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.
At the CDIAP in Parc Taulí, an assessment is made of both the difficulties and the abilities of the children being cared for. Also, an etiological study is proposed in order to know the possible causes of the detected neurodevelopmental alterations. Based on the results of the assessment, a therapeutic plan is established, a therapeutic intervention is performed and, if necessary, genetic counseling is provided. The whole process involves the participation of families and is carried out in close collaboration with the education, health and social services involved.
Interdisciplinary diagnosis and continuous evaluation
El diagnostic process in early childhood it is evolutionary and consists of a neurological and / or psychological evaluation that will be adapted to the different stages according to the age of the child and the moment of his development. This assessment is based on sessions with the child to observe how it relates to objects and people, interviews with the family, child assessment sessions based on specific standardized tests and explorations. complementary medical.
If the professionals who make the diagnosis (psychologist and / or neuropediatrician) consider it appropriate, they can also request the intervention of other professionals from different disciplines that make up the CDIAP therapeutic team (social work, speech therapy, physiotherapy, psychopedagogy / psychotherapy). Based on the results of the assessment, a initial diagnostic hypothesis and a plan is proposedtherapeutic care agreed with the family, which will be reviewed throughout the follow-up.
The main objectives of the diagnostic process are:
- Assess the concerns referred by the family and / or professionals and contextualize them in the child's developmental process.
- Establish a functional diagnosis of the child's abilities and difficulties and assess possible deviations and / or developmental delays.
- Make a differential diagnosis between the different diagnostic hypotheses.
- Discard the existence of undetected pathologies that may condition the development.
- Make the etiological diagnosis and genetic counseling, if applicable.
- Orient therapeutic care.
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.
Interdisciplinary therapeutic intervention
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.
The professionals who will carry out the therapeutic intervention specialize in physiotherapy, psychology, psychopedagogy and early childhood speech therapy, with a broad knowledge of neurodevelopmental disorders and therapeutic strategies aimed at both the child and their families.
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.
The child's weaknesses will be reinforced based on their abilities in order to optimize their functionality, promoting the well-being of both the child and the family.
The therapeutic intervention will start from the baseline of the child's developmental profile obtained in the neuropediatric and / or psychological evaluation.
La methodology of therapeutic intervention in the CDIAP it 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 care plan and the intervention program the following variables will be combined as efficiently as possible:
- Level of intensity of the intervention: intensive (2 therapeutic sessions per week), weekly (1 therapy session per week), fortnightly (1 therapy session every 15 days), Tracking (a monthly therapy session), control (a quarterly therapy 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 available 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, groups of families, parallel groups. children and families).
- Intervention technique: the therapeutic intervention of children in the CDIAP can be carried out through different models, techniques and strategies depending on the needs of children and their families, and also depending on the specialization of the professionals who carry it out.
- Areas of intervention: the intervention will take place at the CDIAP. In special cases, the operation will be performed in the same hospital (if the child is admitted).
Coordination with the service network
The coordination between the different health, educational and social devices of our territory constitutes one of the fundamental axes to be able to develop the tasks of detection, prevention and intervention with the child and his family.
This coordination allows us to make better use of the resources of the area, to exchange and share experiences, to design strategies for joint action, to share the vision of the cases, to do research and training, etc.
The privileged situation of the CDIAP integrated in the Pediatric Medicine Service of the Parc Taulí Hospital makes the coordination with the field of health extraordinary, providing a unique value of quality and efficiency in the territory. The CDIAP establishes coordination with:
- Primary Care Centers.
Child and Adolescent Mental Health Centers (CSMIJ):
- CSMIJ of Sabadell (children of Sabadell, Barberà, Castellar, Sentmenat, Polinyà, Sant Llorenç and Gallifa).
- USM Bay
- CSMIJ de Mollet (children of Santa Perpètua and Palau)
- CSMIJ of Terrassa (children of Sant Quirze).
- Pediatric specialties of Parc Taulí.
- Other hospitals.
Given that the CDIAP Parc Taulí has a wide coverage area, it coordinates its care work with four School Psychopedagogical Advisory Teams (EAP) of the Department of Education of the Generalitat de Catalunya:
- EAP B-34 of Sabadell Sabadell (Sabadell and Sant Quirze)
- EAP B-50 of Castellar del Vallès (Castellar, Sentmenat, Polinyà, Palau-Solità, Sant Llorenç Savall, Gallifa)
- EAP B-25 of Badia del Vallès (Barberà and Badia)
- EAP B-16 of Santa Perpètua
It is through each of the EAPs that the CDIAP manages the relationship with all schools in a two-way coordination where the detection, referral and follow-up of cases is carried out.
