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Ottawa Red Flags AGENDA 9:00am Welcome and Objectives of the Day Ottawa Red Flags Guide Overview and Putting the Red Flags to Use Talking to Parents About.

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Presentation on theme: "Ottawa Red Flags AGENDA 9:00am Welcome and Objectives of the Day Ottawa Red Flags Guide Overview and Putting the Red Flags to Use Talking to Parents About."— Presentation transcript:

1 Ottawa Red Flags AGENDA 9:00am Welcome and Objectives of the Day Ottawa Red Flags Guide Overview and Putting the Red Flags to Use Talking to Parents About Sensitive Issues Denyse Deslauriers, Ottawa Childrens Treatment Centre Discussion 12:00pm Wrap up and Adjournment Workshop evaluations will sent to participants electronically. Dont forget to complete yours!!

2 Case Study 3 year old Sasha Three year old Sasha has come to your centre today with her mother. Sasha is playing with other toddlers and mom is sitting off by herself reading a newspaper. You notice that Sasha has a large bandage on her leg. Sasha is taking toys from other children, and has already hit one of them with a toy. When you approach the mother, you notice that she has a blackened eye under her dark glasses and several bruises on her arm in various stages of healing. You learn that mom is new to the community and that she has no friends or relatives in the area. She had seen an advertisement for the OEYC in the news and thought that she might find other children for Sasha to play with here. Through gentle probing questions you learn from the mother that Sasha received a cut on her leg yesterday from a broken piece of glass. Sashas father had thrown a plate at his wife and when it shattered on the kitchen floor somehow Sasha was cut. The mother begins to sob.

3 Sasha 1. What additional information would you like to know? How will you ask these questions? 2. What is your duty to report? 3. How you will address the Red Flags you have identified with mom? 4. What are the appropriate contacts and referrals for the family in question?

4 Sasha There is a Duty to Report as there are concerns of violence in the home and a child being injured If in doubt, always consult Childrens Aid Society Concerns identified: Child Maltreatment – Witnessing Violence, physical injury Family isolation and support Ottawa Resources Ottawa Childrens Aid Society Ottawa Public Health Referral to appropriate Early Years programs Encourage family to return to your centre

5 Ottawa Red Flags Guide Overview

6 Why Red Flags Early identification and early intervention makes a difference The early years set the base for ability, competence and coping skills affecting learning, behaviour and health Nurturing relationships, quality stimulation and good nutrition optimize brain development Parents and professionals working with children have the opportunity to make a difference

7 Why Red Flags? To promote early identification of children who are in need of additional resources to ensure healthy and optimal development Additional services and supports may be needed to ensure healthy and optimal development Children identified as quickly as possible and referred to the most appropriate program and service

8 Ottawa Red Flags Guide Red Flags Guide is a quick reference guide for early years professionals Red Flags helps to identify when a child (0 – 6 years) may be at risk of not meeting his/her health or developmental milestones Includes: developmental domains areas that impact child health and development - postpartum mood disorders, child maltreatment etc. community resources and where to refer families for additional screening and/or intervention it is not an Assessment or Diagnostic tool

9 Who should use Red Flags? Professionals working with young children and their families Early Childhood Educators Early Childhood Educators Kindergarten Teachers Kindergarten Teachers OEYC staff OEYC staff Early years staff Early years staff Public Health Public Health Childrens mental health staff Childrens mental health staff Healthcare professionals Healthcare professionals Social workers and family counselors Social workers and family counselors Nursery schools and preschools Nursery schools and preschools Home child care providers Home child care providers Any professional working with children 0-6 Any professional working with children 0-6 A basic knowledge of child development is assumed

10 Developmental of Red Flags Guide Original version from Simcoe County (2004) Since 2005 – Red Flags has been adapted in 14 different regions in Ontario Ottawa = 15

11 Acknowledgements Ottawa Best Start Steering Committee Ottawa Best Start Special Needs Working Group Red Flags Task Group Roxane Bélanger, First Words Preschool Speech and Language Marie-Louise Chartrand, Centre Psychosocial Julie Kanter, CISS Susan Thompson, Ottawa Public Health Jama Watt, Child and Youth Health Network for Eastern Ontario

