Unit 1/Ch5: Working with Families

Question 1

Why do we study families?

Answer 1

• Families are complex systems (family friends, extended family, support systems, siblings)
• OT’s must be prepared to work with a variety of families (foster, single parent, multi-generational care, grandparents)
• OTs must understand the influence of the family’ daily routines/goals on how children spend their time
• Involvement of family members is central to the best practice of occupational therapy

Question 2

Families

Answer 2

• A group of occupational beings
• Transmit a cultural model
• Give children a sense of support, identity, and emotional well- being
• Help children develop fundamental routines and lifestyle habits
• Prepare children to become productive adults

Question 3

Master (Outcomes of Family Occupation)

Answer 3

Help children learn to master routines and habits that support health and wellbeing

Question 4

Participate (Outcomes of Family Occupation)

Answer 4

Foster readiness to learn and participate in educational programs

Question 5

Assume (Outcomes of Family Occupation)

Answer 5

Foster readiness to assume place in community and society

Question 6

A family system is composed of… (system perspective of family occupations)

Answer 6

individuals who are interdependent and have reciprocal influences on each other’s occupations.

Question 7

Within a family, subsystems are defined by… (system perspective of family occupations)

Answer 7

Their own patterns of interaction and shared occupations.

Question 8

A family must be understood as a… (system perspective of family occupations)

Answer 8

Whole, and it is more than the sum of the abilities of each member.

Question 9

The family system works to… (system perspective of family occupations)

Answer 9

Sustain patterns in family occupations and to be part of a larger community.

Question 10

What is inherent in a family? (system perspective of family occupations)

Answer 10

Change and evolution

Question 11

A family as an open system is influenced by… (system perspective of family occupations)

Answer 11

Its environment

Question 12

Parents

Answer 12

-Birth, adoptive, partner, blended or foster
-Caregiver” sometimes used to refer to
grandparents, foster parents
-Effect of child with special needs on mothers and fathers (Mothers/fathers may have different priorities/perspectives for the child)
-Effect of child with special needs on parent’s relationship: Marriages that have children with special needs have increased divorce rate

Question 13

Siblings

Answer 13

-Effect of child with special needs on siblings: Acting-out, extra-caring behavior
-Siblings can be a source of support: Siblings can help encourage child to
achieve OT goals
-Siblings also need support and care due to caregiving role: Art therapy for sibling care-givers.

Question 14

Extended Family

Answer 14

• Aunts, uncles, grandparents
• Extended family can provide additional support
• Many children being raised by grandparent: Aging parents can be an added stressor

Question 15

Normative Events (transitions- the family lifecycle)

Answer 15

Normative changes are changes that you can prepare for:

• Birth of new child
• Begin Kindergarten
• Middle school, High School, College Transition

Question 16

Non-Normative Events (transitions- the family lifecycle)

Answer 16

Non-Normative changes are changes that normally can/’t be prepared for.

• Grandparents moving in
• Divorce
• Moving away

Question 17

Early Childhood (Family Resources and the Child with special Needs)

Answer 17

• Diagnostic process.
• Parents request information.
• Parents have questions.
• Parents gather information systems, their rights and community resources.
• Caregiving for an infant with special needs may be similar to caring for typical infant.

Question 18

School Age (Family Resources and the Child with special Needs)

Answer 18

• Families may experience less support when the child enters school.
• They may be no longer directly involved with the child’s program.
• The gap between the child’s performance and that of typical peers may widen.
• Making friends may be a priority.

Question 19

Adolescence (Family Resources and the Child with special Needs)

Answer 19

• May be a stressful time with growing social, financial and sexual needs.
• Parents may be increasingly concerned about child’s vulnerability.
• Increased social stigma from peers.
• Parents have difficulty caring for child’s growing physical and emotional needs.

Question 20

Financial Resources (Family Resources and the Child with special Needs)

Answer 20

• Parents may have many hidden and ongoing expenses.
• Special procedures may require travel to distant facilities to receive care.
• Childcare may be more expensive or unavailable.
• One parent may quit work to care for the child.

Question 21

Human Resources (Family Resources and the Child with special Needs)

Answer 21

• Does the family have a support group available?

