Through ethnography influenced by public health and anthropological theory, I explored the cultural perceptions of autism among eight caregivers whose children received services from a local Dallas-Fort Worth autism treatment organization. Participant observations and semi-structured interviews with caregivers and program employees provided a rich and nuanced view into the state of care currently available in the DFW area while also highlighting areas for improvement. This research will be used to not only identify the barriers faced by North Texas Families while seeking out care,but also the strategies the organization uses when connecting with families from different backgrounds.

This study was done to determine whether the recently employed program of Family Group Decision Making (FGDM) is working in the San Bernardino County Department of Children Services (DCS) in the way it was intended to by reunifying children with their parents and reducing children's time in foster care.

Learners experiencing barriers to learning often require intervention and support from multiple professionals with different areas of expertise. Collaboration between professionals is important in avoiding fragmented and incoherent service delivery. Transdisciplinary service delivery allows for maximum integration among the various role players. Disciplinary boundaries are transcended through a process of skills transference and sharing of roles and provide child-centred, coordinated and collaborative support. This study investigates professionals in the Western Cape’s perceptions of a transdisciplinary service delivery approach for supporting learners experiencing barriers to learning. A sequential mixed method approach was utilized to gain an in depth understanding of professionals’ perceptions. Data were collected in two phases. During the first phase, a quantitative questionnaire was sent to various professional categories in the Western Cape who are expected to provide services to learners experiencing barriers to learning. The aim of the quantitative study was to provide background information for the second phase in which professionals’ perceptions of a transdisciplinary approach for supporting learners experiencing barriers to learning were obtained through eight focus group discussions. Four focus groups consisted of professionals who had not previously been exposed to a transdisciplinary approach. These professionals attended a two hour informative workshop on a transdisciplinary service delivery approach prior to the focus group. The remaining four focus groups consisted of professionals who had previously been exposed to transdisciplinary service delivery. Data were systematically analysed through a hybrid process of inductive and deductive analysis. Findings indicate that professionals providing services to learners experiencing barriers to learning perceive a transdisciplinary approach as useful and much needed for services provided both in schools and in private practice. Certain aspects of the transdisciplinary approach are perceived as more or less valuable, depending on the context and specific category of learning barrier. Although professionals acknowledge all aspects of the approach as valuable, multiskilling and role release are viewed as most needed. The transference of skills among therapists, teachers, parents and caregivers is perceived to contribute to effective and feasible service delivery. / Psychology of Education / D. Ed. (Psychology of Education)

Thesis (DPhil (Social Work))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The changes in child and youth care policies over the last fifteen years have had profound consequences for the staff at Youth Care and Education Centres (hereafter referred to as YCECs). These changes included systemic changes, philosophical changes, and changes in the way services are rendered to children and youth in their care. It was thus expected of team members to not only change their behaviours but to also make mind shifts. The mandates were that they move from working in silos (educators, residential educators and support team) to working in teams; from rendering generic services to developing individualised plans for children and youth; from following a medical (deficit) approach in service delivery to following a strength based- and developmental approach. Whereas a punitive approach to discipline was followed in the past staff members now have to follow a restorative approach. In addition, the emphasis on children’s rights, in general, and the abolishment of corporal