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“Holistic Approach to Improving Children with Developmental Delay” 7Th – 31St May 2019 at Rajanagarindra Institute of Child Development, Chiang Mai, Thailand

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“Holistic Approach to Improving Children with Developmental Delay” 7Th – 31St May 2019 at Rajanagarindra Institute of Child Development, Chiang Mai, Thailand Lessons Learned from the Training Program “Holistic Approach to Improving Children with Developmental Delay” 7th – 31st May 2019 at Rajanagarindra Institute of Child Development, Chiang Mai, Thailand Rajanagarindra Institute of Child Development Department of Mental Health, Ministry of Public Health, Thailand 2019 Contents Chapter I Introduction Purpose of the Training Course 3 Course Objectives 3 Course Outcome 4 Procedure 4 Participants 5 Training materials 5 Statistical Tools for Quantitative Analysis 5 Duration 5 Evaluation of Course Competencies: 6 Chapter II Result of Training Evaluation 1. Quantitative Data 7 1.1 General Information 7 1.2 Evaluation results of trainees’ scores 8 1.3 The result of the quality of the training program 9 1.3.1 Utility 9 1.3.2 Feasibility 10 1.3.3 Propriety 11 1.3.4 Accuracy 13 1.4 The Results of the Trainees’ satisfaction 15 2. Qualitative Data 2.1 Trainees 16 2.2 Speakers’ suggestions 34 3. Corse Content Summary 3.1 Topic: Thai Child Developmental System Model 35 3.2 Topic: Introduction to RICD and Field Visit 37 3.3 Topic: Guide to Living in Chiang Mai 39 3.4 Topic: Children with Developmental Delay and NDD 40 3.5 Topic: DSPM 43 3.6 Topic: DAIM 46 3.7 Topic: TEDA4I 48 3.8 Topic: Early Stage Development and Postural Support Devices 52 3.9 Topics: Thai Massage Therapy for Children with CP and ASD 57 3.10 Topic: Sensory Integration and Snoezelen 59 3.11 Topic: Applied Speech Therapy for Children with ASD 62 3.12 Topic: Picture Exchange Communication System, PECS 63 3.13 Topic: AAC for children with complex communication needs 66 3.14 Topic: Social Skills Training 69 3.15 Topic: Applied Behavioral Analysis 72 3.16 Topic: Shared Action model for treating children with ADHD 73 3.17 Topic: Neurofeedback 75 3.18 Topic: Applied Eastern Psychology for Children with ADHD 76 3.19 Field Visits 77 3.20 Elective Courses (Field-based observation) 80 3.21 Project Proposal Presentation 87 Chapter III Improvement of the Training Program 89 Appendix 91 2 Chapter I Introduction Rajanagarindra Institute of Child Development (RICD) is a specialized hospital providing medical services to children with developmental delay and mental health problems such as Autism spectrum disorder (ASD), Attention deficit hyperactivity disorder (ADHD), Cerebral palsy (CP), Learning disorder (LD) and Intellectual development disorder (IDD). Moreover, RICD provides and promotes support of academic and technological research and development to related agencies in order to improve child development and mental health. This year, RICD conducted a training course “Holistic Approach to Improving Children with Developmental Delay” for international participants to gain a better understanding of children with developmental delay, to know how to assess children with developmental delay, provide appropriate intervention and be able to make suitable referrals for further intervention. The training program “Holistic Approach to Improving Children with Developmental Delay” was conducted at Rajanagarindra Institute of Child Development, Chiang Mai, Thailand from 7th to 31st May 2019. The course duration was 98 hours/around 3 weeks, and was divided into 3 parts including the 56 hour core course consisting of 2 modules, a 30 hour elective course for field-based observation, and a 12 hour course outline, presentation and examination. This training course had 24 participants, consisting of 4 psychiatrists, a pediatrician, 3 psychologists, 4 physiotherapists, 2 nurses, a social worker, and 9 teachers from 13 organizations. The 24 participants were from different agencies in Cambodia, Vietnam, Singapore and Myanmar, namely Provincial Referral Hospital, Preah Kossamak Hospital, Kantha Bopha Children’s Hospital, EMDR Association Cambodia, Hanoi Medical University, National Pediatric Hospital, Basic Needs Vietnam, Danang Social Work Center, Parami General Hospital, 500 Bedded Mandalay Children’s Hospital, Mental Health Hospital, Little Aces Pre-School and Special Education Center, Smart Kids College, Future Light Special Education Learning Center, and New Hope Association. During the program, participants were trained on a Holistic Approach to Improving Children with Developmental Delay. As the 24 participants had different educational backgrounds, they were divided into three groups: Medical Doctors, Medical Multidisciplinary Team and Teachers. The three groups trained together in the core course and separately for electives. However, during the last week, there were four groups, because of numbers, in order to present project proposals on child development, and on the last day there was an examination. All training materials and information were provided to the trainees before the training program started, to help trainees understand more about the details, assignments, and evaluation criteria before they came to this training program. Purpose of the Training Course The purpose of