Annually, before the start of pre-enrollment in schools, specific meetings are held with the different EAPs in order to establish the coordination of the necessary actions for all those children cared for in the CDIAP with specific educational support needs (NESE). who must start P-3 next year.
Area of social services
Coordination is maintained with the Municipal Social Services and the Child Care Teams in order to carry out a mutual transfer of information and coordinate the main actions by carrying out, in cases that require it, a network work that allows to act in the child's environment bearing in mind the globality of the child's reality.
The CDIAP Parc Taulí has also been collaborating in the Caritas Maternal and Child Course for more than 25 years. The aim of the course is to support disadvantaged mothers to cope with raising their children. The participation of the CDIAP takes the form of two professionals attending the course on a monthly basis, which promotes information on the doubts raised by the mothers themselves, planning sessions to observe the mother-child dyad and giving them guidance in order to encourage them. better development of your child. This work is done in coordination with the course tutors and, if necessary, action guidelines are also given. In the event that any signs of risk or alteration in the development of children are detected, their follow-up is directly linked to the CDIAP.
Coordination with other specific devices
Coordination with other specific care devices such as the Hearing Resource Center (CREDA), the Joan Amades Center of the ONCE and the Augmentative Communication Techniques Unit (UTAC), supports the work of the CDIAP in improving specialized care. which require some of the children being cared for who have severe sensory and / or mobility difficulties.
Specific functional units
Functional Unit for the Care of Autism Spectrum Disorders (UFTEA)
The CDIAP, the Center for Child and Adolescent Mental Health (CSMIJ) and the Pediatric Neurology Unit, together with the School Psychopedagogical Advisory Team (EAP) among others, make up the care devices of the Sabadell Functional Unit which, since January 2013 is conducting the pilot test of the "Comprehensive Care Plan for People with Autism Spectrum Disorder."
The Comprehensive Care Plan for People with ASD arises from a Parliamentary Resolution (Resolution 280 / VIII, of May 2008 of the Parliament of Catalonia), with the will of three departments of the Generalitat (Social Rights, Education and Health) and in order to respond to the need for consensus among professionals from the different services (social, educational and health).
The main objectives of the Care Plan for People with ASD are:
- Establish an effective detection, assessment, referral, and intervention circuit, with available resources.
- Create a common framework for action that facilitates cohesion between the various services and the development of common strategies, based on integrated training and the transmission of knowledge between the various professionals involved in the care of people with ASD and their families.
Oropharyngeal Dysphagia Unit
Swallowing disorder is a motor disorder that benefits from specific speech therapy work and can have respiratory consequences when swallowing is unsafe, as well as nutritional consequences if a balanced diet is not organized.
Some of the children treated at the CDIAP have, for various reasons, disorders of swallowing or eating behavior (infantile cerebral palsy, neuromuscular disorders, malformations such as cleft palate, intellectual disability, conduct disorders, etc.).
The Unit is made up of an interdisciplinary group of specialists (nutrition, physiotherapy, speech therapy, psychology, neuropediatrics) who aim to diagnose and treat swallowing problems in order to achieve a safe and effective diet that prevents malnutrition and lung complications.
Clinical Specialization Unit in Attention to Genetically Based Cognitive-Behavioral Rare Diseases (XUEC)
Parc Taulí has been designated to be part of the first Network of Units of Clinical Expertise (XUEC) in minority diseases in Catalonia.
Genetically based cognitive-behavioral disorders manifest at an early age and with varying degrees of impairment, but they all have common characteristics that define them: cognitive deficit; recognized behavioral disorders or patterns of behavior; target organ involvement; malformative or dysmorphic traits in most cases, accompanied by chromosomal abnormalities that escape, due to their complexity and specificity, which can provide a simple karyotype, being necessary to use more advanced cytogenetics and molecular biology techniques.
These children should be detected and diagnosed very early by a multidisciplinary team of neurodevelopmental specialists, along with other specialties (endocrinology, cardiology, traumatology, digestology ...) that, working in network with the children's reference professionals, can provide a diagnosis as quickly as possible, appropriate genetic counseling and guidelines as a very precise “therapeutic schedule” so that these children have the opportunity to make the best possible development.
The CDIAP, as an expert center for the prevention, detection, diagnosis and therapeutic intervention of neurodevelopmental disorders that can occur in early childhood, is the reference service that addresses the early stages of most of these diseases.
Unit for pediatric complex chronic patient care
In recent years we have witnessed a shift in pediatric care. Acute illnesses have fallen sharply thanks to vaccination programs and accident prevention, while children surviving major illnesses such as prematurity, childhood cancer and minority diseases have risen sharply. As a result, the percentage of children with disabilities has increased because they are increasingly surviving very serious illnesses that lead to a situation of fragility and vulnerability for many years.
