Despite all of my misgivings about working full-time, leaving my children, balancing life, etc., I can honestly say that I love my job. It feels like I am a part of something good-- and I pretty much need that if I am leaving my children each day. So what exactly do I do?
I am a "case manager" although this role is different from other times that I have held the title case manager. In this role, the main part of what I do relates to running/organizing evaluation days, coordinating scheduling, providing support and followup to parents, conducting workshops for parents and being a resource regarding available services and how to access them. I am also a team member in terms of input during team consultation- which is great. The evaluation days happen 3 days of the month and they are crazy-busy...I don't have a minute to myself those days.. other days are much less stressful!
The autism screening team I am a part of is based out of our county's intermediate unit- in Pennsylvania, special education services for preschool and school age children are provided mostly by these "intermediate units" to sort of streamline things- so that each individual district doesn't have to set up every single program/service independently. While problems exist, I think it is a pretty good system overall.
Anyway, this particular team was created about 5 years ago. And I happened to work for another agency at the time that was invited to send a consultant to be part of this team & I happened to be the person in the right position to be the consultant. So I remember this team when it was just getting started, when things were still falling into place. They created the case manager position when I was about 7 months pregnant with Michael--and I remember wishing I could have applied for it but it didn't really make sense at the time.
This team is meant to be a means of early identification and diagnosis of autism. It is also meant to provide an entry point to the service system for families- so that they don't have to figure out the complexities of accessing necessary services on their own. Children who are involved with Early Intervention, Preschool Special Education and even school-aged children up to second grade can be referred--if there are concerns about a possible Autism Spectrum diagnosis. One of the screening tests for young children is called an M-CHAT, it consists of 23 yes/no questions that can be answered by parents--your pediatrician may have had you fill one out (I hope they did!) when your child was around 18 months old.
The coolest thing about this is that we work in coordination with several other places including CHOP (Children's Hospital of Philadelphia). There are 2 developmental pediatricians who come out to our location a few times a month to conduct autism screenings. Others involved include- school psychologists, behavioral health representatives...also anyone working with the child (like a speech or occupational therapist) can attend the evaluation. So parents get to have several people whose expertise is related to autism and developmental delays. They can usually be seen by our team within 3-4 months...if they called CHOP or A.I. Dupont for a similar evaluation, it is an 18-24 month wait list.
We use a play-based assessment test to observe a child's communication and socialization skills. So the kids are playing with bubbles, balloon, various toys-fun stuff for most kids. Along with some diagnostic tools and team discussion, a conclusion is made about the child's needs and diagnosis-if any. The developmental pediatrician also reviews any medical concerns and does a brief physical. Parents receive a formal report and the opportunity to review all of the information with the team...the report is basically their ticket to accessing additional services for their child without too much hassle.
This email is probably so boring but it's hard for me to put into words all of the good work that this team does. I feel like the family has an opportunity to establish a working relationship with members of the team. I have ongoing contact with the family, they see the developmental pediatrician for a 6-month followup. It also helps the family to know that the various people involved with their child are working together.
I am quite sure no parent wants to hear that their child has any delay, let alone autism...but if it were me, I would want to know as soon as possible so that I could start providing my child with whatever was needed to help him be as happy as he can be...
3 comments:
Thanks for the explanation - I had an inkling of what you did, but this is helpful - and very interesting. I think you know that I'm an OT, and I work from home doing office management for an EI clinic. So I work with the county EI and BDD, who fund our services.
Is the M-CHAT a standardized assessment that you have to purchase? Our pediatrician didn't have us do one, but perhaps he only offers it if he has a concern. I'm just curious if parents can access this test on their own or only through a service like yours.
Just in case anyone else is interested...
http://www.firstsigns.org/screening/tools/rec.htm#asd_screens
The above site is one that is authorized to provide the MCHAT and scoring instructions.
Some pediatricians may incorporate similar questions into their well checkups with a child. Ideally, the MCHAT is completed by the parent without any outside "interference".
First signs and other organizations like it promote screening tools like the MCHAT be used with all children at 18 months- whether the parent expresses concern or not.
So cool. I love that so many of our college pals are social workers, or teachers, or OT/PT or other nonprofit kinds. I'm with you- I'd rather know if something's wrong quicker than later. But maybe it's because I have so many friends in EIP (lol)... but really, I've heard so much about how it makes a difference the earlier you start with treatment or modifications, etc. so THANKS for being so cool with your job- and for juggling your own family craziness for it.
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