coordination of available community resources” (Cumberland Mountain Community Services Board). This service has been extremely beneficial to thousands of families.
These services are typically provided by state-run, family-centered and intervention organizations. Some of these organizations include: the Institute for Family Centered Services, Family Resource Center, Department of Children & Families, and Youth Villages. Although each organization is different, services can be provided by the organizations through the use of “psychiatrists, advanced practice registered nurses, Master’s-level clinicians, and Bachelor’s level case management staff” (Department of Children & Families, 2012). Depending on the service provider and the severity of the family’s needs, intervention services can also include: “behavioral skills teaching focus, parenting education, family therapy, building communication skills, helping to obtaining daily needs, improving home management, budgeting financial planning, culturally relevant services, and mutually develop goals to prevent out-of-home placement” (Family Resource Center, 2012). The services provided by “intensive in-home” therapies are directly related to improving family-life and communication. According to the Department of Medical Assistance Services, “intensive in-home providers for children and adolescents must be licensed as a provider of Intensive In-Home Services by the Department of Behavioral Health & Developmental Services” (Department of Medical Assistance Services, 2010). This level of training ensures that each family is receiving adequate assistance from certified and appropriate providers.
In terms of ceasing services to a family in need because their insurance runs out, several ethical issues can arise. These ethical issues mostly pertain to the child’s and family’s well-being. If a family is in desperate need of services and the only reason they cannot receive services is because of insurance, I feel that is highly unethical. In this way I feel insurance companies are more concerned with money than the actual people they are insuring, and this leads to many families being left behind and struggling.
* Hypothesize as to Vasha's various negative responses to her involvement in the child welfare system.
ReplyDeleteVasha was very resentful of CPS and felt that the social workers predetermined that she was guilty of child neglect before even getting to explain her side of the story. They did not see all the positive things that she had done for Terrance and how she had been desperately trying to better both of their lives. She had come so far but was not acknowledged for anything she had done. Instead CPS only focused on the negative and blamed Vasha for everything.
Vasha was trying her best but the counselor could not relate to her and had no idea what it was like to be a mother, let alone a mother of a child like Terrance. Spending a few hours here and there with Terrance and then leaving and going on about your business without another thought of him until it was time for the next session was nothing compared to taking care of him 24-hours a day 7-days a week. Vasha did not get a break or anytime to be able to relax. Even though Vasha did not think the intensive in-home service was producing any results she felt abandoned by those who were suppose to be helping her when it was decided that Terrance ceased to qualify for the service. Vasha did her part by going to her counselor but the system did not keep their part.
When Terrance accidentally set the house on fire Vasha did exactly what she was suppose to do as a mother by saving her child but CPS again did not look at the good and only focused on Terrance being unsupervised playing with matches. She could not understand why they wanted to take Terrance away from her, after all he wasn’t the only child that ever played with matches and set the house on fire, those other children were not taken from their homes. It seems as though CPS is just out to get Vasha; they were just waiting for something to happen so they could take Terrance away from her. If Vasha turned Terrance over to the care of the state she felt as though she would never get him back and never see him again. She convinced her mother to take him. Vasha did not understand why it was all right for Terrance to go live with her mother since her mother did not do that great a job raising her but at least she was with family even if it was in the loose sense of the word.
* Describe the manner in which a family transitions from Part B of IDEA to Part C. What are the major differences between the services provided under Part B vs Part C?
ReplyDeleteThe Individuals with Disabilities Education Act, IDEA is a law ensuring services to children with disabilities throughout the nation. It is broken up into two parts. For infants and toddlers with disabilities and their families receive early intervention services under IDEA Part C and for children and youth ages 3-21 receive special education and related services under IDEA Part B. In Part C of IDEA the child and family use an Individualized Family Service Plan (IFSP) to guide the early intervention process and under Part B a child has and Individualized Education Program (IEP) that is designed to meet the educational needs of the child. ("Building the legacy:idea," )
When a child is nearing three years of age the IFSP team must conduct a transition/review meeting. During this meeting the parents, IFSP team and possibly the school district will formulate an IEP assessment plan. When the child reaches # years old, the assessments need to be completed and the IEP needs to be implemented. ("Special education advisor," ) Part C, early intervention services are family based and the IEP is solely focused on the child, which is the major difference between the two parts.
