3.10.1 Alcohol and Other Drugs - AOD | 3.10.2 Child Assessment Factors: Developmental Delay | 3.10.3 Child Assessment Factors: Emotional | 3.10.4 Child Assessment Factors: Behavioral | 3.10.5 Developmental Disability - Mental Retardation | 3.10.6 Mental Illness | 3.10.7 Domestic Violence | 3.10.8 Sexual Abuse
3.10 APPENDIX C: Indicators
Following are the indicators for mental illness, substance abuse, domestic violence, sex abuse and developmental disabilities.
Significant Indicators
- Blackouts, if documented or self reported
- Criminal History - DUI's, license suspension, public intoxication, possession of an illegal substance, forgery, theft
- Physical indicators includes track marks, smell of alcohol, staggering, glassy eyed, front teeth missing, nasal problems, slurred speech, hand tremors, slurred or rapid speech
- Physical evidence includes presence of alcohol, empty alcohol containers, drug paraphernalia, inhalants.
- History of treatment - AA, NA, inpatient hospitalization, detox
- Birth of a substance effected infant (SEI)
- Biological child diagnosed as Fetal Alcohol Effects (FAE) or Fetal Alcohol Syndrome (FAS)
Related Indicators
- SSI
- Unemployment, frequent absences from work, excessive use of sick days/absenteeism, history of being fired/quitting
- Unexplained or vague explanations for physical injuries - broken bones, sprains, bruises
- Financial difficulty for basics - food, rent, utilities
- Frequent moves or homeless
- Emergency room and/or hospitalizations for physical injuries or substance related events
- Unkempt appearance, hygiene problems
- Prescription medication usage
- Unusual sleep patterns
- Parentified child(ren) - older child takes care of siblings
- Failure to thrive child(ren)
- Inability to maintain a relationship - divorce, several partners.
- Unknown parentage of biological children
- Isolation from family
- Family member or friend provides child care and residence for periods of time
- Transfer of guardianship or custody, loss of custody or informal arrangement with family member, friend for child(ren)
- Biological history of AOD
- High level of denial, defensive, argumentative response to substance abuse questions
- Inappropriate sexual or aggressive behavior during or after alcohol ingestion
Definition
Developmental delay refers to a condition which represents a significant delay in the process of development. The presence of a developmental delay is an indication that the process of development is significantly effected and without special intervention, it is likely that educational performance at school age will be effected.
A child aged 3 to 5 who exhibits a delay in 2 or more of the following domains:
- Physical development
- Communication development
- Social and emotional developmen
- Adaptive development - child's ability to meet standards expected for his/her age by his/her cultural group
- Cognitive development
The identified area(s) may not be attributable to reduced socio-economic or environmental factors.
Significant Indicators
- 1 SSI
- 2. Enrolled in 0 to 5 program
- 3. Enrolled in special education services
- I.Q. below 80
- Diagnostic history of mental retardation, learning disorder, borderline intellectual functioning, reading disorder, communication disorder, receptive or expressive language disorder, phonological disorder, pervasive developmental disorder, autism.
- Hearing impairment or other sensory deficit
One of the basics in this area would be for staff to receive in depth developmental training so they would be able to identify lags, delays, areas of concern. I am hesitant to list all the related factors that would indicate developmental problems as there would be too many for each stage of development. I also believe that for all our children age 0 to 5, we automatically should be referring them for developmental screenings and ensure that these are done regularly and routinely throughout this age range.
