What is the CDIAP
The CDIAP is the service where early care is carried out, ie the set of interventions - care and prevention - aimed at children (from the time of conception to 6 years), their families and in the natural environment where they develop.
It is an expert center with a multidisciplinary team specialized in the diagnosis and treatment of children who show signs of risk or alterations in their neurodevelopment. The team of professionals consists of neuropediatricians, clinical psychologists, physiotherapists, psychotherapists, speech therapists and social workers.
What are the general objectives of the CDIAP?
The general objectives of the CDIAP are the prevention, detection, diagnosis and therapeutic approach to the developmental disorders of the child in the process of growth and the situations of social, psychological and biological risk that may alter this process.
The priority objective is to promote the development and well-being of the child and his family, his personal autonomy and his integration / inclusion in his natural environment.
Who can refer a child to the CDIAP?
Although the CDIAP may receive referrals from different areas (family, school, pediatric specialties, social services, etc.), we advise that the pediatrician be informed and aware of the referral.
The pediatrician is the leading professional in the child's neurodevelopment, who can assess the need for a consultation at the CDIAP in the face of any sign of risk or concern, both for the family and the school. It will also be the pediatrician who, through the Shared Clinical History of Catalonia (HC3), will have access to all the information related to the work that is being carried out in the CDIAP and who will be able to continue monitoring the development after termination of service.
And once the application for admission to the CDIAP has been made?The CDIAP administration records the personal data and the reason for consulting the applications that arrive at the CDIAP. The territory and age criteria are also checked and any medical, psychological and / or school reports that are deemed relevant are requested.
How is demand prioritized?
The coordinator of the CDIAP and / or the coordinator of Neuropediatrics makes a complete initial analysis of the documentation to assess the needs and determine the suitability of the process. Priority is given to children under the age of 3 and / or those with severe neurodevelopmental impairment. The family is informed about the procedure, which professional will make the first diagnostic visit and the name of the contact person is provided to resolve any doubts.
Do I need to sign any documents?
Yes, parents or legal guardians must sign the Request for attention in the CDIAP and formalize the commitments of the parties: family and CDIAP sign theWelfare agreement. The CDIAP also has one Internal regulations with the general rules of operation and the rights and duties of the beneficiaries, among other information.
What are the goals of the diagnostic process?
- Assess the concerns referred by parents or professionals.
- Make the differential diagnosis with other neurodevelopmental disorders in childhood.
- Discard the existence of other pathologies that may condition development.
- Make the etiological diagnosis and genetic counseling, if applicable.
- Orient therapeutic care.
Which professionals will carry out the diagnosis?
The complexity of the neuropsychological diagnosis process in early childhood necessitates a coordinated strategy that requires interdisciplinary evaluation by professionals in psychology, neurology, and social work. It will often be necessary to request additional tests and the participation of other professionals in the field of genetics, otolaryngology, psychiatry, etc.
How is the diagnosis made?
This assessment will be carried out from sessions with the child to observe how it relates to objects and people, from interviews with the family and from assessment sessions with the child from specific standardized tests, as well. as complementary medical examinations.
If the clinical criteria of the professionals consider it, other professionals from different disciplines that make up the CDIAP therapeutic team may also be involved in the diagnosis.
How long can the diagnostic process take?
The diagnostic process in the young child is evolutionary and the neurological and psychological assessment will be adapted over time to the different stages according to the age of the child and the time of his development.
The professionals responsible for the diagnosis will monitor the child's development periodically until he or she leaves the CDIAP with a final diagnostic impression.
After the first visits in neurology and / or psychology and / or social work, one is performed initial diagnostic hypothesis from which a therapeutic care plan agreed with the family and will be reviewed throughout the follow-up.
What is a therapeutic process?
In the event that the need to give specific support to the development of a child is assessed, a therapeutic process defined by a child is initiated. therapeutic care plan focused on giving a concrete answer to the difficulties that the child may present in each of the areas of his development.
What is one therapeutic care plan?
El therapeutic care plan establishes the type of therapeutic intervention, the frequency and the modality of the most appropriate care for the child according to his needs, and can contemplate:
- Therapeutic discharge in the event that the child's development is assessed as a variant of normalcy.
- Referral to other community services or specialized services.
- Family counseling in parent groups of the child's specific difficulties and referral to other community services or specialized services.
- Evolutionary monitoring of development over a given time.
- Specific treatment of the following specialties: physiotherapy, psychotherapy / psychopedagogy and / or speech therapy.
What is the purpose of treatment?
The aim of the treatment is to maximize the child's abilities by offering the necessary tools and strategies to him and his family, as well as to his natural environment (educational and community environment) in order to promote his development.
Their weaknesses will be strengthened by taking advantage of their abilities with the aim of optimizing their functionality, promoting the well-being of both the child and the family.
In each case, the baseline of the child's developmental profile obtained in the neuropediatric and / or psychological evaluation will be based on.
What are the basics of treatment sessions?
The therapeutic intervention in the CDIAP guarantees a strategy that contemplates the following basic principles:
- Clear establishment of the framework: the space where it will take place, the schedule, the duration, the reference people and the objectives.
- Guarantee the therapeutic relationship between the child and his family with the therapist as a vehicle for intervention (ie, keep the therapist himself during the process, as far as possible)
- Prioritize significant goals for the child and the family and their generalization in the natural environment.
