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Child Guidance Center
FASD Diagnosis and Intervention Subcontractors
Project Contact Information
Child Guidance Center
Cecily Hardin, LCSW, FASD Coordinator
1100 Cesery Boulevard, Suite 100
Jacksonville, FL 32211
Phone: 904-745-3070, ext. 327
Project Summary Statement
The Child Guidance Center, Inc (CGC) is a 501(c)(3) private not-for-profit organization located in Jacksonville, Florida. With a staff of over 125 mental health professionals, CGC serves over 5,600 children. These services include outpatient, in-home and school based counseling, mental health case management, psychiatric services and medication management, day care consultation, child abuse prevention and supervised visitation. This Fetal Alcohol Spectrum Disorders (FASD) project supports the agency mission to provide quality mental health and social services to children and their families. Through this initiative, CGC continues to integrate FASD screening, diagnosis and intervention within its current system of care in Duval County, Florida.
The goal is to improve the social, emotional and developmental level of functioning in children with an FASD who receive services from CGC. The audience of interest is all children ages 0-7 receiving clinical services from CGC. A Needs Assessment completed on July 18, 2008 found that many of the children ages 0-7 receiving clinical services from CGC are referred for disruptive behaviors (e.g. hyperactivity, impulsivity, aggression, and non-compliant behaviors) that may be due to prenatal alcohol exposure. Due to the prevalence of these behaviors in this population, the strategy proposes to screen all children ages 0-7 for an FASD with parental consent. The Needs Assessment also determined that CGC had not to date adequately addressed maternal alcohol use.
While CGC can provide behavioral health services to those children identified with an FASD, the strategy includes a component to address gaps in services and referrals to other agencies for non-behavioral health services (e.g. occupational therapy and speech/language therapies). The FASD Initiative has three outcome objectives: Intervention Success, Improvement on Assessment Scores, and Stability of School/Preschool/Daycare placement. Children will show improvement in at least one area of intervention designed specifically for the each child. Only those interventions that the child begins and participates in as recommended for at least 90 days will be measured. Progress will be measured in 6 month intervals.
The Child Behavior Checklist; Ages and Stages Questionnaire, and the Ages and Stages Social Emotional Questionnaire were used to measure improvement on each child referred for a full diagnostic evaluation before interventions began and again at 6 month intervals. Assessments were completed by the parents/caregivers with assistance from the FASD Coordinator and therapists. Those children who are actively participating in recommended interventions will demonstrate stability of school (grade school and pre-school/daycare) placement as evidenced by a reduced number of suspensions or expulsions.
One of the strategies and methods implemented in year 2 was the development of policies and procedures to expand the target population from children ages 0-5 to children ages 0-7. This expansion of the target population increased the number of eligible children to be screened. Most children do not begin exhibiting symptoms until after entering school, which is typically ages 5 and older. Our focus remains on early intervention, and we wanted to include school aged children as well.
Also In year 2, the strategies and methods implemented were as follows: Provided FASD training to CGC staff; screened all CGC clients ages 0-7 for an FASD with parental consent (215 children); assigned a case manager to children who screened positive (25 children); conducted FASD diagnostic evaluations on children whose parents consent to services (14 children); developed intervention plans for those children diagnosed with an FASD (14 children); provided/monitored referrals for intervention services identified in the intervention plan (14 children); collected data as required by Northrop Grumman; developed annual implementation plan for OY3; maintained an active FASD task force; collaborated with other agencies and organizations serving young children on developing a comprehensive system of treatment, identified gaps in services and continued to work with agencies and organizations in the community to address those gaps in services; maintained on-going communication with the diagnostic evaluation and intervention service providers.
CGC began developing plan of sustainability to ensure that these services continue once subcontract funding ends. For families facing difficult financial situations who do not qualify for Medicaid, the Local Part B and Part C providers (of Florida’s Individuals with Education Act) will be utilized. CGC also offers a sliding fee scale to those who pay out of pocket. In OY1 and OY2, CGC integrated the FASD initiative into its comprehensive system of care.
A major accomplishment of this Diagnosis and Intervention initiative is the successful incorporation of FASD screenings, diagnostic evaluations and interventions into CGC’s policies and procedures. By incorporating FASD screening as part of the initial evaluation, CGC ensures that FASD services are available to children and families. In addition to internal activities, CGC has reached out to the community to increase collaboration with other healthcare providers to develop a more inclusive approach to treatment. Key partners in this effort were speech and occupational therapists as well as primary care physicians and caregivers.
Receiving an FASD diagnosis has enabled caregivers, therapists, and teachers to reframe the behavior problems that the child was exhibiting and to develop more appropriate interventions based on the FASD diagnosis. Thus, the agency has been able to more effectively serve children with an FASD.
In OY2, CGC focused on the coherent integration of the FASD services, increased coordination of its diagnostic services, coordinated provision of the intervention services based on the FASD diagnosis, strengthening of the Task Force involvement and data collection. The field of FASD intervention will benefit greatly through the documentation of successful screening programs and interventions, and through the documentation of program limitations and areas that need more research.