1. Development Service (CCDS) – Early Identification and
Comprehensive Child
Development Service (CCDS) –
Early Identification and
Timely Intervention
Department of Health
Hospital Authority
Social Welfare Department
10 March 2017

2. Content
(1) CCDS Collaborative Model (2) CCDS in Kowloon East Cluster & pregnant psychotropic substance abusers family supporting scheme (3) Development of Parenting Capacity Assessment Framework

3. (1) CCDS Collaborative Model

4. CCDS: Background A 2005 Policy Address Initiative
To address the various developmental needs of young children (0 to 5 years)
An integrated community-based child and family service model

5. The Critical early years
The early years of a child’s life are critical in affecting the outcomes through the life course
Genes set the blueprint for brain development early before birth.
The environment experienced by a young child literally sculpts the developing brain and establishes the trajectory for long term cognitive and social-emotional outcomes
If we want to improve outcomes in adult life we have to focus on the early years
Investing in early childhood is a sound economic investment.
Centre for Community Child Health, Royal Children Hospital, Melbourne

6. CCDS: Aim
To identify and meet, at an early stage, various health and social needs of children (aged 0 to 5) and their families.
Needy children and families identified will be referred to the appropriate health and/or social services for management.

7. CCDS: Partners Labour and Welfare Bureau (LWB)
Department of Health (DH) Maternal and Child Health Centres (MCHCs)
Hospital Authority (HA) Obstetrics, Paediatrics and Psychiatric Services
Social Welfare Department (SWD) &
Non-governmental organisations (NGOs)
Integrated Family Service Centres (IFSCs), Integrated Services Centres (ISCs), and other service units
Education Bureau (EDB) Pre-primary institutions

8. CCDS: Partners Maternal and Child Health Centres (MCHCs)
A network of MCHCs
Antenatal and Postnatal care
A shared care programme for pregnant and postnatal women with public hospitals
Child health service
Integrated child health and development programme
Over 90% of local newborns registered with MCHCs

9. Maternal Health Service

12. CCDS: Partners Child Care Centres and Kindergartens
Percentage of 3 to 5-year-olds
attending pre-school
2011 Census: 91.3%
2016 By-census: 92.5%

13. CCDS: Partners Hospital Authority Hospitals & Clinics
Provision of various specialist
out-patient and in-patient services
Obstetrics, Paediatrics and
Psychiatric Services for CCDS

14. CCDS: Partners Integrated Family Service Centre (IFSC) / Integrated Services Centre (ISC)
Currently, there are a total of 65 IFSCs
and 2 ISCs covering the whole territory.
Each IFSC serves a well-defined geographical service boundary to facilitate the accessibility of services for service users.

15. CCDS: Partners IFSC / ISC
Three major components:
Intensive counselling, therapeutic groups & crisis intervention
Family Counselling Unit
Support services to vulnerable or at-risk individuals & families
Family Support Unit
Family Resource Unit
Developmental &
preventive services

16. CCDS: Partners IFSC / ISC
A continuum of preventive, supportive and remedial family services:
Enquiry service
Resource corner
Family life education /Parent-child activities
Groups and programmes
Volunteer training and service
Outreaching service
Counselling service
Referral service
Statutory cases including DSW Ward / Care or Protection / Guardianship Order cases (by SWD IFSCs only)

17. CCDS: TARGET SERVICE COMPONENTS
Early identification and management of:
At-risk pregnant women (teenage, substance abuse, mental illness)
Pregnant ladies and mothers with depression
Children and families with psychosocial needs
Pre-primary children with physical, developmental and behavioural problems

18. Inter-sectoral / Inter-disciplinary Collaboration
Interdepartmental Coordinating Committee HA
Specialist Departments DH
MCHCs
SWD
IFSCs
Labour and Welfare
Bureau
Task Group -
Developing PCAF

19. Inter-sectoral / Inter-disciplinary Collaboration
Referral and reply mechanism
Out reaching service
Unified protocol / assessment framework
Communication to facilitate client management
Regular / ad hoc case conference (MCHC staff / psychiatric team / paediatricians / social workers) to discuss the management of difficult clients
If child abuse / neglect are identified, the mechanism of Multi-disciplinary Case Conference on Suspected Child Abuse Cases will be activated

20. Identification and Management of High-risk Pregnant Women
2018/2/8
Identification and Management of High-risk Pregnant Women
NGOs
(Drug addicts)
HA OBS AN clinics
MCHCs
HA Paed
NGOs (teenagers)
HA Psych (mental health)
IFSCs / ISCs

21. Identification and Management of Pregnant Women & Mothers with Depression
MCHC
To screen and assess clients with depression/ psychological distress HA
Psych team
On-site service
IFSC / ISC

22. Identification and Management of Pregnant Women & Mothers with Depression
Antenatal period:
Nurses and Doctors in MCHC
Identify pregnant women with mood problem or
past history of psychiatric illness
Offer supportive counselling service
Refer to the CCDS midwives at the obstetric clinics
of HA or the visiting psychiatric team for assessment
and follow up