From the Lisa Yoo group :::
ReplyDelete1) Where can Vasha go/who can she talk to about her concern about the services Terrance is receiving? Are there any other services that are available for Terrance, other than those offered in IDEA and if so what are they?
A potentially large piece of the puzzle that is contributing to the failure of the counseling services for Terrance is Vasha’s hesitations and incapacity to see eye to eye with the “young, childless counselor who came to their home and had no idea about what she was doing or how to handle her child.” This idea is based on the concept of mirror neurons in the theory that Vasha’s hesitations and negative feelings toward the in home counselor are being mirrored onto Terrance’s emotions about the situation, hence the temper tantrums every time the counselor leaves. With that being said, maybe it would be helpful for Vasha to meet with the counselor privately, and then have her meet with Terrance without Vasha in the same room to hinder the transfer of mirror neurons.
Vasha’s friend Sarah is also someone who can be of great assistance in the idea that it is someone who CAN see eye to eye with her. She can also be a source of “venting of emotions” that could otherwise affect Terrance emotionally or physically. Vasha’s counselor whom she has been seeing since her post-partum depression was diagnosed, is also a very good outlet for her emotions and concerns. This counselor could also step in and speak with CPS about the concerns that Terrance is not growing from the services that are being provided, and a change may be in order.
Vasha could also contact CPS services and request a different social worker to be on their particular case. Seeing as the in home counseling needed to stop after 6 months, and they have had the same worker on their case for a year and a half with no improvement, and in fact a considerable decline since the first CPS investigation, a change in counselor would most likely be justified.
From the Lisa Yoo group :::
ReplyDelete1) Where can Vasha go/who can she talk to about her concern about the services Terrance is receiving? Are there any other services that are available for Terrance, other than those offered in IDEA and if so what are they? (CONTINUED)
As for the question if there are any other services available to Terrance other than the ones being offered through IDEA and CPS, the answer is yes. There are many organized groups that have been put together to help with this very issue. One example would be the Continuum of Care. Their missions is to,
“ensure continuing development and delivery of appropriate services to those children and their families whose needs are not being adequately met by existing services and programs.
In order to carry out this mission, the Continuum will supplement existing services available to this population and promote supports that encourage family strength and self-sufficiency by providing or procuring services to complete the range of services needed in the least restrictive, most appropriate setting. Further, the Continuum will ensure that the delivery of those services represented in its Array of Services (in-home treatment programs; residential treatment programs; education services; counseling services; outreach services; volunteer and community services) are in compliance with appropriate state laws (McGeorge, n/a).”
Another example would be Sierra Vista Child and Family Services which focuses on helping abused, neglected, and emotionally disturbed children and families in crisis. They focus on community based services which focus on not only the child but also the adult. This could help Vasha immensely in flattening the assumption that she is going through this alone, with the hopes that she could find and talk to people from her own community with the same issues she is having. Adult treatment would consist of services in effective parenting, domestic violence, anger management, and child abuse counseling/prevention (Sierra Vista and Family Services, 2009).
As you can see, there are many private, non-profit organizations that are available to families going through exactly what Vasha and Terrance are going through. These can be Community Based, and offer services that still follow the guidelines of the states, yet may be different in the accommodation of those guidelines to better suit the family. I would highly encourage Vasha to look into the services and organizations that are offered in her own community and take a leap of faith and join with an open mind.
From the Thomas Mahoney group :::
ReplyDelete1) What is Vasha’s relationship with her parents like? With the babies’ father? Can any of these relationships be affecting the way that she is raising Terrance or the way she is reacting to motherhood?
In terms of Vasha’s relationship with her parents, tensions are high. Due to Vasha’s troubles with drugs and alcohol in the past, her parents felt it necessary to outcast their only daughter in hopes of her gaining control of her life and to protect themselves emotionally. However, the decision to outcast their daughter ultimately led to a divorce and only heightened Vasha’s level of resentment towards her parents. In terms of contacting her parents for help, Vasha is only able to get in touch with her mother but both are reluctant to communicate. The relationship between Vasha and Terrance’s father was practically non-existent after Terrance’s birth. He could not handle the pressures of having a child with a disability. There is a high probability that Vasha’s relationships with her parents and baby’s father is affecting the way she reacts to motherhood and raising Terrance. Vasha has a complete lack of social support from the people who are supposed to be there for her the most. Although she loves Terrance very much and is doing the best she can to support him, the lack of support and guidance she has received herself is severely damaging to her parenting ability.