3.10.3 Child Assessment Factors: Emotional
Significant Indicators
- SSI
- Enrolled in special education emotionally disturbed or behaviorally disturbed
- History of residential placement for emotional disturbance
- History of psychiatric hospitalizations or suicidal attempts
- Diagnostic history of attachment disorder, anxiety disorder, separation disorder, post traumatic stress disorder, adjustment disorder, personality disorder, depressive disorder, mood disorder, psychotic disorder
- Psychotropic medication
Related Indicators
- Cries for lengthy periods of time
- Few if any friends,
- Difficulty sleeping or sleeps too much
- Tantrums for 30 minutes or more
- Self-abuse; hits head, picks at skin, cuts self
- Suicidal gestures
- Unkempt appearance, hygiene problems
- Biological history of mental illness
- Unexpected anger outbursts with little connection for provocation
- Withdrawn, shy, not talkative, loner
- Doesn't smile or laugh
- Fearful of dark, new situations, people and places
- School difficulty not related to specific disorder or condition
- Homicidal ideations or threats
- Eating or feeding problems
- Has history of loss of parent or significant adult or sibling
- Head trauma
- Inability to stay on task
- Changes in caretakers
- Placement disruptions and changes
- Substance abuse or self medication with substances
- Running away - 24 hours or more
- Gang involvement and/or delinquent acts
- Destruction of property - others' and self
- Inappropriate sexual behavior - masturbation, touching, clingy
- Screaming, yelling,
- Sexual promiscuity
3.10.4 Child Assessment Factors: Behavioral
Significant Indicators
- SSI
- Child has history of residential placement for emotional or behavioral disturbance or delinquent acts.
- Child has history of psychiatric hospitalizations or suicide attempts
- Child is on psychotropic medication
- Diagnostic history of attention deficit disorder, attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, post traumatic stress disorder, psychotic disorder, mood disorder, attachment disorder, anxiety disorder, adjustment disorder, separation disorder, depressive disorder
Related Indicators
- Property destruction, others' and self
- Stealing, theft,
- School problems,
- Criminal charges/convictions for assault, battery
- Head trauma
- Suicidal ideations and gestures
- Tantrums for 30 minutes or more
- Running away for over 24 hours
- Changes in caretakers
- Gang involvement and/or delinquent acts
- Homicidal ideations and gestures
- Substance abuse, self medication
- Loss of parent or significant adult or sibling
- Placement disruptions or changes
- Self-abuse, cutting,
- Inability to stay on task or focus
- Jittery, constantly needs direction or re-direction
- Unkempt appearance, hygiene problems
- Refuses to follow directives
- Inappropriate sexual behavior, masturbation, exposing self, coercing or bribing for sex, rape, sexual assault
- Eating or feeding problems
- Enuresis or Encopresis
- Difficulty sleeping or sleeping too much
- Screaming, yelling, shouting obscenities
- Physical fights with peers or adults
- Sexual promiscuity
Definition
- I.Q. - 70 or below,
- Impairment in meeting standards of age or cultural group in at least 2 areas:
- Self- care
- Communication
- Home Living
- Social/Interpersonal Skills
- Use of community Resources
- Self-direction
- Functional Academic Skills
- Work
- Leisure
- Health
- Safety
- Onset before age 18
Significant Indicators
- Guardianship or limited guardianship of some individual responsibilities - protective payee, authorization for medial care
- History of institutionalization for mental retardation
- TMH educational placement
- Involvement with DHS, Office of Developmental Disabilities
Related Indicators
- SSI
- Unemployment or frequent job changes - jobs have low skill level, i.e. no math, writing, sheltered workshop employment
- Frequent moves or homelessness
- Difficulty or cannot read, complete simple math
- Flat, dull affect
- Psychotropic medication
- History of seizures
- History of severe head trauma prior to age 18
- Difficulty concentrating
- Inability to maintain clean, hazard free environment
- Transportation difficulty - no driver's license
- Social isolation
- Biological history of mental retardation
- Unkempt appearance, hygiene, odor
- Transfer of guardianship or custody, loss of custody or informal arrangement with family member or friend for biological child(ren)
- Parentified child(ren) - older child takes care of siblings
- Child(ren) takes care of parent
- Biological child diagnosed as Failure to Thrive
- Resides with adult who takes responsibility for money, groceries, child care
Significant Indicators
- Guardianship or limited guardianship of some individual responsibilities - protective payee, authorization for medical care.
