A Quick Adoption and Special Needs Guide for Professionals

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Introduction

Oftentimes, those who are adopted and/or fostered feel a sense of emptiness and lack of belonging no matter how affectionate and inclusive their adoptive parents or foster parents may be. If not dealt with at a young age, these issues may affect a child's emotional and intellectual growth and level of social interaction, which may result in depression, learning challenges and isolation later in life. There are many issues that are specific to adopted children and children who are in the foster care system. These issues may be related to a parent's grief in discovering that he or she has adopted a child with a serious illness or disability. Behavioural challenges related to possible physical and sexual abuse may surface as an adopted child matures. Or he or she may have trouble attaching to a new caregiver due to traumatic events that occurred in the past.

As a post-adoption support society that assists parents and professionals with a multitude of special needs issues, we know how difficult it is for professionals to keep up-to-date on issues around adoption and foster care. Many families face daily challenges that affect all aspects of their lives. For professionals with clients who are fostering a child, or, for those with clients who are adoptive parents or adoptees, there are many issues to be aware of. Depending on the particular special need of the child, information such as the biological parents' medical history and a child's cultural background and birthplace can be vital to know. We hope that this information will facilitate communication between families and professionals so that they can effectively assist each other in accessing much-needed services and information.

Corrections

How Special Needs Might Affect Your Work

· Many inmates in the correctional system have special needs ranging from Fetal Alcohol Syndrome to mental illnesses. While all special needs are different, many disabilities may include such characteristics as memory deficits and difficulties with processing information. It may seem that an inmate is purposely ignoring or defying your orders, when in fact he or she may be unable to understand those orders.

· Many inmates who are undiagnosed or who have hidden disabilities are housed with the general population. This makes it especially difficult for corrections workers to provide appropriate services to inmates who may have special needs. While it is not up to those in corrections to diagnose or assess inmates, it is important that professionals observe and try to address whatever special need they suspect. Probation officers and correctional officers are in good positions to recommend assessments, as they are very involved in the lives of their clients.

· Youth court workers (probation officers) are in a particularly good position to recommend specific assessments and treatments for their clients. They can include previous assessments, social and medical histories and other details in their pre-sentencing reports, which will help judges order appropriate sentences and treatments, if necessary.

· Offenders with special needs often have unique living needs upon release. Probation officers will need to assist their clients with housing, disability benefits or income assistance, employment and drug and alcohol treatment. Many released inmates have little money so trying to find resources that they can access is a big challenge.

5 Simple Things You Can Do to Make Your Clients' Lives Easier

1. Don't assume an inmate or released inmate understands you. Many adults and adolescents with special needs will have difficulty processing information. Make your instructions clear and simple and ask the inmate or released inmate to repeat what you have said in his or her own words to ensure that he or she understands.

2. Take your time. When an inmate has special needs, remember that every process will take longer. Not only will the inmate need additional attention, the way you deal with that inmate will change.

3. Ask for previous assessments and family/medical histories early. When a probation officer makes recommendations in pre-sentencing reports, it is imperative that he or she has complete and up-to-date histories for the offender. As well, upon release, prior assessments could help with income assistance or disability benefits and different types of housing (i.e. community living, half-way houses).

4. Involve the inmate's family. Many special needs adults and adolescents need the support of their families to stay on track, particularly post-release. If a released inmate has addictions or intellectual disabilities, it may be difficult for him or her to arrive at probation appointments or other court appearances on time or at all. As well, your inmate's family can provide you with vital information regarding histories and living arrangement.

5. Ensure that support continues after release. This is perhaps the most difficult task of all. Released inmates who have special needs are vulnerable to falling back into criminal activity and will need appropriate family and community support. Impress upon the inmate's family that he or she will need some level of supervision. Get the inmate involved with a community organization.

Counseling

How Special Needs Might Affect Your Work

· Parents with children who have special needs might go through as many as three counselors in six months. This can increase a family's stress levels and cause them to be less open and reluctant to share details of the child's disorder or illness and its impact on the family. Long waiting lists for funded services is another difficulty that can add to a family's stress levels.

· Some parents aren't always aware of how the 'system' works and how to seek support in their community. They might be reluctant to ask questions for fear of not wording them properly. Sometimes a counselor and a parent may be saying the same thing, although their language in saying them may be different.

