Clinical Tools

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Children & Youth

Children and Youth New to Canada
The Canadian Paediatric Society developed a Global Child Health Curriculum intended for Canadian paediatric trainees and provides foundational information on global child health. Here they provide an introductory module on issues surrounding the health of immigrant and refugee children and youth new to Canada.

Caring for Kids New to Canada
This website is intended for health professionals who care for immigrant and refugee children, youth, and families. Throughout the site, you’ll find information and resources to enhance patient care and help you better understand the unique health needs of children new to Canada. Developed by the Canadian Paediatric Society with input from a range of experts and organizations, Caring for Kids New to Canada has evidence-based information on assessing and screening patients, medical conditions, health promotion, child development, and much more. It also explores how issues beyond the clinical setting affect health, such as culture, social and environmental conditions, health care systems, and public policy.

Immigrant Youth: Acculturation, Identity, and Adaptation
In this article, John Berry  (Queen’s university) and colleagues examine the process of immigration and contributing factors that determine the nature of the experience as a positive event. In particular, they examine the personal and societal experience of acculturation among 26 groups of immigrant youth in 13 countries, including Canada, and compare their experiences to those of their native counterparts. They report four types of acculturation profiles: 1) integration, 2) ethnic, 3) national, and 4) diffuse. with two distinct forms of adaptation: psychological and socio-cultural. Based on their results they recommend immigrant youth should be encouraged to retain both a sense of their heritage and simultaneously establish close ties with the larger national society.

Guidelines on Screening for Child Maltreatment
These guidelines were developed by the Canadian Collaboration for Immigrant and Refugee Health (CCIRH) based on a systematic review of evidence on screening, prevention, and intervention for child maltreatment. Topics examined include benefits, harms, applicability, clinical considerations, and implementation issues relevant to recently settled immigrants and refugees. The report concludes ethnic minority children are unduly over-screened and over-reported for child maltreatment and that the screening instruments used have unacceptably high false positive rates resulting in significant harms because of the risk of mislabeling parents for child maltreatment.

Growing up in a New Land
This guide is for service providers who work with newcomer families who have children aged zero to six. It will help service providers understand the special needs of families that are new to Canada. The resource includes programming suggestions to address these needs. The information in this guide will be useful to a range of service providers, including public health nurses, home visitors, parent-child drop-in facilitators, childcare staff, primary health care providers and kindergarten teachers.

Standards for Multicultural Assessment (US)
This document is a compilation of various assessment standards produced by diverse professional associations. The document is based on a study completed by the Committee on Diversity in Assessment. The document focuses on five major cultural groups in the United States and its territories: African/Black, Asian, Caucasian/European, Hispanic/Latino, and Native American. Sixty-eight standards specifically relevant to the assessment of multicultural and diverse populations are identified. Assessment roles, functions, and tasks cited in these standards are outlined. These include content and purpose of assessments, norming, reliability, and validity of assessment instruments, administration and scoring,  interpretation and finally the application of assessment results.

The CYCC Network: Children and Youth in Challenging contexts
The CYCC Network is a knowledge mobilization network created to improve the mental health and well-being of vulnerable and at-risk children and youth in Canada. It promotes the use of research, best and promising practices and local knowledge in mental health programs for vulnerable and at-risk youth. The Network brings together community groups, front-line practitioners, government officials and researchers who work with children and youth in challenging contexts (CYCC) in diverse Canadian communities.

Youth Engagement: Empowering youth voices to improve services, programs, and policies
This document summarizes the report called Working with Children and Youth in Challenging Contexts to Promote Youth Engagement, produced by the CYCC Network.

Mental health, Mental Illness and Addictions in youth: What do we know about racialised youth health?
A report by the Canadian Association of Mental Health (CAMH) about mental health, mental illness and addictions in youth in Canada, with emphasis on specific needs of racialized youth in Ontario.

