By: Cassandra Coote

Lee is a six year old boy. He transferred from Bosnia to Canada. Bosnia is located near Serbia; the capital of Bosnia is Sarajevo. Lee and his mother lived in a refugee camp, and were recently taken over by hostile troops. Lee has experienced living in refugee camps and witnessing war, of which contains fighting and unfair punishment by men. Lee has been diagnosed with post-traumatic stress disorder. Posttraumatic stress disorder is an emotional illness which is also known as an anxiety disorder or shell shock. (http://www.anxietybc.com/parent/post.php) It develops as a result of an extremely frightening and life-threatening experience. The child has reacted to the trauma with intense fear, helplessness, or horror. (www.medicinenet.com ... posttraumatic stress disorder indexCached Similar)

Lee engages in dramatic play and has been demonstrating violent play through his story telling and interacting with peers.
Mother and caregivers speak very little English. Bosnia language is a form of Serbo-Croatian, a South Slavic language, spoken by Bosniaks. (http://en.wikipedia.org/wiki/Bosnian_language)

Father of child was separated and father is no longer involved in Lees life.
He is starting daycare in the school age room program. Lee shows signs of separation anxiety when his mother leaves. Lees mother has asked for advice and services available in Toronto.

The needs of the child is: Make Child feel welcomed.

Separation anxiety disorder occurs because a child feels unsafe.

Accepted into the new environment. Anxiety can be triggered by a new environment. Helping child adjust to the new environment and demonstrate that the child is safe. Practicing separation will help the child deal with his fear of leaving his mother for period of time.

Separation anxiety is a normal stage of development, according to, help guide http://www.helpguide.org with children who experience separation fears. Child needs time to warm-up and during transitions. The child needs a trusting relationship and respect.

Leave your child with a caregiver for brief periods and short distances at first. Schedule separations after naps or feedings. Develop a goodbye ritual. Rituals are reassuring and can be as simple as a special wave through the window or a goodbye kiss. Keep familiar surroundings when possible and make new surroundings familiar. When your child is away from home, let him or her bring a familiar object. Have a consistent primary caregiver. Leave without fanfare. Tell your child you are leaving and that you will return, then godont stall. Minimize scary television. Your child is less likely to be fearful if the shows you watch are not frightening. Try not to give in. Reassure your child that he will be just finesetting limits will help the adjustment to separation.

http://www.helpguide.org/mental/separation_anxiety_causes_prevention_treatment.htm

The Needs of the child are: support through Child psychiatrists, child psychologists, or pediatric neurologists who can treat Post-traumatic stress disorder Specialists help the child develop coping strategies, and provide problem solving. Assessing with the childs mental state. This is done through Talk therapy, Play therapy, counselling for the family, school based counselling and medication. This will allow the child to understand himself and able to cope with fears. Talk therapy will provide a safe place for Lee to express his feelings and having someone to listen empathetically and guide Lee toward understanding his own anxiety. Play therapy is examined through play. According to help guidetreatment for Post-traumatic stress disorder, it is a common and effective way to get children talking about their feelings.

Counseling for the family will involve the whole Family which can help your child express his thoughts that provoke his existing anxiety, while the parent/caregivers can help the child learn coping skills. Counseling is also good for one on one interaction
providing social and emotional needs. This will help with Lees Posttraumatic stress disorder by providing his mental support in a calming environment, for example Lee will express his thoughts and feeling and will be more reluctant to accept himself. School-based counseling provides opportunity through the childs school. According to help guide- treatment for Post-traumatic stress disorder, this can help a child with separation anxiety disorder and Posttraumatic stress disorder (PTSD) and will promote exploration in the social, behavioral, and academic demands of school. Medication may be used to treat severe cases of PTSD. Lee will gain trust in others and to reduce the stress of leaving his mother on day to day events, such as when he arrives at daycare, or school knowing that he is safe and that his mother will return for him.

Needs of the family are: Language spoken with family. Resources available. Advice and support Collaboration with staff
Recommendation to consider the needs of the family because Children with anxious or stressed parents may be more at risk to separation anxiety in children. Caregivers and parents should help themselves to be able to help their child overcome separation anxiety disorder.

Plans to meet with child care settings and school environment are: Collaborate with staff at the childs center by providing the staff with the childs behaviour temperaments. The childs past Provide information on childs progress with counselling medical support for his anxiety and Post-traumatic stress disorder. Inform the Childcare/ school how he is dealing with his anxiety and PTSD at home his practises, behaviours and his coping styles. This way the staff will be prepared and sensitive between departure of the parents and child and accommodating throughout the day. The staffs are there to assist and provide guidance to the parent and the child at any given time. The physical environment should be open and exciting, but not over whelming. The centres in the room should be, a quiet area, reading corner, listening centre, dramatic centre, the craft table should be open-minded materials and allow all children to be successful. Science centre, tables should be available to children and a carpet area for children to play on for large group play and physical activities or used for circle time.

