EARLY SCREENING OF DEVELOPMENTAL AND EMOTIONAL DISORDERS Joint project FGC-UNRWA-HI

1. EARLY SCREENING OF DEVELOPMENTAL AND EMOTIONAL DISORDERS Joint project FGC-UNRWA-HI The Family Guidance Centers (FGC) are part of the National Institution of Social Care and Vocational Training – Beit Atfal Assumoud, Lebanon. The agency provides services to the Palestinian refugees displaced to camps and gatherings around the country. And through 3 centers in Beirut, the north and the south, the FGC’s offer mental health services to the Palestinian communities living in these challenging environments The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), is the main service provider for the Palestinian communities, especially in the health and education departments. And thus, the biggest majority of Palestinians go through routine visits to this agency’s clinics for medical services. And given the growing need for early screening of emotional and developmental disorders for children, and with the support of Handicap International, FGC and UNRWA launched this pilot project in the 3 areas of Beirut, the north and the south, as part of the Mother-and-Child Health Care in UNRWA clinics. Nurses were the ones chosen to conduct this screening, being the first line contact with the patients. Introduction • Early screening of developmental and emotional disorders in infants and toddlers • Detection and early intervention in parental disorders • Detection and treatment of maternal depression • Prevention of child abuse and neglect Objectives • Administration of a questionnaire to the parents of the child, during a routine visit to the MCH clinics. Nurses were trained to use it, and it was pre-tested before its finalization. • Referral of detected problematic cases to the Family Guidance Centers • Evaluation and treatment plan designed by FGC teams • Treatment and follow-up done jointly by FGC teams and UNRWA nurses, and other social and educational actors • Circulation of information and feed-back between FGC teams and the parents and nurses, was through written reports Method • 72 cases referred from July to December 2008, in the 3 centers • The assessments showed some medical problems with the children: Cerebral palsy (5 cases), Down syndrome (2) Seizures (6), Other (prematurity, head trauma, hydrocephalus, etc., in 15 cases) Reasons for referral Results • • Maternal problems were also depicted: • 17 cases of depression; • 3 financial problems; • 2 marital problems; • 2 war effects; • 1 father absence; • 1 spouse abuse; • 1 obsessive compulsive disorder; • 1 mental retardation • Parenting problems: Abuse (7) ; Limited interaction (5) ; Poor limits setting (5) ; Neglect (4) ; Hypnotics to child (3) • This project proved its effectiveness in increasing the sensitivity and specificity in the referrals of the nurses, whenever a developmental or emotional disorder was suspected. It is still pursued on in the 3 areas. And the numbers of referrals are constantly increasing. • It was a successful screening-assessment-intervention program, one to build on for more extensive programs • It showed once again the importance of early intervention, as a cost-effective way to increase impact of interventions • This partnership FGC-UNRWA-HI reflected the effect of positive collaboration between major services providers in challenging environments Conclusion