- Is there someone who can provide respite care for the child as needed?

Question 22

Time Resources (Family Resources and the Child with special Needs)

Answer 22

• Extra caregiving required (Preparing for school in the morning can take a long time)
• Additional supervision.
• May require more structure and organization in daily life.
• Routines may need to change to accommodate the child.
• Parents may have less time for socialization/recreation.

Question 23

Emotional Energy Resources (Family Resources and the Child with special Needs)

Answer 23

• Children with disabilities may require more emotional energy from the parents.
• Parents may experience anxiety and depression.
• Parents may become exhausted and sleep deprived: NICU babies have strict feeding schedules that impact parent’s sleep patterns.
• Stress levels in families seem to relate to the resources they have: Financial, educational, emotional or social.

Question 24

Sources of Diversity (Family Resources and the Child with special Needs)

Answer 24

1. Ethnic Background
2. Family Structure
3. Socioeconomic Status
4. Parenting style and practices

Question 25

An Ecological Perspective (Family Resources and the Child with special Needs)

Answer 25

- Social and Physical Features - Brings awareness of the influence of distant things not under the family’s control - Communities vary in how they support the inclusion of families of children with disabilities.

Question 26

Phases of Ecological Perspective

Answer 26

1. Household Members: List everyone that lives in the home 2. Direct Support: Where do the grandparents live?, Who are their best friends? 3. Indirect Support: Are they on Medicaid?, Are they on SSI?, Who are their Doctors, Who are their doctors?, Who are their best friends?, Who is their employer? 4. Relationships: Describe your relationship with your doctors: Is it positive/stressful?

Question 27

Emotional Energy Resources (supporting participation in family life)

Answer 27

- Adapting daily routines to conserve energy an avoid injury. - Strategies to increase children’s independence in self-care. - Embedding adapted strategies and learning opportunities into the family’s daily routine.

Question 28

Socialization & Participation in Social Activities (supporting participation in family life)

Answer 28

- With ADA more recreational activities have become available. - OTs suggest strategies to increase family’s level of participation.

Question 28

Fostering readiness for community living (supporting participation in family life)

Answer 28

- Provide Families with Information. | - OTs help to advocate for youth.

Question 29

Adaptation (family adaptation, resilience & acommodation)

Answer 29

Recognize the situation, and interruption in activities, or a loss of emotional well-being.

Question 30

Resilience (family adaptation, resilience & acommodation)

Answer 30

Families draw on resources to restructure add/or get rid of routines.

Question 31

Accommodation (family adaptation, resilience & acommodation)

Answer 31

Changes that maintain daily routine

Question 32

Family Partnerships Include: (family adaptation, resilience & acommodation)

Answer 32

- Family-centered services - Family support - Direct services - Family Education

Question 33

Emotional Energy Resources

Answer 33

- Trust Building - Equality - Respect

Question 34

Providing helpful Information

Answer 34

- Child or diagnosis-related info | - Characteristics of helpful communication

Question 35

Effective Communication builds on:

Answer 35

- Trust & respect | - Honesty & sensitivity

Question 36

Communicate with parents

Answer 36

- Formal & informal - Written - Verbal - Nonverbal

Question 37

Home Programs: Blending Therapy into Routines

Answer 37

- Learn information about important and meaningful daily routine activities. - Identify naturally occurring moments where behaviors can be taught and modified

Question 38

Parents Appreciate (Home Programs Blending Therapy into Routines)

Answer 38

- Specific, objective information - Flexible service delivery - Sensitivity & responsiveness to their concerns - Positive, optimistic attitudes - Technical expertise and skill (P.132)

Question 39

Families are a Group of Occupational Beings

Answer 39

- Consider parent’s intellectual abilities when teaching strategies - Parent have their own mental/medical issues - A referral to counseling or family services may be required. - Can help parents in problem solving

Question 40

Conclusion

Answer 40

- Family participation is a critical element of intervention. - Therapy goals & activities must reflect family priorities. - Families are unique & multidimensional. - Children with disabilities have positive & negative effect on families. - Occupational therapists who respect family values and maintain a positive attitude can become important supports to families of children with special needs.