This situation generates emotional dysfunction on an emotional, economic and spiritual level and a feeling of loneliness in access to health care.
In the context of the Pediatric Medicine Service, the 'Comprehensive Pediatric Complex Patient Care and Palliative Care Plan' has been launched. Most of the children who need this type of care are children also cared for in the CDIAP. The main objective of the Plan is to implement a new model of comprehensive care for children and young people in the reference area of Sabadell Hospital affected by limiting and / or life-threatening illnesses.
This care must make it possible to improve their quality of life and to stay at home with the maximum possible comfort, and to make it easier for them to die at home (if the patient and / or family so wish). At the same time, the care model will focus on the coordination of care of the different professionals who support the patient and thus optimize health resources.
Pilot test to implement the 'Recommendations for care for people with limited intellectual functioning (FIL)' in Sabadell
Intellectual Functioning Limit (FIL) is a metacondition of health that prevents the proper functioning of the person, such as a basic level of education or access to the labor market.
Studies on the prevalence of FIL are scarce and the results are widely variable. In Catalonia, it is estimated that 3% of the population has limited intellectual functioning and needs for intermittent support.
From the Government of the Generalitat, in 2014 a FIL Consensus Group was promoted with the participation of professionals from different fields - health, educational, social, labor and judicial services -, experts in the care of this group. school. The aim of this group was to develop recommendations to improve the early detection and diagnosis of FIL, define an individualized care plan, improve social and labor integration, and ensure interdepartmental and interdisciplinary coordination in the care of this col. School.
The CDIAP is involved in the detection and diagnosis processes in early childhood.
Guidance and counseling for families: the family at the center of care at the CDIAP
The family is the natural environment where the child grows and develops and is therefore the context and the main driver of his development. When any difficulties arise, families need support to answer and understand three basic questions:
- What is happening?
- What can we do?
The task of the CDIAP is to empower families by providing them with advice and support to deal with the difficulties of their children in the most calm and efficient way possible and to strengthen their potential.
It is for this reason that in all the care processes of the CDIAP the family actively participates in a coordinated work with the different professionals with the common goal of seeking a development as optimal as possible within the characteristics and needs of each child.
In addition to the follow-up and continuous participation in all the care processes in which the child attends, the referring professionals can propose a specific attention aimed exclusively at families in order to delve into specific issues that require time to reflect, to to share, to learn strategies and to discover one's own personal resources.
The following groups of families are carried out at the CDIAP:
Family groups of children with language difficulties
Groups of families of children with communication and relationship difficulties
Family groups of children with behavioral difficulties
This website has also been developed with the aim of being a useful tool for families to know and understand the complexity of the Early Care resource, while also having the specific section 'Therapeutic resources' designed for provide them with strategies, materials and advice on different topics.
Prevention-guidance and advice to early childhood education professionals
Educational environments, such as nursery school and school, are welcoming children as they grow up, becoming fundamental environments in their motor, cognitive, communicative and social development. Along with the family, the educational environment is a major player in the education and stimulation of the child's development.
The CDIAP team conducts courses, talks and presentations for early childhood education professionals in the stages from zero to three years and from three to six years. The aim is to guide, advise and offer guidelines and strategies for detection, referral and intervention in children with specific educational support needs.
Teaching and research
The activities in the field of knowledge related to training, teaching and research are a great added value to the care work of our CDIAP, providing updates and innovation that has a very important impact on the quality of care. to children and their families.
The professionals at CDIAP Parc Taulí are fully committed to teaching, collaborating in university training, master's and postgraduate courses, as well as in courses and talks in different disciplines related to early childhood neurodevelopment.
- Teaching of university studies subjects.
- Collaboration with university and postgraduate master's studies: tutoring of practical teaching by students from different universities.
- Collaboration in the training of Resident Internal Psychologist (PIR) and Resident Internal Medicine (MIR): participation in the training activity of professionals in training for both Pediatric MIR and Psychiatric and PIR MIR training professionals who they do their residency at the Child and Adolescent Mental Health Center (CSMIJ).
- Course organization.
- Other teaching activities such as talks, classes, etc.
The CDIAP Parc Taulí has historically been a benchmark in the development of research studies related to neurodevelopment in early childhood, some of which have resulted in various doctoral theses and numerous publications in conferences and scientific journals.
Interdisciplinary work, both within the team and in relation to other services and disciplines related to neurodevelopment, makes possible the participation of the CDIAP Parc Taulí in various research studies that provide interdisciplinary knowledge.