this course is to increase participants' understanding of children with developmental delay, to give appropriate intervention and to make effective referrals. Course Objectives The trainees will: 1. acquire assessment skills of the development process of children 2. identify children at risk/developmental delay and provide effective early intervention 3 Course Outcome 1. Gain a better understanding of the development process of children with developmental delay 2. Gain an understanding of how to assess children with developmental delay, give appropriate intervention and make effective referrals. Procedure The training process was as follows: Phase I 1. Development of the international training course (Feb - April 2018) 1.1 Analyze organizational expertise “Developmental Delay” 1.2 Integrate the RICD training experience for Thai medical residents and Myanmarese health personnel 1.3 Development of the training course syllabus and manual 1.4 Development of the training materials 2. Enhancing the developing of teaching skills for speakers (May 2018). 3. The first pilot-testing of the training program by conducting a practice run by speakers and the project manager (Jan - Feb 2019). 4. Improvements from the first trial of the training program (March – April 2019) 5. Development of additional training materials and an evaluation form (March – April 2019). Phase II 1. Conduct a full pilot test of the training program with a group of available participants Pre-training (March - April 2019) 1. The project manager studied the information in the manual for the training organizers. 2. The project manager announced the application for qualified trainees through online social media. 3. Before training, the project manager informed the purposes, objectives, learning plans, assignments, evaluation process and the roles of the trainees. 4. Before training, the project manager distributed the training manual and materials for the trainees to study before trialing the training program and to use during training. 5. Before training, the project manager distributed the manual for the speakers to prepare themselves, to understand the learning process of trainees, and to evaluate the trainees. 6. Before training, the project manager prepared the materials and equipment according to the learning plans of the speakers. 7. Before training, the speakers provided the project manager with materials for trialing the training program. 4 Training Implementation (May 2019) 1. Ran the training trial program according to the schedule from 9.00-16.00 for 17 days. 2. The evaluation for knowledge and skills of the trainees were as follows: 2.1 Pre-evaluation of trainees’ knowledge was held on the 7th of May. It was provided to assess trainees’ knowledge in accordance with the manual. 2.2 Trainee assignments were held on the 7th of May by assigning trainees to write an experience report and make a project proposal plan. The due date for project presentation was the 27th of May, and before the 31st of May for the summary report. 2.3 The post-evaluation of trainees’ knowledge was held on the 31st of the training program. 2.4 Evaluation of the quality of the training program in aspects of utility, feasibility, propriety and accuracy was held on the 31st of May. 2.5 The trainees completed a feedback questionnaire on the 31st of May. Phase III Post-Training (June 2019) 1. Adjustments were made to the training program. 2. Synthesizing of lessons learned. Participants 1. Trainees: this training course had 24 participants, consisting of 4 psychiatrists, a pediatrician, 3 psychologists, 4 physiotherapists, 2 nurses, a social worker, and 9 teachers from 13 organizations, from Myanmar, Cambodia, and Vietnam. 2. Speakers: the training course had 29 speakers from 7 organizations, from the Department of Mental Health, Rajanagarindra Institute of Child Development, Rajanukul Institute, Yuwaprasat Vithayoprathum Hospital, Chiang Mai University, Suanprung Psychiatric Hospital, and The Center for Bioethics and Social Medicine, Taiwan 3. Project manager team: this training course had 3 staff, consisting of a training organizer and 2 general managers Training materials 1 .The training program manual 2. The evaluation form 3. The DSPM 4. The DAIM 5. The TEDA4I Statistical Tools for Quantitative Analysis 1. Frequency, percentage, mean, standard deviation 2. Kruskal Wallis Test 3. Mann-Whitney U 4. Wilcoxon’s Signed Rank test 5. P-value less than 0.05 was considered to confirm significant difference and association. Duration 7th – 31st May 2019 5 Evaluation of Course Competencies: 1. Regular class attendance 5 points 2. Participation in class discussion and activities 5 points 3. Assignments (40 points) 3.1 Experience Summary Report – 20 points 3.2 Project Proposal 20 points 4. Exam – 50 points (Minimum passing score of 25 points) 5. Minimum score to pass for medical doctors was 80%, while the medical multidisciplinary team was 75%, and teachers was 70% 6 Chapter II Result of Training Evaluation 1. Quantitative Data 1.1 General Information Table 1: Numbers and percentages of trainees’ general information General Information Number Percentage Gender 1. Male 4 16.67 2. Female 20 83.33 Total 24 100 Age 1. 20-29 years old 7 29.17 2. 30-39 years old 13 54.17 3. 40-49 years old 3 12.50 4.
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