· Parents may be reluctant to admit the extent of their child's challenges. Grappling with personal issues of guilt, grief and loss, lack of resources, family support and physical exhaustion, it may take a while before they let their guard down and express their feelings.

· Many counselors lack knowledge in particular special needs areas (e.g. Attention Deficit Disorder, Fetal Alcohol Syndrome, adoption-related issues). Often parents may know quite a bit about their child's disorder or illness and, when asked, would be willing to talk about it. Asking the caregiver to share what they know helps create trust between counselor and client. It also helps the parent feel more empowered and more willing to listen to the counselor.

· Counseling sessions might take longer when dealing with a child who has special needs. The child might have speech difficulty, they may be unable to make eye contact or their comprehension skills may be lacking. Remember to schedule more time for these sessions. Be patient and communicate with the child in a way that is respectful and up-front. For instance, when talking to a child who is blind, say hello and identify yourself. Don't tap the child on the shoulder or gesture. When talking to a child with a speech difficulty it's better to say, "Could you please repeat that?" than to pretend you understand.

5 Simple Things You Can Do to Make Your Clients' Lives Easier

1. Tests to qualify for funding. To qualify for funded services the family needs to complete an income test and become familiar with their requirements. Psychiatric evaluations of the child need to be done along with a psycho-educational report to determine the child's I.Q.

2. Short-term intensive services. When you first begin counseling a client, it is important to provide them with short-term, intensive services. Oftentimes a client has waited a long time to access your services. Giving them suggestions on coping strategies or family communication is essential to their success and to the success of the therapy sessions.

3. Record-keeping. Often families have seen many professionals before they see a counselor. Encouraging them to bring relevant reports (school, psychiatric) will save them the frustration of having to report their child's/family history over and over again.

4. Welcome questions and input by parents. It is important to encourage clients to ask a question when something is not clear and to share ideas or articles with you as a basis for further discussion. Parents who have done independent reading to educate themselves about an illness or disability will often be excited to share this knowledge with a professional. This exchange is an important step toward understanding the emotional challenges of a caregiver(s) and his or her (their) child who has special needs.

5. Additional Supports. Parents need to know that supports exist for caregivers to be successful in parenting and counseling. This includes weekend respite for their children so that they are able to get a break and "re-charge their batteries."

Education

How Special Needs Might Affect Your Work

· The most common special needs that teachers have direct experience with are learning disabilities. Students with learning disabilities learn in different ways than other students and will require unique strategies to process and retain information. Teachers will need to assess each student's needs and learning styles and adjust their teaching accordingly.

· Learning disabilities can often be an indication of further special needs such as Attention Deficit Disorder (ADD) or Fetal Alcohol Syndrome (FAS). While it is not up to teachers to diagnose or treat these needs, it is imperative that they gather as much information as possible from parents and other professionals to ensure that their teaching is effective for these students.

· Internationally adopted children are often placed in English as an Additional Language classes.

· Some students with special needs may act out inappropriately in class and openly defy their teachers. It is important to remember and understand that this kind of behavior may be a symptom of a disorder or syndrome (i.e. Oppositional Defiant Disorder, Reactive Attachment Disorder) and not entirely voluntary. As well, much of the acting out may be due to academic frustration, particularly with students who have attention deficits or learning disabilities.

· Students with special needs require extra time and attention from their teachers. This is difficult, especially when many special needs remain undiagnosed or unrecognized and also because teachers have many demands on their time and other students to consider. Utilize the resources that are available to you and your students such as resource rooms and special education teachers.

· Internationally adopted children often arrive in Canada with little or no knowledge of the English language. This inability to communicate in the classroom can mask other special needs that also need attention.

5 Simple Things You Can Do to Make Your Students' Lives Easier

1. Provide structure. Students with attention and memory deficits need structure both in and out of the classroom. Activities and consequences should be predictable. It is especially important for students to have a structured work time at home with minimal distractions to complete their homework with time scheduled for breaks.

2. Use visual and aural teaching aids. Many students have difficulty learning from lecture-style teaching and learn better when supplemental material like videos and pictures are used. Providing lectures or other material on audiotape so that a student can listen again and again can really help him or her retain information.

3. Encourage active participation. Having your students participate is always a good idea, but it is particularly key when teaching children with special needs who have difficulty with traditional teaching.