Children of Parents with a Mental Illness (COPMI) website
The website provides various information relevant to workers in the Mental Health field when working with families where a parent has a mental illness. The resource materials listed on this website includes resources for children, parents, teachers, community workers, resources for children protection and translated resources in various languages. More information is available at: http://www.copmi.net.au/

AACAP Practice Parameters for Cultural Competence
The American Academy of Child and Adolescent Psychiatry (AACAP) Diversity and Culture Committee has developed practice parameters for cultural competence in child and adolescent psychiatric practice. These include thirteen principles to be followed by clinicians, summarized at the bottom of this page.

Guidelines for Mentoring Immigrant and Refugee Children and Youth
Document and associated tools developed by Alberta Mentoring Partnership. Many of the resources have been adapted from Mentoring Immigrant and Refugee Youth: A Toolkit for Program Coordinators. They are intended to support community-based groups and organizations that are striving to develop and deliver quality mentoring programs to children and youth who are new to Canada. The tools are based on research and the combined expertise of those who are already doing this important work.

Eating disorders in children and adolescents: Cultural and social factors
Health link BC provides medically-approved information on more than 5,000 health topics, symptoms, medications, and tips for maintaining a healthy lifestyle. The online Search Directory provides information on health service locations in British Columbia. Although the site is geared toward health-care seekers as end-users, the site provides useful overviews on multiple topics. for more specific information on eating disorders see links on Anorexia Nervosa and Bulimia Nervosa here.

Canadian Child Welfare Research Portal
Canadian Child Welfare Research Portal provides access to research on Canadian child welfare programs and policies. The most relevant international and Canadian studies are summarized and disseminated through the CWRP’s. The Portal is designed to provide child welfare professionals, researchers, and the general public with a single point of access to research related to abused and neglected children as well as programs and policies developed to support and protect these children and their families. The Portal includes a searchable data base of Canadian research publications, a data base of Canadian researchers, and information and statistics about provincial, territorial, Indigenous Peoples and national child welfare policies, legislations and programs.

Cultural competence in child and adolescent psychiatric practice

  1. Clinicians should identify and address barriers (economic, geographic, insurance, cultural beliefs, stigma, etc.) that may prevent culturally diverse children and their families from obtaining mental health services.
  2. Clinicians should conduct the evaluation in the language in which the child and family are proficient.
  3. Clinicians should understand the impact of dual-language competence on the child’s adaptation and functioning.
  4. Clinicians should be cognizant that cultural biases might interfere with their clinical judgment and work toward addressing these biases.
  5. Clinicians should apply knowledge of cultural differences in developmental progression, idiomatic expressions of distress, and symptomatic presentation for different disorders to the clinical formulation and diagnosis.
  6. Clinicians should assess for a history of immigration-related loss or trauma and community trauma (violence, abuse) in the child and family and address these concerns in treatment.
  7. Clinicians should evaluate and address in treatment the acculturation level and presence of acculturation stress and intergenerational acculturation family conflict in diverse children and families.
  8. Clinicians should make special efforts to include family members and key members of traditional extended families, such as grandparents or other elders, in assessment, treatment planning, and treatment.
  9. Clinicians should evaluate and incorporate cultural strengths (including values, beliefs, and attitudes) in their treatment interventions to enhance the child’s and family’s participation in treatment and its effectiveness.
  10. Clinicians should treat culturally diverse children and their families in familiar settings within their communities whenever possible.
  11. Clinicians should support parents to develop appropriate behavioural management skills consonant with their cultural values and beliefs.
  12. Clinicians should preferentially use evidence-based psychological and pharmacologic interventions specific for the ethnic/racial population of the child and family they are serving.
  13. Clinicians should identify ethnopharmacologic factors (pharmacogenomic, dietary, use of herbal cures) that may influence the child’s response to medications or experience of side effects.

Source:  Pumariega, A. J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., . . . Adolescent Psychiatry Committee on Quality, I. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. J Am Acad Child Adolesc Psychiatry, 52(10), 1101-1115. doi: 10.1016/j.jaac.2013.06.019