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Problem:
NH has approximately 1.25 million residents, of whom 27% or 332,267 are age 19 years or younger. The prevalence of CSHCN is 15.1%. There have been dramatic increases in the number of children with autism spectrum disorders (400%) and ADHD (200%) in the last 10 years.
Goals and Objectives:
Goal 1: RECRUITMENT:To implement strategies to recruit graduate and post-graduate trainees and fellows for participation in an interdisciplinary training program.
Objective 1: To increase the number of professionals with the knowledge, skills, and leadership to serve CNDDF with special attention to those from under-represented groups.
Objective 2: A minimum of 10 long-term (350+ hours), 20 intermediate level (160+ hours), and 200 short-term trainees will be recruited for participation during each year of the project. By the end of the Project period (5 years), we have these targeted outcomes.
Objective 3: NH LEND will develop recruitment activities to attract those trainees with leadership potential that are from traditionally under-represented groups.
Goal 2: LEADERSHIP:An interdisciplinary group of long-term and intermediate-level trainees and fellows will develop their awareness, skills, and leadership capability related to providing services to CNDDF
Objective 1: Each long-term trainee and intermediate trainee will master academic and clinical content that reflects current best practices and research in the following 13 core competency areas with respect to specific CNDDF
Objective 2: Each long-term trainee will reflect on and document his/her individual awareness, knowledge, skill and leadership in the 13 core competency areas using a portfolio.
Objective 3: Each long-term trainee will develop their leadership skills through attendance in the NH Leadership Series with families with NDD and self-advocates.
Goal 3: FAMILY-CENTERED PRACTICES: Trainees will develop their knowledge & skills to provide family-centered services to CNDDF through clinical, research & public health & policy totaling 200 hours annually
Objective 1: Each long-term trainee will participate in seminars, research and continuing education events that involve at least one consumer or family member of a CNDD to gain knowledge of consumer viewpoints, self-determination, and historical aspects of disability.
Objective 2: Each long-term trainee will attend the NH Leadership Series to gain knowledge of state of the art supports for CNDDF and an understanding of the legislative process; and to develop leadership, advocacy, and community organizing skills.
Objective 3: Each long-term trainee will demonstrate skills in collaborating with families who have CNDD to advocate for services and changes in systems and public policy.
Goal 4: PUBLIC HEALTH Trainees will develop their awareness, knowledge, skills, and leadership in the area of public health relative to MCH/Title V and related legislation
Objective 1: Each long-term trainee will develop an understanding of public policy and legislation within broad public health perspective
Objective 2: Each long-term trainee will develop the knowledge and skills to collaborate with private and publicly funded community providers, especially the NH Special Medical Services Bureau (SMS) programs and the NH Division of Public Health Services.
Objective 3: Faculty and trainees will collaborate with the SMS and the NH Division of Public Health Services to present findings of research related to current public health issues as they impact children with NDD two times per year for community professionals and families.
Goal 5: INTERDISCIPLINARY TRAINING & PRACTICE provide interdisciplinary training for trainees from a range of health care professions.
Objective 1: Each long-term trainee will demonstrate team building and group process skills as defined in their individualized Interdisciplinary Training Plans.
Objective 2: Each long-term trainee will demonstrate knowledge and skills as members of an interdisciplinary team as defined in their individualized Interdisciplinary Training Plan.
Objective 3: aculty will develop and implement a training program for physicians who wish to increase their competency and their skills in the evaluation and care of CSHCN via workshops, conferences and mentored clinical “mini-fellowships” held throughout NH.
Methodology:
The curriculum is guided by 13 core competencies in which Trainees will develop their values, knowledge, clinical expertise, and leadership skills, while supporting research, public policy development, continuing education, and technical assistance activities. The curriculum consists of didactic seminars, interdisciplinary clinical preparation, and community-based practica. The curriculum emphasizes a) family centered and culturally competent practices b) an understanding of populations as well as individuals c) public and private health care environments (including a medical home and specialized care settings), and d) integrated systems of care across settings.
Coordination:
The NH LEND program will provide technical assistance to NH Title V staff, NH Area Agency systems, regional early intervention programs, Head Start programs, the NH Division of Developmental Disabilities, and pediatric practices. Collaboration with these programs and organizations provides the opportunity for faculty members and trainees to be active partners in service delivery, policy development, and research.
Evaluation:
The NH LEND Program uses both formative and summative project evaluation procedures that focus on the ability to produce leaders in family-centered care, special health-care, and developmental disabilities. The evaluation questions are derived directly from each project goal. The Dartmouth Center for Educational Outcomes is a partner in developing the process for measuring the impact of the NH LEND Program
Experience to Date:
During the past year, 8 long-term trainees from the disciplines of early childhood/special educaiton, nutrition, occupational therapy, speech language pathology, nutrition, social work and 1 post-doctoral fellow in psychology completed interdisciplinary, family-centered, culturally competent training through in the NH LEND program.. A total of 678 short-term trainees and 22 intermediate term trainees received training. A total of 635 individuals participated in continuing education offerings presented by NH LEND faculty members on topics related to early intervention, evidenced-based practices in autism spectrum disorders, and literacy for children with significant disabilities. A total of 70 Individuals/Organizations were provided technical assistance and consultation by NH LEND Program faculty/staff. Faculty published 21 products, including 8 peer-reviewed articles, 1 book chapter, 3 books, 5 non-peer reviewed publications, 3 grant application, and 1 new course on issues related to disability. v1,260 patients received care seen through the clinics at the Children’s Hospital at Dartmouth and the Seacoast Child Development Clinic from NH LEND affiliated faculty during FY2006.
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