From the Ahmad Nassar group :::
ReplyDelete1) Is there any information available about the success rates of community services overall? Have they actually been proven to be effective?
There are numerous studies that have focused on community services and their proven effectiveness. In regards to Terrance, according to Watson, Finkelstein, Gurewich, & Morse, 2011, which specifically focused on children with Fetal Alcohol Spectrum Disorders (FASD), recent studies suggest "that interventions for children with an FASD can improve both learning and behavior using simple, low-cost strategies (Bertrand, 2009; Coles et al., 1997; Frankel, Paley, Marquardt, & O'Connor, 2006; Kable et al., 2007; O'Connor et al., 2006; Olson, 2007; Paley & O'Connor, 2009)." Additionally the article goes on to state that early intervention programs "have positively influenced developmental trajectories of children served (Meisels & Shonkoff, 2000) especially for children with diverse genetic and developmental delays, and adverse social environments" (Watson, Finkelstein, Gurewich, & Morse, 2011).
2) If CPS suspects that the child is being abused or neglected, why was he not taken out of the home?
The social worker for CPS did see some evidence of neglect on Vasha’s part of being a mother due to her depression and battle against alcoholism. However CPS felt that the services that are included in Vasha and Terrance’s plan and require intense involvement in are: family training/counseling to be the most important, physical and speech therapy for Terrance and psychological services for both Vasha and Terrance. These services are going to be more frequent and intense than the ones provided by IDEA, as well as more specific to the strengths and weaknesses that have been identified within the home. Hopefully with this new, more intense and invasive array of services offered through CPS, and a close watch on both Vasha and Terrance, it will be enough to see a change rather than splitting the family apart.
References
ReplyDeleteBuilding the legacy:idea 2004. (n.d.). Retrieved from http://idea.ed.gov/
Clayton County Public Schools. (2012). Developmental milestones: Characteristics of 4 year olds. Retrieved from http://www.clayton.k12.ga.us/departments/instruction/prek/developmentalmilestones.asp
Cumberland Mountain Community Services Board. (n.d.). Intensive In-Home Services. Retrieved February 24, 2012, from http://www.cmcsb.com/inhome.htm
Department of Children & Families. (2012). Community Based Behavioral Health Services. Retrieved February 24, 2012, from http://www.ct.gov/dcf/cwp/view.asp?a=2558&q=314366
Department of Medical Assistance Services. (2010). Children’s Community Mental Health Services: Intensive In-Home Services H2012, Intensive In-Home Assessment H0031. Retrieved February 24, 2012, from www.dmas.virginia.gov/downloads/ln-mh_iihsrv.ppt
Destefanis, J., & Firchow, N. (2009, Janurary 15).Developmental milestones ages 3-5. Retrieved from http://www.greatschools.org/special-education/health/724-developmental-milestones-ages-3-through-5.gs
Family Resource Center. (2012). Intensive In-Home Services. Retrieved February 24, 2012, from http://frcmo.org/inhomeservices.html
Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 10
Institute for Family Centered Services. (2007). What are Intensive In-Home Family Centered Services. Retrieved February 24, 2012, from http://www.ifcsinc.com/what_is_inhome.php
McGeorge, S. (n.d.). The continuum of care. Retrieved from http://www.oepp.sc.gov/coc/default.html
Medline Plus. (2012, February 07). Developmental milestones record-4 years. Retrieved
from http://www.nlm.nih.gov/medlineplus/ency/article/002015.htm
Meisels, S. J., & Shonkoff, J. P. (2000). Early Childhood Intervention: A Continuing Evolution (2 ed.). New York, NY: Cambridge University Press.
Sierra Vista and Family Services. (2009). We care. Retrieved from http://sierravistacares.org/
Special education advisor. (n.d.). Retrieved from http://www.specialeducationadvisor.com/special-education/transition-planning/transition-from-idea-part-c-to-idea-part-b/
Watson, E. M., Finkelstein, N. P., Gurewich, D. P., & Morse, B. P. (2011, April/June). TheFeasibility of Screening for Fetal Alcohol Spectru Disorders Risk in Early Intervention Settings: A pilot Study of Systems Change. Infants & Young Children, 24(2), pp. 193-206. doi:10.1097/IYC.0b013e31820d97c9