punishment, in particular, brought about changes in the nature of the adultchild relationship. It was required of the team members to learn to use alternatives to this form of punishment. The study explored how the members of the institutional level teams at the four YCECs in the Western Cape were experiencing the implementation of changed child and youth policies. A combined quantitative and qualitative research methodology was followed in obtaining the data from the residential educators, as well as the educators and the support team members comprising of psychologists, school social workers, occupational therapists, and school nurses. The points of departure were the organisational learning model and the phases of team development. Findings derived from the empirical study were that the difference between the way the participants embraced and implemented changed policies and legislation had much to do with the guidance that the principal and senior management provided for them. Where the principal set the tone and conveyed the message that the implementation of the policies were not negotiable and gave staff members the opportunity to thoroughly discuss these changes, they eventually shared the underlying principles of the changed policies. Where the principal provided direction, support and encouragement for the implementation of the changed policies the participants felt secure and empowered. Where this support was not present participants felt uncertain and to some extent let down. When a shared vision was articulated to them the participants were able to align their personal visions thereto, which further led to a greater understanding of their roles within the team. Where participants, however, were not clear on the shared vision they seemed to struggle with role division and status and power issues. When team members were left to their own devices a measure of personal mastery still took place due to the commitment of individuals but team learning was either limited or virtually nonexistent. Systems thinking remained a challenge due to the forming of subgroups within the YCEC and the limited or nonexistent services rendered by external social workers to the families of the children and youth. The most important recommendations resulting from the study indicate that provision must be made for frameworks for the implementation of changes in policy and guidelines for team processes. To ensure that new staff is informed about the policies that guide their services an orientation programme must be in place. Training for principals in effective introduction and implementation of change should also be provided. To ascertain what the staff complement should be to effectively implement changes in the policies, a work-study and a fast track pilot project should be conducted. From this, job descriptions should be developed that make provision for the incumbent’s role within the team. Consideration should also be given to the incentive system that currently only makes provision for individual performance and could hamper teamwork. / AFRIKAANSE OPSOMMING: Die veranderinge in kinder- en jeugsorgbeleide oor die laaste vyftien jaar het diepgaande gevolge ingehou vir personeel by Jeugsorg- en Onderwyssentrums (hierna verwys as JSOS). Hierdie veranderinge het sistemiese en filosofiese veranderings, asook verandering in die wyse waarop dienste gelewer word, aan kinders en jeug in hul sorg, meegebring. Dit word dus van die spanlede verwag om nie net hul gedrag nie, maar ook hul denkwyse te verander. Die mandate vervat in die beleide is dat personeel skuif van werk in silos (opvoeders, residensiële opvoeders en ondersteuningspan) na werk in spanne; van die lewer van generiese dienste tot die ontwikkeling van individuale planne vir kinders en jeug; van die volg van ‘n mediese benadering aangaande dienslewering tot ‘n sterkte-gebaseerde- en ontwikkelingsbenadering. Waar daar in die verlede ‘n strafgerigte benadering gevolg is moet daar nou beweeg word na ‘n helende benadering. Verder het die klem op kinderregte in die algemeen, en die afskaf van lyfstraf in besonder, veranderings meegebring in die aard van die volwasse-kind verhouding. Dit was verwag van die spanlede om te leer om alternatiewes tot die vorm van straf aan te leer. Die studie het ondersoek ingestel na hoe lede van die inrigtingsgebaseerde span by die vier JSOS in die Weskaap die implementering van veranderde kinder- en jeugbeleid ervaar. ‘n Gekombineerde kwantitatiewe en kwalitatiwe navorsing metodologie was gevolg in die insamel van data van die residensiële opvoeders, die