4. Be specific. Provide detailed written assignment descriptions for your special needs students that answer questions they might have. Remember that many students need practical and simple directions in order to understand and complete assignments.

5. Involve the parents. Special needs students will need support and structure from their families even more than other students and it is key to their academic success. Parents will need to understand their child's learning needs and be able to apply teaching strategies in their own home.

Health Care

How Special Needs Might Affect Your Work

· Many parents and caregivers have children with a variety of special needs ranging from Attention Deficit Disorder (ADD) and Fetal Alcohol Syndrome (FAS) to spina bifida, cerebral palsy, cystic fibrosis and adolescent depression. Parents of these children often lack time, experience high burnout and have a need for respite care. They may already have consulted another, if not several, health care specialists, explaining their child's chronic illness or disability.

· The parent with a child who has special needs might not be aware of his or her child's medical condition. The child may exhibit behaviors without the parents having a clear idea of the cause. He or she may be suffering from two or three challenges that have gone undiagnosed. Or the child may have been misdiagnosed or only diagnosed for one of the challenges. It could also be that he or she might have been diagnosed with a disorder or illness, but that the treatment is not working. Depending on the child's age, he or she will often have a history of treatments and medications. Also, if the child is adopted, the adoptive parents may know little about the child's family history because of incomplete or inaccurate records, or because of illnesses that are common in other regions or places.

· Locating financial resources are a constant struggle for parents with children who have special needs. Supplementary fees for physical and speech therapy, developmental assessments, medical supplies and equipment keep them constantly seeking adequate funds to cover their children's basic requirements. There are often additional costs for home support and long-term care if a parent becomes ill or too old to care for a child needing constant support.

· Diagnostic equipment should be suited to the individual child and his or her size and developmental stage rather than age. Along with adequate medical support, children who have special needs require emotional and mental support to cope with disease and illness. For this reason health care providers should be trained to understand children's growing minds and bodies.

· If they are old enough to visit the doctor on their own, depending on the specific challenge, these individuals may have difficulty processing information. As a result they can sometimes misunderstand a health care worker's advice for medications and treatments. It is important to make the information as simple and straightforward as possible. This might involve having them writing down your suggestions. They might need someone with them to make sure they've understood what the treatment involves.

5 Simple Things You Can Do to Make Your Patients' Lives Easier

1. Request historical, medical and/or family records beforehand. That way when they meet you they won't have to repeat information that already exists.

2. Learn standards of care or treatment guidelines. Knowing what approach to take for a particular illness or disability will help you choose a medical plan of action appropriate for the child. Is there a relevant specialty? A clinic nearby? If not, do funds exist to cover child/caregiver travel costs?

3. Be a medical advocate for your client/patient. Physicians are often a patient's most influential allies. Agree to endorse letters to a health plan explaining why a specific treatment or device is "medically necessary". Call to remind parents of appointments. Listen carefully to their stories to understand what it's like to be a parent with a child who has special needs.

4. Monitor a child's health. Many children who have special needs are at high risk for developing other disorders and diseases. For instance, sickle cell disease in children can develop into eye disease later on. Engaging the services of an ophthalmologist or retinal specialist to examine the child regularly will benefit him or her.

5. Advise parents or patients to document healthcare history. This includes having the parent or caregiver keep a child's journal of doctor's appointments, treatments, articles, letters and therapy sessions. When requested, give them copies of a "history sheet" for surgery outcomes, side effects of medications, etc.

Legal

How Special Needs Might Affect Your Work

· In criminal law, a client's mental state will affect potential defenses (i.e. not criminally responsible by reason of mental disorder) as well as sentencing hearings. It is the responsibility of defense counsel to inform the court of concerns regarding the defendant's mental state and fitness for trial and certainly, many special needs (like Fetal Alcohol Syndrome) can directly affect this.

· Lawyers will need to adjust the way they work when dealing with special needs clients and their families. Often, these clients will have difficulty with the legal process. Lawyers have to make allowances for challenges such as brain damage, memory deficits and atypical language development. It is also important that lawyers help other professionals involved (judges, other counsel, corrections officials) understand and take into account these kinds of challenges.

· When issues like child support and guardianship come up, a lawyer must take into account the caregiver and his or her daily activities, which, for special needs children in particular, may be very complex.