23. Identification and Management of Pregnant Women & Mothers with Depression
Postnatal period:
Nurses and Doctors in MCHC
Identify mothers with probable postnatal depression (PND) using the Edinburgh Postnatal Depression Scale (EPDS)
Perform systematic assessment of the condition and the associated psychosocial factors
Those with symptoms suggestive of PND or psychosocial distress are referred to the visiting HA psychiatric nurses at MCHCs for further assessment and counselling.
Depending on the severity of the condition and needs of the mothers and babies, referral are made to:
- the HA visiting Psychiatric teams or paediatricians,
- regular Psychiatric service of HA
- IFSC / ISC

24. Identification and Management of Pre-primary Children with Health & Developmental Problems
Aims to enhance the identification (by Preschool teachers) and referral (to MCHCs) of pre-school children with physical, developmental & behavioural problems
Formal referral mechanism established between preschools and MCHCs
Briefing cum training for preschool teachers
Development of a training kit on child development and behavioural management for pre-primary teachers
Regular training provided to existing KG teachers and teachers-to-be

25. Identification and Management of Children & Families with Social Service Needs
MCHCs
To screen and assess families with high risk factors for their psychosocial needs
IFSCs /
ISCs

26. Identification and Management of Children & Families with Social Service Needs
In MCHCs
To assess the psychosocial needs of high risk families
Single parents
Teenage parents
Mother / father having substance misuse
Other notorious risk categories e.g. History of domestic violence, family history of drug abuse
Parents observed to have parenting inadequacy
To link families in need with appropriate social services in the community
Supportive on-site services at MCHC, introduce / refer to IFSC / ISC / other supportive community services

27. Identification and Management of Children & Families with Social Service Needs
By IFSCs / ISCs
District Support to Needy Cases
Assessment of parenting capacity
Casework and counseling support
Educational / support / mutual-help / therapeutic groups and programmes
Support for MCHCs
Briefing on family services and community resources
Setting up information booth to introduce welfare services and deliver service leaflets to service users

28. (3) Development of Parenting Capacity Assessment Framework

29. Suboptimal child care and parenting capacity
It is always one of the main problems found in high risk families.
At times, discrepancy among different professionals on assessment of child care adequacy, and
lack of a common language for sharing their respective assessment and proposed management plans for the at-risk families.

30. Standardised framework parenting assessment capacity
Development
Alignment of assessment/intervention among different professions
Enhancement of inter-disciplinary communication and collaboration
Mutually agreed care plans in the best interest of children could be formulated
Lack of common language
Standardised framework
for
child care
and
parenting assessment capacity is
thus critical
among different professionals
Discrepancy in respective assessment and proposed management plans

31. Parenting Capacity Assessment Framework (PCAF)
Overview
Designed for the use by various disciplines of social and health sectors
Developed and implemented by phases for children aged between 0 to 3 years
First PCAF is targeted for children aged between 0 to 12 months for use by social workers
6 domains including nutrition and growth, sleep pattern, development and parenting, personal hygiene, safety and health care
Remarks
It is NOT a checklist or a psychometric scoring test pointing to any specific diagnosis.
The PCAF provided reference in assessing the capacity of the parents/carers when social worker conduct the social assessment.

32. Pilot Assessment Framework on parenting capacity was worked out
Task group was formed with members from HA, DH and SWD
Assessment Framework on parenting capacity was worked out
Pilot use of the Assessment Framework in Tsuen Wan / Kwai Tsing and Yuen Long districts since June 2015
Pilot

33. Training, sharing and focus group
Seminars and Workshops
Case Sharing Sessions
Focus groups

34. Feedbacks
Positive feedback -
a useful reference tool to facilitate social workers to conduct a comprehensive assessment on parents with new born babies
for formulating intervention
for facilitating inter-disciplinary collaboration
for engaging clients

35. Feedbacks (cont’d)
Sharing of difficulties
unmotivated parents
clients live in partitioned cubicle / rooms
Comments on
training design / needs
Manual and Record Forms
collaboration with other professionals

36. Refinement after pilot - manual
Elaboration on the part related to assessment on parents with drug / substance abuse habit
Matrix table
highlight key words
Record forms
format
adding bullet points

37. Manual

38. Elaboration on the part related to assessment on parents with drug / substance abuse habit

39. Development and parenting
Matrix Tables and Record Forms
Good enough parents
Nutrition and growth
Sleep
Safety
Health care
Personal hygiene
Development and parenting
Framework
“Usual” condition/practice as well as “Alerting” and “Serious” conditions for further follow up and intervention in the following aspects

46. Refinement after pilot - training
videos for illustrating the application
having small group discussion
providing two cases for discussion each group for practice
experienced social worker to share practical tips

47. 3-Phase Roll-out Phase Districts Roll-out month 1
All districts in the New Territories
November 2016 2
Shamshuipo,
Wong Tai Sin & Sai Kung, and
Kwun Tong
April 2017 3
Central Western, Southern & Islands,
Eastern & Wanchai, and
Kowloon City & Yau Tsim Mong
July 2017

48. Encourage to use
Social workers of IFSCs and the related settings are encouraged to use the framework on any at-risk families

49. Way forward
Assessment framework for social worker for children aged 13 to 36 months and another version for health sector.

50. Experience Sharing