opvoeders en die lede van die ondersteuningspan (sielkundiges, skool maatskaplike werkers, arbeidsterapeute en skool verpleegkundiges). Die vertrekpunt was the organisasieleer model en die fases van spanontwikkeling. Bevindings wat gemaak is uit die empiriese studie was dat die verskille tussen die wyse waarop die deelnemers die veranderde beleid aanvaar en implementeer het baie te doen gehad het met die mate van leiding wat die prinsipaal en senior bestuur vir hul gegee het. Waar die prinsipaal die toon aangegee het en die boodskap oorgedra het dat die implementering van die beleide nie onderhandelbaar was nie en personeellede die geleentheid gebied is om die veranderings deeglik te bespreek, het hul geleidelik ingekoop in die veranderde werkswyses. Waar die prinsipaal rigting en ondersteuning vir die implementering van die veranderde beleid gebied het, het die deelnemers veilig en bemagtig gevoel. Waar die ondersteuning egter ontbreek het, het die deelnemers onseker en, tot ’n mate, in die steek gelaat gevoel. Wanneer ‘n gedeelde visie oorgedra is aan hulle was die deelnemers in staat om hul persoonlike visies in lyn te bring daarmee. Dit het verder aanleiding gegee tot beter begrip vir hul rolle binne die span. Waar deelnemers egter nie duidelik was oor die gedeelde visie nie, het dit geblyk dat hulle probleme gehad het met rolverdeling, status en magaangeleenthede in die span. Wanneer spanlede oorgelaat is aan hul eie lot het ‘n mate van persoonlike bemeestering nog plaasgevind as gevolg van die persoonlike toewyding van individue, maar spanleer was óf beperk óf feitlik afwesig. Sisteem denke was steeds ‘n struikelblok as gevolg van die vorming van subgroepe binne die JSOS en die beperkte of afwesige dienslewering deur eksterne maatskaplike wekers aan gesinne van die kinders en jong mense. Die belangrikste aanbevelings, wat voortspruit uit die studie, dui aan dat voorsiening gemaak moet word vir raamwerke vir die implementering van beleidsveranderings en riglyne vir spanprosesse. Om te verseker dat nuwe personeel ingelig is omtrent die beleide wat hul dienslewering rig moet ‘n oriënteringsprogram in plek wees. Opleiding van prinsipale in die effektiewe bekendstelling en implementering van veranderings moet ook voorsien word. Om vas te stel wat die aanvulling vir personeel moet wees om die veranderings in die beleid te implementeer, behoort ‘n werkstudie en ‘n snel loodsprojek onderneem word. Hieruit kan pligstate opgestel word wat voorsiening maak vir die ampsdraer se rol in spanverband. Oorweging moet geskenk word aan die aansporingstelsel wat tans net voorsiening maak vir individuele werksverrigting en wat spanwerk kan strem.

Thesis(MEdPsych)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autism or Autism Spectrum Disorder (ASD) is a condition that, at present, affects approximately one out of every 100 children globally and indications are that the prevalence thereof is steadily on the rise. ASD is a complex neurological condition that impairs social interaction, communication and behaviour. Research on the wide-ranging effects of ASD and its unique characteristics in each child with ASD is widely available. Several studies refer to the fact that ASD has an impact on the family unit, but very few researchers have investigated the support that families from different cultural groups in South Africa are enjoying whilst raising a child with autism. The current situation being what it is means that professionals and families have very little data on the subject and inadequate support is available to address the specific needs of families who are raising a child with autism. The aim of this study was to investigate the support structures of three families from three different cultural groups in South Africa who were raising a child with autism. The central issue that was researched was the support structures available to parents raising a child with autism, and how parents access that support. This is a qualitative study within an interpretive research paradigm. In this case study, the methods of data collection comprised semi-structured interviews, observations and reflective journals. This design embraced qualitative research methods that could expose the uniqueness of each family’s experience and allowed participants the freedom to express this. The three families, who were purposefully selected for this study, were from different cultural backgrounds. One of the children in each family met the criteria published in the Diagnostic and statistical manual of mental disorders, fourth edition, text revision (American Psychiatric Association, 2000) for Autism or Pervasive Developmental Disorder not Otherwise Specified (PDD-NOS). The study found that the parents in the three families received support from their spouses and the neuro-typical siblings. The families also enjoyed physical support, financial support and emotional support from different sources. Parents reported feeling supported when others show acceptance and understanding of their children’s deficits and when such others are prepared to ‘go the extra mile’. The three families also perceived information and guidance as a valuable source of support. Even though they had firm support structures in place, they also reported on the lack of support available to them. All three families enjoyed these forms of support, but it was interesting to find out that the families received the support from different sources. / AFRIKAANSE OPSOMMING: Outisme of outisme spektrum versteuring (OSV) is 'n toestand wat tans ongeveer een uit elke 100 kinders wêreldwyd affekteer en daar is aanduidings dat die voorkoms daarvan steeds toeneem. OSV is 'n komplekse neurologiese toestand wat swak sosiale interaksie, kommunikasie en gedrag tot gevolg het. Navorsingsresultate oor die breë gevolge van OSV en die unieke eienskappe daarvan in elke kind met OSV is algemeen beskikbaar. Verskeie studies verwys na die feit dat OSV 'n impak het op die gesinseenheid, maar tot dusver het baie min navorsers die ondersteuning ondersoek wat gesinne uit verskillende kulturele groepe in Suid-Afrika tydens die opvoeding van 'n kind met outisme geniet . Die huidige situasie voorsien professionele mense en gesinne van baie min data oor die onderwerp en onvoldoende ondersteuning is beskikbaar om die spesifieke behoeftes van gesinne met 'n kind met outisme aan te spreek. Die doel van hierdie studie was om ondersoek in te stel na die ondersteuning wat gesinne in verskillende kultuurgroepe in Suid-Afrika tydens die opvoeding van ‘n kind met outisme geniet. Die sentrale ondersoekvraag het betrekking gehad op ondersteuningstrukture vir gesinne met ‘n kind met outisme binne hul kultuurgroep, sowel as die wyse waarop die gesinne toegang tot die ondersteuning verkry. Die studie was kwalitatief van aard binne 'n interpretatiewe navorsingsparadigma en ’n gevallestudie is as navorsingsontwerp gekies. Data is deur middel van semi-gestruktureerde onderhoude, waarnemings en reflektiewe joernale ingesamel. Die kwalitatiewe navorsingsmetodes omvat die uniekheid van elke gesin se ervaring en laat deelnemers die vryheid om uitdrukking daaraan te gee. Drie gesinne is doelbewus vir hierdie studie gekies. Die gesinne moes oor die volgende kenmerke beskik: Hulle moes uit verskillende kulturele agtergronde (Afrikaan, Wit en Indiër) kom. Hul kind moes voldoen aan die kriteria in die Diagnostiese en Statistiese Handleiding van geestesversteurings, vierde uitgawe, teks hersiening (2000) vir Outisme of pervasieve ontwikkelingsstoornis nie anders gespesifiseer nie (PDD-NOS). Verskeie etiese beginsels is vir hierdie studie nagekom om te verseker dat die navorsing eties was. Die studie het bevind dat die ouers in die drie gesinne ondersteuning van hul gades en die neurotipiese broers en susters van die kind met outisme ontvang het. Die gesinne het ook fisiese ondersteuning, finansiële steun en emosionele ondersteuning vanuit verskillende bronne geniet. Die gesinne het aangedui dat hul ondersteun voel wanneer hul kinders se afwykings aanvaar word, begrip daarvoor getoon word en andere bereid was om die ‘ekstra myl te loop’. Die drie gesinne het ook inligting en leiding as waardevolle bronne van ondersteuning ervaar. Selfs al het die families sterk ondersteuningstrukture in plek gehad, het hulle ook die gebrek aan ondersteuning uitgelig. Al drie gesinne geniet die bogenoemde vorme van ondersteuning, maar dit was interessant om uit te vind dat die families hierdie ondersteuning vanuit verskillende bronne ontvang het.