· With adopted clients, it is often not possible to obtain any medical or family history, which can sometimes be detrimental, especially when preparing for a criminal trial. In these cases, it is important that you try to obtain assessments or diagnoses.

· Special needs may also come up if you are working with victims of crime (unfortunately, people with special needs are often easy targets), particularly when they are witnesses in criminal proceedings. If their special needs affect their memory or language skills, testimonies can be particularly difficult.

5 Simple Things You Can Do to Make Your Clients' Lives Easier

1. Write instructions down in clear and simple language. Many people with special needs may have language development challenges or memory deficits. In these cases, it is important to present a document that they can follow and check again and again.

2. Repeat yourself. It is difficult to gauge just how much of the legal process a special needs client may understand, so it is essential to repeat your advice. Also, many people with special needs may also have addictions to drugs or alcohol and will need the extra repetition to actively participate in their representation.

3. Ask for previous assessments and medical/family histories early. Although some clients (adopted people in particular) will not be able to provide this information, there are other professionals (doctors, social workers) who will be able to give you some useful information.

4. Involve your client's family. Many special needs clients will need the supervision and support of their family in order to understand or participate in the legal process. This may mean that your client will need or want to have his/her family members involved in your meetings.

5. If you don't know the answer, ask. Try to find out all you can about your client's special need. You may have to obtain an assessment or expert witness or you may have to do some independent research on your own. Question what you already know and don't be afraid to learn more.

Social Services

How Special Needs Might Affect Your Work

· Parents or caregivers with children who have special needs might not always understand the impact of their child's background on his or her development. They might not fully know how their development may be different from other children of the same age. If the child is adopted, chances are the parents might not have been given a full family/medical history.

· Some parents aren't always aware of how the 'system' works and how to seek support in their community. Because parents don't always use the same language as professionals, misunderstandings can occur even though both parties might be saying the same thing.

· Sometimes parents are reluctant to admit the extent of their challenges and therefore do not always gain access to particular resources that might be available.

· Seeking support services and funding is a constant struggle for parents. Supplementary fees for physical and speech therapy, developmental assessments, medical supplies and equipment keep them constantly seeking adequate funds to cover their children's basic requirements. Likewise, to keep up with the ever-changing and continuous needs of these children, support services are being sought on a regular basis.

· Adoption can present various challenges to professionals in social services. It is important to remember that families and children from other countries or cultures may have a different set of values as well issues that are specific to their geographic or cultural origin.

5 Simple Things You Can Do to Make Your Clients' Lives Easier

1. Help parents understand the adoption process. When a family is adopting a child it is important to help prepare them ahead of time. Let them know that they'll need to obtain a Criminal Record Check and a doctor's medical exam as well as provide references along with a prior contact check which is done through the Ministry of Children and Family Development. While the child's worker develops a Comprehensive Plan of Care, the adopting family must be involved in the completing and signing of the Adoption Agreement. If the child is First Nations, a Cultural Plan will be developed. If warranted, a form indicating that the child is special needs should be completed prior to adoption. If the family is eligible, this will allow access to the Post Adoption Assistance Program.

2. Assist with parenting strategies. When a particular parenting technique is not working with the child, it is important to help parents look at alternative approaches.

3. Connect them to medical services. When adopting a child who has special needs some parents may not always know the full extent of the child's physical/emotional or behavioral challenges. It would be helpful to prepare them by ensuring that their home is set up to manage the needs of the child and that they have access to medical supplies if needed. If a family is adopting a child with extensive medical needs it is important to make certain they have a good knowledge of the short and long term outcomes of the medical condition. Connect them to medical professionals who know something about the disorder or disease.

4. Connect them to support. Some families pull back from community support when a child is diagnosed with a particular illness or disorder. Encourage them to seek support and tell them you will help advocate on their behalf. Ensure the family has a good support network they can go to for advice and respite. Make sure that school programs are in place to meet the child's particular needs and that extended family and friends will be there to provide support. See that they are accessing suitable counseling and/or therapy services.

Call between appointments. Calling parents to ask how things are going or to remind them of appointments is a sign to them that you know they are dealing with many significant challenges and that you are there to support them.

Credits: Jennifer Lee and Lissa Cowan

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