12 Thank you to our Community Partners! Ottawa Childrens Aid Society Ottawa Carleton Headstart Association For Preschoolers Ottawa Public Health Ottawa Childrens Treatment Centre CHEO / CHEO Autism Crossroads Childrens Centre LINC First Words Communicare Learning Disabilities Association of Ontario Heart and Stroke Foundation of Ontario Wabano Centre for Aboriginal Health Centre Jules-Léger Parent Resource Centre Algonquin College ECE St Marys Home Cite collégiale Family Services à la famille Ottawa Ontario Foundation for Visually Impaired Children Learning Disabilities Association of Ottawa Carleton Community Information Centre of Ottawa

13 Changes to the Ottawa version Enhanced/Added: Duty to report Sleep Postpartum mood disorders Learning disabilities Child maltreatment Healthy active living Removed: Safe sleep practices Prematurity Important telephone numbers Contacts and resources lists Screening tools used in the community

14 How to use this manual 3 sections Introduction Domains Resources Quick reference guide of developmental domains (in alphabetical order) Includes areas that may impact health and development Increase awareness of when and where to refer a family for additional support or intervention

15 How to use the Manual Identify area of concern Speak to parents about your concerns Talking to parents about sensitive issues Cultural Competency Refer family to most appropriate community resource or family physician

16 Introduction Includes: Background Talking to parents about sensitive issues Cultural Competency Duty to Report

17 Anyone who suspects that a child is or may be in need of protection should contact a Children's Aid Society immediately The report must be made directly to a CAS by the person who has the reasonable grounds to suspect abuse or neglect. People working closely with children have a special awareness of the signs of child abuse and neglect, and a particular responsibility to report their suspicions. If you suspect abuse, you must report directly to a Childrens Aid Society and not rely on someone anyone else to report on your behalf.

18 Domains Attachment Attention Difficulties Autism Spectrum Disorder Behaviour Child Maltreatment Dental and Oral Health Feeding and Swallowing Fetal Alcohol Spectrum Disorder (FASD) Fine Motor Gross Motor Healthy Active Living Hearing Learning Disabilities Literacy Mild Traumatic Brain Injury Nutrition Postpartum mood Disorders School Readiness Sensory Sleep Social Emotional Speech Vision

19 Domains - Growth & Development Sensory Sensory Attachment Attachment Social/Emotional Social/Emotional Behaviour Behaviour Speech & Language Speech & Language Hearing Hearing Vision Vision Fine Motor Fine Motor Gross Motor Gross Motor Attention Difficulties Attention Difficulties Literacy Literacy School Readiness School Readiness

20 Domains - Health Nutrition Nutrition Feeding & Swallowing Feeding & Swallowing Dental and Oral Health Dental and Oral Health Healthy Active Living Healthy Active Living Sleep Sleep

21 Domains - Child Maltreatment Witnessing Family Violence Witnessing Family Violence Physical Abuse Physical Abuse Sexual Abuse Sexual Abuse Emotional Abuse Emotional Abuse Neglect Neglect

22 Domains - Special Needs Autism Spectrum Disorders Autism Spectrum Disorders Fetal Alcohol Spectrum Disorder Fetal Alcohol Spectrum Disorder Learning Disabilities Learning Disabilities Mild Traumatic Brain Injury Mild Traumatic Brain Injury

23 Domains - Other Factors Family/ Environmental Stressors: Family/ Environmental Stressors: Parental Factors Parental Factors Social/Family Factors Social/Family Factors Economic Factors Economic Factors Postpartum Mood Disorder Postpartum Mood Disorder

24 Resources Community Resources Screening Tools References

25 Suggested roles for Early Years Professionals Screen Identify risks and concerns Reduce Risk Education and support Referral Duty to report Enhance Development Education and support