Thesis (MEdPsych)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The worldwide increase in the diagnosis of autism, the immense pressure parents experience in raising a child with autism, as well as the accessibility of internet-based support, provided a unique opportunity to research parents’ experiences in such an online community. Knowledge about their experiences, the value and meaning of an online support group in their daily lives, as well as which parents access online support, could shed light on how online communities could possibly be better utilised to provide instant and low-cost information and support to parents who are otherwise excluded from face-to-face support groups due to various constraints. Additionally, research about online support groups for autism in South Africa seems to be non-existent. This research could contribute significantly to the gap in knowledge about South African parents’ experiences. The aim of the study was to engage with South African parents participating in a Facebook support group in finding out what value (positive or negative) it adds to their lives and determining the meaning they ascribe to their participation in this group. This was a qualitative study based on a social constructionist theoretical framework as it is concerned with how every person’s reality is shaped through social interaction with others, as well as through the historical and cultural influences in that person’s life. Participants for this study were purposively selected and data was collected through observations of their exchanges within the Facebook support group, as well as through an electronic interview questionnaire. These interactions and correspondence were analysed using thematic analysis. The research findings indicated the multifaceted role that the Facebook support group plays in the lives of each parent who participated. The amount of support they derived from the group and the value of the group depended on each parent’s unique needs and experiences, as well as their unique interpretations of the interactions within the group. Their interactions within the group showed, however, that the group provided a platform where they were able to construct their own identities as autism parents as the experts of their children’s lives, as well as advocates in the realm of autism. Their experiences were in line with international literature on online support groups. / AFRIKAANSE OPSOMMING: Die wêreldwye toename in die diagnose van outisme, die geweldige druk wat ouers ervaar om ʼn kind met outisme groot te maak, asook die toeganklikheid van internet-gebaseerde ondersteuning, het ʼn unieke geleentheid geskep om navorsing te doen oor ouers se ervarings in sodanige aanlyn gemeenskap. Kennis rakende hulle ervarings, die waarde en betekenis van ʼn aanlyn ondersteuningsgroep in hulle daaglikse lewens, asook watter tipe ouers aanlyn raad soek, sou lig kon werp op die onderwerp van hoe sulke aanlyn gemeenskappe moontlik beter aangewend kan word ten einde onmiddelike en goedkoop inligting en ondersteuning te bied aan ouers wat andersins uitgesluit word van kontak-ondersteuningsgroepe as gevolg van verskeie beperkings. Hierdie navorsing kan ʼn belangrike bydrae lewer tot die verbetering van die gebrekkige kennis oor aanlyn ondersteuningsgroepe vir outisme in Suid-Afrika. Hierdie navorsing kan grootliks bydra tot die gebrekkige kennis oor Suid-Afrikaanse ouers se ervarings. Die doel van hierdie studie was om betrokke te raak by ouers wat deelneem aan ʼn Facebook ondersteuningsgroep ten einde vas te stel watter waarde (positief of negatief) dit toevoeg tot hulle lewens, asook om te bepaal watter betekenis hulle heg aan hul eie deelname aan die groep. Hierdie was ʼn kwalitatiewe studie gebaseer op ʼn sosiaal-konstruksionistiese teoretiese raamwerk, aangesien dit gemoeid was met hoe elke persoon se realiteit beïnvloed word deur sosiale interaksie met ander, asook die historiese en kulturele invloede in daardie persoon se lewe. Deelnemers aan hierdie studie was doelgerig gekies en data is deur waarneming van hul interaksie binne die Facebook ondersteuningsgroep versamel, asook deur ‘n elektroniese onderhoudsvraelys. Hierdie interaksies en korrespondensie is deur tematiese analise ontleed. Die navorsingsbevindings het die veelkantige rol wat die Facebook ondersteunings-groep in die lewens van elke deelnemer gespeel het, aangetoon. Die mate van ondersteuning wat elkeen uit die groep ontvang het, asook die waarde van die groep, was afhanklik van elkeen se unieke behoeftes en ervarings en elkeen se unieke vertolking van die interaksie binne die groep. Die ouers se interaksie binne die groep het egter aangedui dat die ondersteuningsgroep ʼn platform daargestel het waar hulle hulle eie identiteite as outisme ouers, en kundiges oor hul kinders se lewens, kon konstrueer. Benewens dit was hulle ook kampvegters op die terrein van outisme. Hulle ervarings stem ooreen met internasionale literatuur rakende aanlyn ondersteuningsgroepe.

A prevention-oriented telephone line intended as an intervention program for latchkey children was studied to determine its impact on the self-esteem, anxiety level, and in-school and at-home behavior of these children.