- Include the family in the intervention sessions so that they participate in the prioritization of the objectives, learn the strategies and generalize them in the natural environment.
- Have attractive and appropriate materials for each case and developmental moment that capture the child's interest and allow the therapeutic work of the objectives set, prioritizing visual aids.
What is one intervention program?
Un intervention program is the collection of individualized work goals set by the therapist and agreed with the family.
The program will be dynamic and will be systematically reviewed throughout treatment.
What is the methodology of the intervention in the CDIAP?
The methodology of the therapeutic intervention in children in the CDIAP will be flexible and adaptable to the symptomatic expression of each child and to each evolutionary moment, also taking into account both the global development and the needs of the family and the environment.
In the therapeutic plan and the intervention program the following variables will be combined as efficiently as possible:
Intensity level of the intervention:
- Intensive (2 therapeutic sessions a week or more)
- Weekly (1 therapy session per week)
- Fortnightly (1 therapy session every 15 days)
- Follow-up (1 monthly therapy session)
- Control (1 quarterly therapeutic session).
modality of the intervention: determined by the characteristics and the evolutionary moment of each child and family, and also by the type of supports of which it has in the educational field. Throughout the diagnostic and therapeutic process of the child in the CDIAP, the different modalities will be combined looking for the best therapeutic option for each case:
- Individual therapeutic sessions
- Therapeutic sessions in groups of children
- Parent groups
- Parallel groups of children and parents
- Technique of the intervention: the therapeutic intervention of children in the CDIAP can be carried out through different models, techniques and strategies depending on the needs of the children and their families, and also depending on the specialization of the professionals who perform it.
- Areas of the intervention: the intervention will be carried out in the CDIAP. In very special cases the intervention will be performed in the pool (aquatic therapy), and in other cases (when the characteristics of the family and the needs of the child make it important to bring attention to the child's natural environment) it can be carried out at home, at the school, or at the hospital itself (if the child is admitted).
Depending on the needs and the evolutionary moment of the child and the family, it is possible to go through different modalities throughout the therapeutic process.
What role does the family play in the therapeutic process?
The family plays an active role in the process of therapeutic intervention and, therefore, will play a key role in proposing goals, implementing strategies and assessing evolution. The therapist's care for the family is basically to inform, guide, advise, give strategies and accompany the parents in the process of understanding the difficulties that the child presents and how they affect their development.
However, it is important to inform and offer the social protection resources that the family can turn to depending on the diagnosis and the severity of the condition that their child suffers (recognition of the disability, application for the degree of dependency, deduction for large families or dependent people with disabilities, aids for personal autonomy, family benefits for dependent children, benefits for the care of minors affected by cancer or other serious illness, advice for architectural barriers and adaptations).
What will we achieve with the intervention?
- Know how the child moves, perceives, coordinates, thinks, relates and communicates, as well as being aware of their ability to pay attention, their control of impulses, how they manage their emotions, how they learn, etc. . = Get to know the child
- Understand the evolution of the child in each of the areas of development and how, together, they are expressed through their relationship with the physical and social environment. = Understand how it works
- Know how we can help the child to realize his potential to compensate for his difficulties. To be able to set work objectives appropriate to the evolutionary level and specific difficulties it presents and to incorporate the most appropriate strategies in order to maximize its development and well-being. = Know how we can help you
- Adapt the environment to the needs of the child by supporting both the family and the educational environment in the search for resources conducive to the overall development of the child. = Adapt the environment
- Strengthen the network of support resources so that we can work together and efficiently with shared goals. = Coordinate resources
How long can the treatment last?
Completion of treatment will be considered when the established objectives have been achieved. This means when the child, the family and the educational and community environment have already acquired the necessary tools and strategies to be able to enhance the child's abilities and promote their development.
Discharge and referral
When the treatment ends, is the child discharged from the CDIAP?
Not necessarily. Once the therapeutic goals have been achieved, follow-up visits for Neurology, Psychology and / or Social Work may still be scheduled.
When is the termination of the CDIAP formalized?
Follow-up visits will be maintained until the diagnostic process is completed, the family situation is stabilized, schooling is adequate and supported (if necessary), coordination with other services has been carried out and the family has been guided. on the continuity of follow-up and therapeutic care (if any) in other devices.
What other reasons cause the termination of the CDIAP?
The child may be discharged for any of the following reasons listed in the Internal regulations:
- By written waiver of the father and mother or legal representative.
- For therapeutic discharge when there is an improvement or symptomatic remission.
- For change of usual family address, when it is outside the scope of the provision of the service.
- By chronological age (maximum 6 years), in accordance with article 4.4 of Decree 45/2014, of 1 April, amending Decree 261/2003, of 21 October, which regulates the early care services.
- For non-attendance at three consecutive sessions, without just cause.
- For non-compliance with applicable current regulations, care agreement or internal regulations, in accordance with the procedure established in defense of the rights and duties of individuals, especially for the benefit and interest of the child.
How do I request a CDIAP report?
If you need CDIAP reports, you must request them from the Clinical documentation of the Parc Taulí, either in person or Online. The request must be made by the child's parents or legal representatives, and they will also be the people authorized to collect them.
At the time of discharge from the CDIAP, each child must have a report with information on the diagnostic and therapeutic process performed.
If you need a report before the end of the care process, it is important to state the reason so that you can adjust it to the needs and level of urgency.