ipad apps to enhance tf-cbt for children with disabilities

Ipad Apps to Enhance TF-‐CBT for Children with Disabili;es

BASPCAN -‐ The Associa1on of England, Ireland, Northern Ireland, Scotland and Wales for Child Protec1on

April 14,2015

Beth Reiman, Westchester Ins1tute for Human Development [email protected]

1 Beth Reiman [email protected] BASPCAN

Trauma

Beth Reiman [email protected] BASPCAN 3

Trauma and Children with Intellectual Disabili;es

•  Prevalence of trauma;c events •  Impact of sexual abuse on CWDs

•  Lack of studies regarding this popula;on •  Symptoms are similar to those without disability but oNen mistaken

•  Not every person with ID needs treatment


Disconnect from feelings

Behavior problems

Fear and anxiety

Intrusive thoughts

Hyper-‐vigilance

Sleep problems

Trauma Symptoms 5 Beth Reiman [email protected] BASPCAN

Myths: People with ID…

•  Don’t recognize or understand a trauma;c event

•  Don’t experience trauma and its sequelae

•  Don’t exhibit symptoms of trauma

•  Don’t have feelings about trauma;c events

•  Can’t benefit from therapy


When is therapeu;c interven;on needed

•  When person does not return to their typical state aNer a couple of months.

•  Disrupted sense of safety •  Disconnec;on from suppor;ve people


TF-‐CBT

•  Developed by Deblinger, Cohen and Mannerino*

•  Evidenced based, research •  Developed for people without disabili;es

*Cohen, K., Mannerino, A., Deblinger, E., (2012), Trauma-‐Focused CBT for Children and Adolescents, New York: Guilford Press


Research project

•  3-‐year LEND research project •  Children with disabili;es served at a child advocacy center

•  Focus group regarding mental health needs of children with disabili;es

•  Use of technology to make service more accessible


Use of technology to support TFCBT

•  Millions of Apps •  Use of Ipad •  Therapeu;c rela;onship •  Developmental factors to consider

•  The Matrix

•  Tes;ng it out


Children with disabili;es and treatment

•  Challenges due to verbal and cogni;ve delays •  Ensuring that treatment is appropriate

•  Agen;on span •  Comfort level of clinicians

•  Appropriate tools and resources


Adapta;ons: tradi;onal

•  Adjust pace, session length •  Structure and rou;nes •  Repe;;on •  Use of visuals


Adapta;ons: Current

•  Assessment •  Ask “Why do we offer….”

•  Use of technology


Challenges Psychoeduca;on

•  Difficulty generalizing •  Poor comprehension and reten;on

•  Limited agen;on span

•  Fixated on par;cular interest


Toca Doctor

Parts of the body

Anatomical dolls

My Body for Girls

Au;smate


Challenges Relaxa;on

•  Sensory s;mula;on •  Impulsivity

•  Increased anxiety levels •  Poten;al for behavioral manifesta;ons


Calm Talk

CBT4Kids

Breathe, Think, Do

Breathe2Relax

Flowpaper


Challenges: Affect Regula;on

•  Difficulty iden;fying emo;ons •  Connec;on of body responses to emo;on

•  Verbal and nonverbal responses •  Impulsivity


No More Meltdowns

Between the Lines

Feeling Electric

Emo;ons

GT Colour Faces

Emo;ons, Feelings and Colors


Challenges Cogni;ve Coping

•  Abstract thinking •  Sequences of events •  Priori;zing •  Task breakdown •  Ambiguity


ICBT

CBT4Kids

Popplet


Challenges Trauma Narra;ve

•  Organiza;onal problems •  Cri;cal thinking •  Academic skills for wri;ng


Story Maker

Notability

Puppet Pals

Popplet

Anatomical dolls


Children with disabili;es

Opportunity for Healing


Apps Links •  Au;sMate: : hgp://au;smate.com/Au;sMate-‐Comprehensive-‐App-‐For-‐Au;sm •  Anatomical Dolls:

hgps://itunes.apple.com/us/app/anatomical-‐dolls/id591616357?mt=8 •  Toca Doctor: hgps://itunes.apple.com/us/app/toca-‐doctor/id424209938?mt=8 •  My Body: hgps://www.appannie.com/apps/ios/app/my-‐body-‐for-‐girls-‐ad-‐free/ •  Calm Talks: hgps://itunes.apple.com/us/app/calm-‐talk/id668393731?mt=8 •  Emo;ons, Feelings and Colors:

hgps://itunes.apple.com/us/app/emo;ons-‐feelings-‐colors-‐!/id581936735?mt=8 •  Parts of the Body:

hgps://itunes.apple.com/us/app/parts-‐of-‐the-‐body/id578592791?mt=8 •  CBT4kids: hgps://itunes.apple.com/us/app/cbt4kids-‐toolbox/id605222992?mt=8 •  Breathe, Think,Do:

hgps://itunes.apple.com/us/app/breathe-‐think-‐do-‐with-‐sesame/id721853597?mt=8

•  Breathe2Relax: hgps://itunes.apple.com/us/app/breathe2relax/id425720246?mt=8


App Links (con;nued) •  Flowpaper hgps://itunes.apple.com/us/app/flowpaper/id424499611?mt=8 •  iCBT: hgps://itunes.apple.com/us/app/icbt/id355021834?mt=8 •  No More Meltdowns:

hgps://itunes.apple.com/us/app/no-‐more-‐meltdowns/id407341438?mt=8 •  Between the Lines 1:

hgps://itunes.apple.com/us/app/between-‐the-‐lines-‐level-‐1-‐hd/id574405272?mt=8

•  Feel Electric: hgps://itunes.apple.com/us/app/feel-‐electric!/id463493101?mt=8 •  GT Colour Faces:

hgps://itunes.apple.com/us/app/gt-‐colour-‐faces/id682209555?mt=8 •  Popplet: hgp://popplet.com/app/ •  StoryMaker:

hgps://itunes.apple.com/us/app/storymaker-‐for-‐social-‐stories/id570007786?mt=8 •  Notability: hgps://itunes.apple.com/us/app/notability/id360593530?mt=8 •  Puppet Pals: hgps://itunes.apple.com/us/app/puppet-‐pals-‐hd/id342076546?mt=8 •  Emo;ons: hgp://bridgingapps.org/app/?id=525637590


Resources •  Trauma-‐Focused CBT for Children and Adolescents:

hgp://www.amazon.com/Trauma-‐Focused-‐CBT-‐Children-‐Adolescents-‐Applica;ons/dp/1462504825

•  Focht-‐New, G., Clements, P., Barol, B., Faulkner, M., Services, K., (2008), Persons with developmental disabili;es exposed to interpersonal violence and crime, Perspec'ves in Psychiatric Care, 44(1).

•  Haddock, K., Jones, R., (2006), Prac;;oner consensus in the use of cogni;ve behaviour therapy for individuals with a learning disability, Journal of Intellectual Disabili'es, 10(3) 221-‐230.

•  Mevissen, L., de Jongh, A., (2010), PTSD and its treatment in people with intellectual disabili;es, Clinical Psychology Review, 30 308-‐316.

•  Sturmey, P., (2004), Cogni;ve therapy with people with intellectual disabili;es, Clinical Psychology and Psychotherapy, 11(4), 222-‐232

•  Na;onal Child Trauma;c Stress Network: hgp://www.nctsn.org/ •  Child Trauma Academy: hgp://childtrauma.org/


ipad apps to enhance tf-cbt for children with disabilities

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