Childhood abuse, whether physical or sexual, is a major public health issue. The most recent United States data from Child Protective Services (CPS) show that in 2013 there were 3.5 million referrals of child maltreatment involving 6.4 million children. Out of these cases, 18% were for physical abuse and 9% were for sexual abuse. However, researchers argue that CPS data grossly underestimate the prevalence of childhood abuse as most childhood abuse goes unreported. Indeed, to date, the true prevalence of childhood abuse remains unknown as research has been hampered by inconsistent definitions of abuse and wide variation in methodologies including measures for its identification and modes of administration of these measures. Although a health care visit presents an opportunity to identify a childhood abuse history, health care providers frequently fail to ask about it. The reasons doctors give for not asking about abuse include lack of training, not knowing how to ask, and lack of familiarity with practical methods for screening that can be used in primary care settings. There is little to no research on effective means for identifying childhood abuse histories, especially in the adolescent and young adult population, or on how different modes of administration of screens to identify childhood abuse compare to each other. The net result is that most childhood physical and sexual abuse is never identified and many victims do not get the needed services to help them heal. When unaddressed, childhood abuse has negative impacts on victims’ health and wellbeing over the life course. Prior studies of adults show that when compared with non-victims of abuse, victims tend to perceive their health as poorer and utilize more health care services including emergency room and urgent outpatient care. These studies also suggest that adult victims use less routine and preventive care than non-victims. Only two studies, conducted among widely different adolescent populations, have examined how adolescent victims perceive their health. Similarly, limited evidence examining perception of health is available for young adults. These studies found that victims perceive their health as poorer than non-victims. There have been no adolescent-specific studies of how victimization impacts adolescents’ utilization of health care. One study includes participants ages 15 to 98 years and only two studies focusing on this issue in samples primarily of young adults attending college have been published. These studies found that victims utilize more health care than non-victims. Therefore, we lack a sufficient body of evidence to come to clear conclusions of how childhood abuse affects self-perceived health in adolescents and young adults. The general lack of evidence about both how childhood abuse impacts perception of health and utilization of health care in adolescents and young adults indicates a need for further study. Given that little is known about how to best identify an abuse history in adolescents and young adults and the impact of abuse on perception of health and utilization of health care, this dissertation pursued three aims: (1) to review the literature comparing modes of administration of screens to identify adolescent and young adult victims of childhood physical and sexual abuse; (2) to investigate how different modes of administration of screens to identify adolescent and young adult victims of childhood physical abuse within a primary care health setting compare to each other, and; (3) to examine the association of a history of childhood abuse (defined as none, physical only, and sexual with or without physical) with perceived health status and the health care utilization patterns among adolescents and young adults. For aim 1, a comprehensive literature review was conducted via PubMed of studies, published between January 1st, 1994 and December 31st, 2014 that compared modes of administration of screens to identify a history of childhood physical and sexual abuse in adolescents and young adults. Only one study was found. This study compared paper and pencil questionnaire, computer assisted survey, and face to face structured interview in the identification of childhood physical and sexual abuse among young adults in a college setting. No significant difference in the proportion of childhood physical abuse or childhood sexual abuse was identified by mode of administration. The identification through this search of only one study – which was conducted among college students, with no studies done among adolescents – shows a significant gap in our knowledge regarding this issue. Given that understanding how to identify childhood abuse is a critical issue, this gap is disturbing and underscores the need for studies of identification of childhood abuse to be a research priority. For aim 2, a sample of participants, ages 12-24 years, receiving health services at the Mount Sinai Adolescent Health Center in New York City were randomized to one of four modes of administration to identify a history of childhood physical abuse. The four modes of administration of screens to identify childhood abuse were paper and pencil screen, Audio Computer Assisted Self Interview screen (ACASI), face to face structured screen and face to face unstructured interview. The full sample also completed measures to assess demographic characteristics and to screen for depression symptoms. Of the sample, 44.5% of the participants disclosed childhood physical abuse. There was a statistically significant difference in the proportion of childhood physical abuse identified according to mode of administration: face to face unstructured interview identified the highest proportion of childhood physical abuse victims, followed by face to face structured screen. After adjusting for age, gender, race/ethnicity, depression, living arrangement and last grade completed, the odds of identifying physical abuse was 1.6 (95%CI: 1.0, 2.7) and 4.5 (95%CI: 2.6, 7.8) greater for face to face structured screen and for face to face unstructured interview, respectively as compared to paper and pencil screen. ACASI and paper and pencil were similar to each other but inferior to the face to face methods. For aim 3, in addition