Early Identification and Intervention: St. David’s Center for Child & Family Development

By Hannah Stuart
Friday, August 11, 2017

Identifying medical challenges early in life and having access to proactive care are game changers for families with children facing developmental delays.

As a trusted community partner for families and physicians in the Twin Cities area, St. David’s Center for Child & Family Development improves the way children are assessed for developmental delays and connected to resources with the power to better their lives.

St. David’s Center is home to an inclusive preschool, children’s mental health clinic, autism treatment center and pediatric therapy clinic, all housed under one roof. The center is uniquely equipped to meet a wide spectrum of families’ needs, from early childhood education both for typical children and those with a wide range of developmental needs — to the specialized therapies necessary for all of these children to thrive.

Research indicates children experience a variety of benefits in their interpersonal relationships and development trajectory when delays in their progress are identified early in life. Here’s how St. David’s Center is working to make families as strong as possible, as early as possible.

Coordinating Care

When parents or providers notice a potential problem with a child’s development, the St. David’s Center intake team serves as a vital resource of support and information. Developmental red flags — for example, trouble communicating effectively, struggles in a classroom setting, or lack of successful reciprocal interactions with peers or caregivers — are frequently noticed during well-child visits, at home, or by educators or childcare providers. After collecting information about the concern, the intake team helps connect the pieces, working together with parents and providers to form an investigative plan to understand and address the potential issue.

“The medical system tends to be broken up into silos with teams or providers working alone, and the gift of being a multidisciplinary center is that we work against the infrastructure that forces us into those silos,” says Julie Sjordal, CEO of St. David’s Center. “Our autism day treatment program is a great example of this. Speech therapists, occupational therapists and mental health clinicians work as a team with the children in the program. They collaborate to create treatment goals for each child, so they can assist children with achieving improved well-being and functioning — not just in a single area, but overall.”

The spirit of collaboration and cooperation at St. David’s Center also extends to the support of community providers whose patients may benefit from additional resources.

“If a parent or physician discovers a child isn’t keeping pace with his or her peers or is exhibiting maladaptive behaviors, we encourage them to reach out to our team for support,” says Cara Benoit, MA, CCC-SLP, Senior Program Director of Pediatric Therapies at St. David’s Center. “We invite them to call our Central Office of Resources and Enrollment and explain the presentation they’re seeing. Our intake team will help identify the appropriate assessments, offer suggestions for reaching an accurate diagnosis, and recommend additional resources or referrals to our specialists when appropriate.

“Developmental delays can prove challenging to fully address in a primary care setting, and the team at St. David’s Center can help,” Benoit continues. “Physicians don’t need to have a definitive diagnosis to utilize our resources. We are willing to explore concerns alongside providers and families to come to correct conclusions and select appropriate courses of treatment.”

The Harman Center for Child & Family Wellbeing

Scheduled to open its doors in March 2018, the Harman Center for Child & Family Wellbeing will expand access to autism care and other life-altering services provided by St. David’s Center for Child & Family Development.

Work is already underway on the new facility, which will take up an expansive 10,000 square feet at Westminster Presbyterian Church and house the new location of the East African Autism Day Treatment program. Other services offered at the new location will include infant and early childhood mental health treatment, occupational therapy, speech therapy and the Family Place day treatment program for children ages two to six who have a mental health diagnosis.

“Our vision for the Harman Center for Child & Family Wellbeing is to support and strengthen parent-child relationships, improve outcomes in children who have faced trauma, and partner with families and communities to create and sustain a center that supports healing, health and wellbeing,” says Julie Sjordal, CEO of St. David’s Center.

One way St. David’s Center accomplishes this is by building onto the successful downtown location of the Autism Day Treatment program, which will have room to grow at the new facility. After almost 10 years of consistently positive outcomes at the Minnetonka-based Autism Day Treatment program, and in response to the rising rate of autism among the Twin Cities’ East African community, St. David’s Center opened a second Autism Day Treatment program location closer to the East African families seeking treatment for their children.

“The program serves around a dozen children in two sessions, morning and afternoon, and is staffed by a team sensitive to students’ cultural and medical needs,” Sjordal says. “Our goal is to bring more comprehensive autism treatment to the East African community, where the prevalence of autism is high and early identification has been particularly challenging. We are learning right alongside the community, and we’re all benefiting as a result.”

Learn more about the Harman Center for Child & Family Wellbeing by visiting stdavidscenter.org/harmancenter.

Early Intervention, Lifelong Benefits

It is vital to be proactive in identifying challenges that children face, Benoit stresses. Early identification and intervention help children move forward and succeed as well as thwart the development of maladaptive behaviors that may obscure the underlying causes of developmental delays. Such behaviors can develop into patterns of poor peer relationships and trouble communicating with adults.