The child care providers will be educated in ways to help Lee progress throughout the day and encourage him throughout the school years. Encourage the child s development in physical, cognitive, social and emotion domains such as providing the child with experiences to develop his lifelong skills. This will promote imagination, curiosity and investigation skills of which will encourage lee to discover and learn. Child care settings should be welcoming and warm for children and parents to feel welcomed and secure. Planning curriculum and experiences, according to our inclusive class notes, the experiences should prevent accidents and support independence. For example clutter free and materials should be in working conditions. The environment should be safe and clear of hazards, according to our inclusive class notes, visual boundaries between activity areas which could accommodate for a variety of special needs. When working with children who have Post-traumatic stress disorder and promote positive strategies to encourage the child adjust in a childcare centre/school are providing a safe feeling and acceptance within the classroom. The child should be warmly greeted each day, make eye contact, and let the child know that he is valued and that you care about him.

If the child is showing stress or upset during an activity a good strategy would be to interrupt or avoid circumstances. Dont hesitate to interrupt activities and avoid circumstances that are upsetting for the child. According to, Childrens mental disorder- PTSD fact sheet, Watch for increased symptoms during or following certain situations, and try to prevent these situations from being repeated. Provide a consistent, predictable routine. This will help promote and maintain security in the childs life. According to, Childrens mental disorder- PTSD fact sheet If the schedule does change, try to explain beforehand to the child what will be different and why. Be flexible to provide support during transitions. According to, Childrens mental disorder- PTSD fact sheet Consistency shows children that you have control of the situation; they may become anxious if they sense that you are disorganized or confused. Allow the child to have choices within this pattern. This will give them some sense of control and help to build self-confidence. Eliminating stressful situations when possible, According to, Childrens mental disorder- PTSD fact sheet, create a balance of noisy versus quiet activity areas and clearly define them; and plan your day or class period so that alternates between active and quiet activities (being forced to maintain the same level of activity for too long may cause the child to become restless and anxious).

When working with children who have experienced war and life threatening situations, be sensitive and patient, and never tell the child to forget about his past. Listen to the childs cues and interests and encourage him to try and participate in daily activities. Do not push or rush the child to join in social experiences, let the child work at his or her way at own pace. Love the child for who he/she is and not, what he/she cannot do. Praise the children for what they has done by smiling and telling the child they has done a great job. Accommodate time to be with all children and allow interactions with individual / group of children. After the day, and parents are arrived at the centre, inform each childs parent, including Lees mother, what their child/ children have done and what they each had enjoyed throughout the day. Allow the children to show his/her parent/ caregiver his/her art work or what they played with during the day, this will provide a relationship between parent and child and allow the child to express his/her experience at the centre. Display all childrens art work on the walls for their parents to see. This way the children can remember the experience they each have done and continue this ongoing. Support all children in the centre based on their development and interests.

Ways to adapt to meet the needs of children and families: Be patient and sensitive towards parents wishes and demands. Listen to the child/ children Collaborate with staff and parents at the centre Respect all children, families, staff and yourself Planned and spontaneous age appropriate experiences for each child, ability, level development. Be friendly, calm, empathetic Give choices, reasons, advice and support

Centre for Addiction and Mental Health Toronto: 416 535-8501 CAMH -R. Samuel McLaughlin Addiction and Mental Health Information Centre Toronto: 416 595-6111 Toll-free number: 1 800 463-6273 Address: 901 King Street West Suite 502, P.O. Box 20 Toronto, ON M5V 3H5 Web site: www.camh.net

CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues, by promoting a client-centered care to meet the diverse needs of people facing addiction and mental health challenges at different stages of their lives and illnesses. CAMH works with the government to help shape the public policy and resource development process to ensure it promotes health and works towards eliminating the stigma associated with mental illness and addiction. http://www.camh.net/education/index.html CAMH has been recognized internationally as a Pan American Health Organization and World Health Organization Collaborating Centre. CAMH supports children, adults and seniors. Clinical services include assessment, brief interventions, inpatient/ residential programs, day treatment programs, continuing care, outpatient/ambulatory services, and family support. This agency assists those with mood disorder such as, anxiety disorders, and provides trauma programs also cognitive behavioral therapy clinic programs for those in need.

The program is contained with Psychiatrists, social workers, occupational therapists, psychologists, nurses, psychometrics and recreation therapists staff.
CAMH has six specialty clinics which provide clinical care, and education. The program offers consultations; time limited treatment and follow-up, education and services for families. For cognitive Behavior therapy there is no cost and no waitlist to enroll in this therapy.

According to the media, http://www.supportcamh.ca/page.aspx?pid=787 Money is donated to the Centre for addictions and mental health agency. The money is donated from supporters, Bell Canada, CBC news, Thomson, Campbells family has donated over 30$ million dollars and globe and mail for research.
CAMH receives its operating funds from the Toronto Central Local Health Integration Network Research grants and funds for special programs are received from the University of Toronto, Foundations and other granting and funding bodies.

http://www.anxietybc.com/parent/post.php
www.medicinenet.com ... posttraumatic stress disorder indexCached Similar http://en.wikipedia.org/wiki/Bosnian_language http://www.camh.net/education/index.html

www.childcarelounge.com/.
http://www.helpguide.org/mental/separation_anxiety_causes_prevention_tr eatment.htm http://www.supportcamh.ca/page.aspx?pid=295&txtSearch=cost