to what was measured for aim 2, the sample completed measures on a history of childhood sexual abuse and perceived health and health care utilization. The sample was then categorized into three groups: no abuse, physical abuse only, and sexual abuse with or without physical abuse. The association of childhood abuse status with perceived health and health care utilization were examined. There was no statistical significant association between a history of childhood abuse status and perceived health. However, the odds of reporting a fair/poor perception of health among those reporting childhood abuse were at least 40% lower regardless of whether the abuse was physical (OR: 0.60; 95%CI: 0.3,1.2) or sexual (OR: 0.50; 95%CI: 0.2,1.1). No significant association was found between childhood abuse status and health care utilization. However, the odds of victims reporting using urgent care only versus routine care only were at least 10% lower regardless of whether the abuse was physical (OR: 0.50; 95%CI: 0.3, 1.1) or sexual (OR: 0.90; 95%CI: 0.4,1.9). The odds of reporting using both urgent and routine care versus routine care only was similar between victims and non-victims for physical abuse (OR: 1.0; 95%CI: 0.6, 1.5) and was 30% higher for victims of sexual abuse (OR: 1.3; 95%CI: 0.8, 2.2). The findings from the three aims examined identified significant gaps in our knowledge on childhood abuse among adolescents and young adults suggesting an urgent need for further research. While much research has focused on the impact of childhood abuse on health and well-being, aim 1 reveals that little is known about which mode of administration of screens to identify childhood abuse is most effective in the identification of childhood abuse in adolescent and young adults. Furthermore, we know even less about what modes of administration of screens might be practical in primary care settings, or what must be done to improve the level of screening for childhood abuse by physicians and other health care providers. Although the findings from aim 2 suggest that face to face modes of administration are most effective in screening for childhood physical abuse in primary care settings, further studies are needed to support these findings. In addition, there is a need for studies that examine what are the best methods to use to identify childhood sexual abuse in primary care settings. The findings from aim 3 suggest that adolescents and young adults with a history of childhood physical and sexual abuse, receiving health care at the Mount Sinai Adolescent Health Center, do not perceive their health as worse than non-victims nor do they appear to utilize health care differently from non-victims. These findings contrast with results from prior studies of perceived health status and health care utilization among adolescents and young adult childhood abuse victims. Understanding how abuse impacts both the perception of health and health care utilization will be crucial in the development of interventions to identify and support adolescent and young adult victims of childhood physical and sexual abuse.

Families of children with a mental disorder typically have many stressors due to their children's behavioral functioning. These families do not always choose to receive community-based services that are intended to decrease the stressors within the families and prevent the children from being placed out of the families' homes. This study investigated the relationship between clients' functioning during their initial assessment provided by the Victor Community Support Services (VCSS), compared to their functioning when they were discharged from VCSS based on the families utilization of community-based services.

Learners experiencing barriers to learning often require intervention and support from multiple professionals with different areas of expertise. Collaboration between professionals is important in avoiding fragmented and incoherent service delivery. Transdisciplinary service delivery allows for maximum integration among the various role players. Disciplinary boundaries are transcended through a process of skills transference and sharing of roles and provide child-centred, coordinated and collaborative support. This study investigates professionals in the Western Cape’s perceptions of a transdisciplinary service delivery approach for supporting learners experiencing barriers to learning. A sequential mixed method approach was utilized to gain an in depth understanding of professionals’ perceptions. Data were collected in two phases. During the first phase, a quantitative questionnaire was sent to various professional categories in the Western Cape who are expected to provide services to learners experiencing barriers to learning. The aim of the quantitative study was to provide background information for the second phase in which professionals’ perceptions of a transdisciplinary approach for supporting learners experiencing barriers to learning were obtained through eight focus group discussions. Four focus groups consisted of professionals who had not previously been exposed to a transdisciplinary approach. These professionals attended a two hour informative workshop on a transdisciplinary service delivery approach prior to the focus group. The remaining four focus groups consisted of professionals who had previously been exposed to transdisciplinary service delivery. Data were systematically analysed through a hybrid process of inductive and deductive analysis. Findings indicate that professionals providing services to learners experiencing barriers to learning perceive a transdisciplinary approach as useful and much needed for services provided both in schools and in private practice. Certain aspects of the transdisciplinary approach are perceived as more or less valuable, depending on the context and specific category of learning barrier. Although professionals acknowledge all aspects of the approach as valuable, multiskilling and role release are viewed as most needed. The transference of skills among therapists, teachers, parents and caregivers is perceived to contribute to effective and feasible service delivery. / Psychology of Education / D. Ed. (Psychology of Education)