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Hidden Disabilities 101: Tips and tools for including children with Hidden Disabilities and their families at church Stephen Grcevich, M.D. President,

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Presentation on theme: "Hidden Disabilities 101: Tips and tools for including children with Hidden Disabilities and their families at church Stephen Grcevich, M.D. President,"— Presentation transcript:

1 Hidden Disabilities 101: Tips and tools for including children with Hidden Disabilities and their families at church Stephen Grcevich, M.D. President, Key Ministry Presented at Cuyahoga Valley Church Broadview Heights, OH October 17, 2010 ©Key Ministry

2 What are Hidden Disabilities? A hidden disability (HD) is a serious emotional, behavioral, developmental or neurological disorder with no outwardly apparent symptoms

3 Examples of Hidden Disabilities: Autism, autistic spectrum disorders Developmental disabilities Attention-Deficit Hyperactivity Disorder (ADHD) Learning disabilities Anxiety disorders Mood disorders (depression, bipolar disorder) Attachment disorders (common among adopted, foster children) Fetal Alcohol Effects (FAE) Brain injury: resulting from trauma, epilepsy, stroke Stephen Grcevich, MD, Case Western Reserve University School of Medicine

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5 “Rethinking” disability and church An individual with a disability is defined as a person who has a mental or physical impairment that substantially limits one or more major life activities, a record of such impairment, or is regarded as having such an impairment. Taken from www.joniandfriends.org

6 “Rethinking” disability and church If a mental or physical impairment substantially limits a person’s ability to actively pursue spiritual growth and fully participate in the ministry of a local church, is that person “disabled?”

7 The Ultimate Low-Hanging Fruit for Evangelism, Outreach? 9% of U.S. kids ages 6-17 received Rx for ADHD meds Prevalence of anxiety disorders-U.S. youth: 8-20% 1/91 kids born in 2008 will be diagnosed with autism 22% of U.S. kids entering first grade meet criteria for one or more psychiatric disorders What about siblings and church? Who equips parents to shepherd their kids in the faith? Key Ministry estimate: families of children with HD at least 50% less likely to be involved with a local church J Am Acad Child Adolesc Psychiatry - July 2010 (Vol. 49, Issue 7), Pages 686-698

8 What strategies are useful when a child exhibits inappropriate behavior at church?

9 Increasing positive behavior Know the A,B,Cs (Antecedents, Behaviors, Consequences) Understand the function of his/her behavior (obtain/avoid) Be preventive – look for antecedents to behaviors Be consistent Keep kids busy Teach appropriate behaviors Use of Social Stories

10 Strategies: Behavioral Approaches Finding Solutions for Problem Behaviors: ABC Analysis ABC Analysis is a process for gathering information about the environmental stimuli that are controlling the behavior. Antecedents (A) Antecedents are things or situations which happen before the target behavior. Examples of antecedents are asking a question, time of day, loud noise, a particular toy, etc. Certain behavior may regularly follow each of these antecedents. Behavior (B) This is the target behavior we are studying. It is very important to be specific in our descriptions so that others could easily recognize it. Consequences (C) Consequences are things or situations which immediately follow a particular behavior. They serve two purposes: to increase the behavior or to decrease the behavior that just happened. From Olson & Marker (2000) In-service Training Manual – Pine Grove School.

11 Strategies: Behavioral Approaches Analysis of Function Two main functions of behavior: –To OBTAIN something desirable or communication –To AVOID/ESCAPE something undesirable By identifying the variables that maintain a behavior, we can also identify more adaptive ways of obtaining the same function. Always teach a more appropriate behavior! From Olson & Marker (2000). In Service Training Manual – Pine Grove School.

12 Strategies: Behavioral Approaches From Olson & Marker (2000). Inservice Training Manual – Pine Grove School. A = AntecedentB = BehaviorC = Consequences A stands for antecedent or what happens before the behavior. Antecedents can be a person, place, time, command, object, smell, noise, etc. B stands for behavior. Behaviors are functional, meaning they serve a purpose. Behaviors most often are used to obtain or avoid something. Behaviors should be described in detail. C stands for consequences or what happens immediately following the behavior. Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.) Appropriate Behavior to Teach: Function: To obtain or avoid – Appropriate Behavior to Teach: -. A = AntecedentB = BehaviorC = Consequences Teacher reads paragraph aloud Danny draws on worksheetTeacher redirects verbally Function: To obtain or avoid: Avoid listening to story Appropriate Behavior to Teach: On-task behavior, listening

13 Strategies: Behavioral Approaches From Olson & Marker (2000). Inservice Training Manual – Pine Grove School. A = AntecedentB = BehaviorC = Consequences A stands for antecedent or what happens before the behavior. Antecedents can be a person, place, time, command, object, smell, noise, etc. B stands for behavior. Behaviors are functional, meaning they serve a purpose. Behaviors most often are used to obtain or avoid something. Behaviors should be described in detail. C stands for consequences or what happens immediately following the behavior. Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.) Appropriate Behavior to Teach: Function: To obtain or avoid – Appropriate Behavior to Teach: -. A = AntecedentB = BehaviorC = Consequences Teacher asks question to J. Teacher asks question to R. T. says, “I like how T. is waiting. Danny calls out D. Stamps foot. “I NEVER get called on.” D. Puts head on desk Teacher ignores Teacher puts hand on D’s shoulder T. says, “Good job calming down.” Function: To obtain or avoid: A turn in the lesson, attention Appropriate Behavior to Teach: turn-taking

14 Be sure that reinforcement is: Clear Fair Honest Positive Systematic (ratio of behavior/reinforcer) Manageable Alberto and Troutman, 1986

15 Strategies: Behavioral Approaches INCREASING DESIRABLE BEHAVIORS Reinforcement: Something serves as reinforcement if 1) it immediately follows a behavior and 2) it increases the frequency of that behavior in the future. If it does NOT increase the behavior, it is NOT a reinforcement for that child. It is always better to reinforce (increase) a desirable behavior than to punish (decrease) an undesirable behavior. Doing so teaches good behavior! You should be giving at least 6 positives to your child for every negative you give. Make sure the reward is motivating for your child and is realistic for you to give the child! From Olson & Marker (2000). In Service Training Manual – Pine Grove School. Courtesy of Cara Marker-Daily, Ph.D.

16 DECREASING BEHAVIOR We can decrease unwanted behaviors through a variety of methods. The following list ranges from least to most intrusive. –Extinction/Ignoring –Differential reinforcement of others (DRO) –Response cost –Time Out –Physical restraint From Olson & Marker (2000). In-service Training Manual – Pine Grove School. Strategies: Behavioral Approaches

17 Key Ministry: How Can We Serve You? Key Ministry: www.keyministry.org provides resources to churches free of charge:www.keyministry.org Best Practices Resource Kit “Key Ring Binder” Web-based resources (Blogs, Twitter, Facebook) Opportunities to network with other churches Phone consultation On-site consultation, training Celebrating your successes Local and National conferences Praying for you

18 Please Stay in Touch ! Key Ministry Foundation Rebecca Hamilton, Executive Director 8401 Chagrin Road, Suite 14B Chagrin Falls OH 44023 Phone: 440/708-4488 rebecca@keyministry.org katie@keyministry.org steve@keyministry.org Web: www.keyministry.orgwww.keyministry.org Steve’s blog: http://drgrcevich.wordpress.comhttp://drgrcevich.wordpress.com Katie’s blog: http://katiewetherbee.wordpress.comhttp://katiewetherbee.wordpress.com


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