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Nunavik Intellectual Disability Screening Project Presentation to General Assembly Nunavik Regional Board of Health and Social Services Kuujjuaq, October,

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Presentation on theme: "Nunavik Intellectual Disability Screening Project Presentation to General Assembly Nunavik Regional Board of Health and Social Services Kuujjuaq, October,"— Presentation transcript:

1 Nunavik Intellectual Disability Screening Project Presentation to General Assembly Nunavik Regional Board of Health and Social Services Kuujjuaq, October, 22 th 2008

2 2 Intellectual Disability Screening Project Is a collaborative project between the Nunavik Regional Board of Health and Social Services with the Kativik School Board Its purpose is to improve quality of services provided to a group of children who presents significant limitation in their intellectual function.

3 3 What is Intellectual Disability? An Intellectual Disability is characterized, during childhood, by an important difficulty to learn school matters like reading, writing and calculating. This difficulty is also visible, though less, in all other life activity which makes the child looks as he has a retarded development.

4 4 Why is it important to help these children? These children will have to struggle during their whole life and there is a large chance they will not make it on their own. They need special help, particularly in school, but eventually some support thorough their live, at least during more challenging moments, like during transitions.

5 5 What is Intellectual Disability in a more technical manner? Consensus about the 3 diagnostic criteria: –Significantly subaverage intellectual functioning (IQ of 70 or less, on an individually administered IQ test) –Deficit or impairment in present adaptive functioning –An onset before age 18 years. Usually we find that 2 to 3% of a population present Intellectual Disability and will need help at some point.

6 6 OBJECTIVES To systematically identify students between 6 and 9 years old who have an intellectual disability. To provide this information to school personnel and health and social services Obtain feedback on the application of the instruments and the process of evaluation Eventually to plan services to them

7 7 A LITTLE HISTORY 2004-2008 Before engaging in evaluation, it was decided that valid psychometric instruments were essential. These had to be adapted to the Inuit culture and to the physical and social environment of the Nunavik region. We planned, adapted, validated, translated, back-translated, tested a Nunavik Adaptive Behavior Scale for School age children

8 8 MEASUREMENT OF ADAPTIVE BEHAVIOR Definition of adaptive behavior : many exist The collection of conceptual, social and practical skills that have been learned by people in order to function in their everyday lives. (AAMR, 2002)

9 9 PROCEDURE OF SCREENING What does it involves? Nomination of about 10% of students that have most difficulties learning school curriculum aged 6 to 9 years old in grades 1 to 4. Administration of questionnaires (parents and teacher) evaluating adaptive behavior Administer an IQ test to about a third of the children that have the lowest scores of adaptive behavior. Produce a short report that will be completed by a psychologist.

10 10 PROCEDURE OF SCREENING Nomination of 10% Use of lists of 2007-2008 of children with difficulties produced by schools Current teacher nomination Student counselors nomination School principal nomination Pediatrician nomination Health personnel nomination

11 11 Nunavik Adaptive Behavior Scale School Version This psychometric questionnaire is devised to establish the level of adaptive behavior in school age children in Nunavik children. Helps decide if a significant limitation in adaptive behavior is existent Based on the Quebec Adaptive Behavior Scale Has been developed by the team of Laboratoire de recherche du comportement adaptatif affiliated with UQAM since 2005.

12 12 Nunavik Adaptive Behavior Scale School Version Three language interview: Inuktitut, English and French Two questionnaires required, one for the parents the other for teachers For the parent questionnaire an interviewer is required, preferably in Inuktitut For the teacher, either we proceed by interview or by paper and pencil, if the teacher is familiar with that kind of questionnaire

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15 15 NABS-SV All items revised and evaluated by Inuit or experienced professionals (22) Change for 199 on 250 either removed, modified or added New Domain : On The Land Activities

16 16 Adaptive domains 1- gnc5bstî5 /COMMUNICATION 2– N7ui6 vm5yxi6 /PERSONAL CARE 3– xi3Cu ckw¬D8Niq5 /DOMESTIC SKILLS 4- wªctui4 ckw¬ctc3i6 /SOCIALIZATION 5– kNo7u xg3bsA8Ng5 /COMMUNITY RESOURCES 6- w7uieA8Ni6 /AUTONOMY 7– ckw1qyx3i6 x5bâ5gü8il /HEALTH AND SAFETY 8– wo8ix[7jxzJ5 WJ8Nî5 /PRE-SCHOOL AND ACADEMIC SKILLS 9- hc5yî5 /LEISURE 10– yMu hZM8î5 /ON THE LAND ACTIVITIES

17 17 Question 3 Communication Domain x5paxu4 hNs7m¯5 ÖyAtyi4 scsy3i4 b9omi4 xg§6 Gß5©tQlQ5, -hNsˆV - e7us2 XuszH Names five parts of a picture (e.g. -what is this? -the dog's tail) *

18 18 Question 25 Personal Care Domain xyq8i4 x8kǧ6 xg3bq5 csysogx3mb wWslxo3mb¬8î5 Changes clothes when they are wet or dirty

19 19 Question 41 Domestic Skills Domain x9MtE5yx§6 f[/[i3ui4 isZstj5 Wipes up liquid he has spilled with a cloth

20 20 Question 65 Socialization Domain Wctos§6 xfil Wctc3ixo3hi xbsy3u m3Di¬8î5 Develops and keeps friendship with one or two children

21 21 Question 184 On The Land Activities Domain ki?5bs§5n/i ki?§6 Gß5©tQlQ5, x3„5H Picks appropriate berries (e.g.cloudberries)

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24 24 Adaptive Behavior Questionnaire Evaluation Training of student counselors Inuktitut interviewers during August 2008 Planned visits in fourteen communities taking account of different factors Planning in advance schedule of interviews with parents Planning of interview of teachers Total of about 100 students evaluated

25 25 Parents Interviewers and Teacher interview support Mary Cain Siasi Clunas Louisa Cookie-Brown Nancy Etok Annie Alaku

26 26 Adaptive Behavior Questionnaire Evaluation Schedule Communities visited as per today: –Kangiqsualujjuaq –Aupaluk –Tasiujaq –Kuujjuaq Next visits in November and Winter and Spring 2009 by waves of two to three weeks altogether

27 27 Kangiqsualujjuaq Oct 2008 Akulivik Jan 2009 Tasiujaq Oct 2008 Inukjuak April 2009 Aupaluk Oct 2008 Kuujjuarapik April 2009 Kuujjuaq Oct 2008 March 2009 Umiujaq April 2009 Kangirsuk Nov 2008 Salluit Jan 2009 Quaqtaq Nov 2008 Ivujivik Jan 2009 Puvirnituq Jan 2009 Kangiqsujuaq Nov 2008

28 28 INTELLIGENCE TESTING That measurement will be applied to approximately the third of children for which we have adaptive behavior data Maude Landry will administer individually the test which takes about one hour Test used: Leiter-R non-verbal test of intelligence Maude Landry, psychometrician

29 29 Maude Landry

30 30 Medical Diagnosis Complement A pediatrician of the Health services will be informed if the child has associated medical condition If an evaluation is necessary during his regular visits to the community The screening team will be available for any information necessary

31 31 NABS WEB SITE Information on the development of the scale On line data acquisition and report production (requires user name and password)

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