“The complexity of diagnosis increases when children develop behaviors around an unaddressed need over time,” Benoit says. “A child may struggle with behavior in a classroom setting as a result of a condition that could have been easily managed had it been identified early.”

The sooner such concerns are recognized, the better, as the foundations for learning are established in the first few years of life. These foundations become more difficult to adjust as children age, and maladaptive behaviors, along with factors such as toxic stress and negative early experiences, can exacerbate developmental concerns. Diagnosing children early in life may also lead to shorter treatment periods as children rapidly progress toward improved function.

To accomplish this, therapists with St. David’s Center employ a variety of assessments to achieve early identification and guide referrals to appropriate intervention services. (See “Identification and Intervention Methods” for details.)

“During assessments and interventions, we examine the individual needs of clients and families and meet them with resources appropriate to their specific situations and abilities,” says Benoit. “Even if an initial referral is for one program, such as the Autism Day Treatment Program, our thorough assessment process may indicate the child isn’t ready for a group setting. In cases like that, the child would begin in outpatient occupational and speech therapy, with the goal of moving the child to autism day treatment when he or she does demonstrate group readiness.”

Evaluation remains a vital part of children’s growth and development at every stage. The same proactive approach applies to transitioning children on to the early childhood education program, for example, where children with more significant developmental delays or disabilities can work alongside typical children for improved outcomes across all domains of development. Throughout children’s time at St. David’s Center, the team individualizes the services they receive based on their specific needs, and with that optimization, they gain skills more quickly.

Identification and Intervention Methods

  • Psychological Evaluation — Children are typically referred for psychological evaluation due to social, emotional or behavioral struggles. This evaluation takes place over one or two in-depth sessions.
  • Diagnostic Assessment — Taking place over several weeks, diagnostic assessments help providers pinpoint the causes of delays in children who experience difficulties with everyday activities.
  • Mental Health Consultation — These consultations are conducted at the St. David’s Center outpatient clinic and through partnerships with school districts. Children are referred to this program when their needs exceed the capabilities of their current care settings. Mental health clinicians work with children as well as their educators to discover underlying causes of behavioral challenges and improve children’s functioning in both home and school settings.
  • Infant and Early Childhood Mental Health Assessment — This set of prescribed assessments is selected by behavioral health specialists after observing the parent-child relationship. St. David’s Center team members examine the impact that relationship has on the child’s stress levels and development. Pediatricians may wish to consider referring families to this program if they observe challenges in the parent-child relationship, even before outward signs of stress manifest.
  • Occupational Therapy Evaluation — Children referred for occupational therapy services may not feel comfortable in their environments; this may manifest as difficulty hearing or being over-responsive to sound, vision challenges, or fine motor deficits. Children may qualify for occupational therapy at St. David’s Center even if they do not meet public school requirements for this kind of intervention. The team at St. David’s Center serves children based on their functional skills.
  • Speech Evaluation — St. David’s Center providers evaluate children who have language difficulties, trouble following directions or problems using language to form meaningful relationships. Patients struggling to have positive social interactions with caregivers may benefit from a referral.
  • Feeding Therapy Evaluation — Children who are habitually selective about their food choices may benefit from a feeding therapy evaluation. If clinicians identify an issue — for example, if children are uncomfortable eating or avoid eating certain items — therapists work with these children to adjust any maladaptive behaviors or thought processes they may have developed around food.
  • Autism Evaluation — Ideally, children in need of an autism evaluation are referred to the St. David’s Center team when they are between 12 and 18 months old. Initial evaluations are conducted by the Multidisciplinary Assessment Team in an intense session, at which time children are evaluated by a psychologist, occupational therapist and speech therapist simultaneously. For children who enter the program with a pre-existing diagnosis of autism, a follow-up evaluation is conducted to determine which services are most appropriate for their needs.

Meeting Complex Needs

Children referred to St. David’s Center’s Multidisciplinary Assessment Team typically exhibit anxious or disruptive behaviors or an inability to get along with other children, or they have experienced significant trauma. This team connects clinicians and therapists across disciplines in a collaborative approach to determine the needs of children with complex developmental concerns caused by these and other issues. The makeup of a child’s assessments is adjusted based on his or her unique needs and commonly includes working with a child psychologist, a speech therapist and an occupational therapist.

This particular team’s collaborative approach isn’t solely confined to the area of St. David’s Center’s services, however. The theme of collaboration is mirrored across the work of the entire center.

“We are a multidisciplinary center focused on intervening as early as possible in the lives of children who present with developmental challenges, whether those challenges are due to physiological causes or trauma children have experienced,” Sjordal says. “To have this range of disciplines in one place, and to also house early education for children with typical development in the building, is a beautiful continuum of services driven by a group of deeply committed and experienced clinicians, therapists and educators. Our goal, no matter the children’s level of development, is to move them along in a healthy way toward their best outcomes.”

To refer a patient to St. David’s Center, contact the CORE office at 952-548-8700.