Reference no: EM133876179

Question

When completing the vignettes, there is a vignette assumption. That is, when reading assume that a full assessment has been done and no mention means 'no evidence'. This is the standard quality assurance if it is not documented it does not exist assumption. What that means, then if there is no mention of a need, the rating should be a '0'. If there is no mention of a strength, then the rating should be a '3'. So, no mention of any suicidality would result in a rating of '0' on Suicide Risk. No mention of any talents or interests would result in a rating of '3' on Talents/Interests.

Another way to think about it is that you start the assessment with all 0 ratings on the Needs and all 3 ratings on the Child/Youth Strength and then you look for evidence to adjust your scores accordingly using the action levels. Caregiver ratings use the Need action levels for the vignettes.

Ordinarily certain items would have an N/A option (for example Job Functioning for an underage child, or Foster Caregiver for a child not in foster care). For the purposes of this test please rate such items as '0' for needs and as '3' for strengths.

Rate Parents as Caregiver

Linda is a four-year-old girl with severe autism. She lives in a two-bedroom apartment with her mother, father, and two older sisters, aged ten and thirteen.  Her family emigrated from Vietnam ten years ago and English is their second language. Her father is a mail carrier and her mother is currently staying home with the children.

Linda is non-vocal and communicates her wants and needs by touching and/or pulling an adult - or one of her sisters - towards the desired item. Two days a week Linda attends a special education program focused on improving communication skills.  Linda understands simple directions in context (i.e. "shoes on," "outside," "open," "jump"), but has difficulty understanding directions out of context (i.e. when asked to "jump," while not on the trampoline). Linda has emerging play skills and is eager to play with cause-and-effect toys, blocks, and puzzles. She will run, jump, and skip on the playground; however, her attention to these activities is fleeting and she usually prefers to play on her own, rarely seeking out interaction with her classmates. Linda loves sensory activities like sand and water play.

Linda has difficulties with transition which manifest not as restlessness or irritation but as aggressive behaviors - kicking, screaming, hitting - when she is switching from a preferred activity to a less-preferred activity. She is also defiant towards her teachers, throwing tantrums when she does not get what she wants.  This is a frequent issue and a concern at preschool, as Linda's tantrums often impede her learning and disrupt the class.  Outside of those times where Linda is defiant and there is tension between her and the teacher, Linda gets along with her teachers.

Linda's parents have tried to stop it when she displays this defiant behavior at home but usually give in and give her what she wants. Linda's parents are committed to learning practical strategies to help their daughter even though they are having a difficult time accessing supports and services in their region: they have attended several parent workshops and support groups but difficulties with language, childcare, and financial resources often interfere with their ability to access these services. They have no family in the country and no friends who are able to provide childcare. Their oldest daughter can watch the younger children for short periods but they are uncomfortable leaving them alone for long. Linda's sisters are very fond of her and spend a lot of time playing with her.

Linda needs full assistance to dress herself but she can eat with a spoon and will remain dry on a toileting schedule where she is taken to the washroom every two hours.

Family/Caregiver Module

No evidence of need. No action needed

1. Significant history or possible need that is not interfering with functioning. Watchful waiting/prevention/additional assessment

2. Need interferes with functioning. Action/intervention required

3. Need is dangerous or disabling. Immediate action/intensive action required

1. Self Care/Daily Living
2. Culture Stress
3. Employment/Education
4. Educational Attainment
5. Legal
6. Motivation for Care
7. Financial Resources
8. Transportation