26 Early Identification We all have a part to play

27 Case Study 2 year old Alicia Two year old Alicias mom is expressing concern that Alicia is not talking as well as the other children at the centre who are stringing words together. Although Alicia has about twenty words that the family deciphers, they are not clear. She uses lots of gestures and grunts to make her needs known and is very interactive with her parents and peers. When not understood, Alicia has tantrum behaviour, which is very frustrating to her parents. They feel that Alicia understands well but cannot get out what she wants to say. The parents also noticed that their eleven-month old daughter is already babbling, mimicking and saying words, something Alicia did not do although her birth history and other milestones were normal. Alicias father thinks that she is just a late talker like he was, but the family wants to make sure that there are no real concerns.

28 Alicia 1. If late talking is a family characteristic, does it need to be addressed or will it resolve without intervention? 2. How would you approach mom? What would you say? 3. What are the appropriate contacts and referrals for the family in question?

29 Alicia Early intervention for developmental delays makes a difference and the wait and see approach is not acceptable. Recognize that in addressing the hearing problem it may address the behaviour problem. Concerns identified: Speech and Language Hearing Behaviour Ottawa Resources: Child requires a hearing test Referral to the Preschool Speech and Language program – FIRST WORDS. Referral to appropriate Early Years programs Encourage family to return to your centre

30 Break

31 Case Study 4 year old Joshua Joshua is an active four-year-old. Staff at the centre has concerns regarding Joshuas readiness to enter school. Joshua has poor impulse control as he strikes out at the other children. He sometimes hits, bites or spits at others. He likes to be in control of play situations and insists others do what he says. Peers avoid him during free play and ask not to be his partner. Joshua has a hard time following rules and he does not follow through on requests from adults. He needs to be reminded often to play nicely with others and to finish tasks. Joshua does not sit during circle activities and wanders away or rolls on the floor. He has spit and eaten dirt from the floor. He has difficulty with transitions and changes in routines. At times Joshua avoids situations by pulling his shirt over his head and avoiding eye contact. Joshua avoids crafts and using scissors, he prefers the building blocks and science activities. Joshua loves to run and rough house. His cognitive development appears age appropriate. He can dress himself and was toilet trained a few months ago. Joshua eats quickly and stuffs food into his mouth. He prefers to use his hands to eat and can be very picky about his food choices. Joshua speaks in sentences and can ask and answer questions.

32 Joshua 1. What specific concerns do you have about Joshua? 2. With a partner, either role place or discuss how you would approach mom. What would you say? 3. What are the appropriate contacts and referrals?

33 Joshua Concerns: Difficulty with transitions, aggression and avoidance Social emotional Sensory Behaviour Ottawa Resources Family physician Crossroads Childrens Centre Healthy Babies, Healthy Children Parent Resource Centre E-Mental Health (website)

34 Case Study 19 month old Jasmine Mary has been visiting your centre with her 4 year-old son Ben, and her 19-month old daughter, Jasmine for the past several months. On Marys most recent visit, she tells you that Jasmine seems to be more quiet than usual, and that she doesnt seem to make eye contact with her as often as she used to. Mary states that Jasmine doesnt seem to pay attention to me when I call her name. I wonder if there could be something wrong with her hearing? Oh well, its probably nothing, maybe she will turn out to be more of a deep thinker than Ben. Jasmine isnt interested in stacking blocks either and that was one of Bens favourite activities. Im sure Ben could stack 3 or 4 blocks by 19 months of age, but maybe my memory is not so good.

35 Jasmine 1. Using the Red Flags guide, discuss and determine your findings 2. What questions might you ask Mary to gain additional information? 3. How will you to talk to the parents about the concerns identified? 4. What are the appropriate contacts and referrals for the family?

36 Jasmine Concerns: Speech and Language Hearing Vision Autism Ottawa Resources: Family physician Ottawa Childrens Treatment Centre Ottawa Public Health Immediate referral to family physician is warranted

37 Thank You! What did you think? You will get your workshop evaluation via email. Please dont forget to complete yours!! Red Flags Guide is available online or to order a hard copy of the Ottawa Red Flags Guide, please email

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