- History of institutional placement for mental illness
- History of psychiatric hospitalizations
- Unusual behavior such as repetitive, non-sensical speaking, repetitive physical motions, inability to concentrate, not connected to date, time, place, extreme mood swings, excessive worries and fears
Related Indicators
- Suicidal ideation and gestures
- Unusual sleeping patterns
- Self abuse - cuts on arms, legs, chest
- SSI
- History of unemployment, frequent absenteeism, job changes, sheltered workshop employment
- History of severe head trauma
- History of severe trauma - death, victim of violence
- Dramatic changes in eating, weight loss/gain
- Parentified child(ren) - older child takes care of siblings
- Child(ren) takes care of parent
- Substance abuse
- Psychotropic medication
- Biological history of mental illness
- Frequent doctor appointments for unspecified ailments
- Receiving or history of mental health counseling
- Transfer of guardianship or custody, loss of custody or informal arrangement with family member, friend for biological child(ren)
- Unkempt appearance, hygiene, odor
- Biological child diagnosed as Failure to Thrive
- Inability to maintain a clean, hazard-free environment or home environment is closed; i.e. aluminum foil on windows, blinds always closed
- Resides with adult who takes responsibility for money, groceries, child care
- Frequent moves or homelessness
Significant Indicators
- Police involvement, orders of protection
- Criminal history of assault, trespassing, damage to property
- Unexplained or vague explanations for physical injuries as in broken nose, black eyes, burns, bruises, cuts
- History of domestic violence counseling or usage of shelter care facility
Related Indicators
- Home damage - holes in walls, smashed furniture, broken doors
- Frequent moves
- Isolation from family, community, friends
- Frequent absences from work, usage of sick days
- Frequent hospitalizations for physical injuries
- Prescription for pain medication
- Refers to partner being in charge - uses can't or won't allow statements
- Defers decision making to partner
- Partner controls money
- Partner usually present or nearby listening to conversation
- Child(ren) have school and behavior problems
- Child(ren) withdrawn and fearful
- Child(ren) actively physically aggressive toward alleged victim, victim allows behavior
- Substance abuse
Significant Indicators
Adult
- Criminal history - sexual assault, pornography
- Biological history of sexual abuse, sexual aggression, incest
- Presence of graphic sexual and violent materials - magazines, videos
- High level of denial, defensive, argumentative, offers alternative explanation for allegation, i.e. accidental touching, blaming the child
Child
- Sexually transmitted disease
- Child states they were molested, raped, sexually assaulted
- Medical evidence of sexual abuse - torn hymen
Related Indicators
Adult
- dominant, over protective, secretive, closed family system
- Rigid, strict, controlling parenting
- Substance abuse
- Substance abuse which results in neglect and lack of supervision
- Victim of sexual abuse, incest
- Inability to maintain a relationship - divorce, several partners
- Violence - physical, domestic violence
- Numerous adults in and out of the home
- Psychotropic medication
Child
- History of yeast and urinary tract infections
- Enuresis and/or Encopresis
- Substance abuse
- Physically aggressive, oppositional
- Running
- Self-abuse, suicidal ideation and gestures
- Promiscuity
- School problems or over-achieving student
- Parentified child(ren) - older child over protective of siblings
- Withdrawn, fearful, depressed, flat affect
- Psychotropic medication
- Difficulty sleeping
- Eating Disorder
- Hygiene problems
- Cruelty to animals - primarily mammals
- Masturbation - excessive and in inappropriate settings
- Inappropriate for age and developmental level touching of children and/or adults
- History of children `escaping' the family - early marriages, moving away, pregnancy
3.10.1 Alcohol and Other Drugs - AOD | 3.10.2 Child Assessment Factors: Developmental Delay | 3.10.3 Child Assessment Factors: Emotional | 3.10.4 Child Assessment Factors: Behavioral | 3.10.5 Developmental Disability - Mental Retardation | 3.10.6 Mental Illness | 3.10.7 Domestic Violence | 3.10.8 Sexual Abuse