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Article

Autism Spectrum Disorder  

Sandy Magaña and Lauren Bishop

Autism spectrum disorder is a heritable, developmental disability that is characterized by challenges with social communication and the presence of restrictive and/or repetitive patterns of behavior. Autism spectrum disorder affects development and quality of life from very early development through old age. Social workers play a number of different roles in supporting and advocating for individuals on the autism spectrum and their families. It is important that social workers understand the etiology, diagnosis and treatment of autism spectrum disorder, how it manifests throughout the lifespan, and challenges faced by families affected by ASD.

Article

Children’s Health  

Shirley Gatenio Gabel

The history of social work is deeply rooted in helping vulnerable populations improve their well-being, and children have been at the forefront of these efforts since the inception of the profession. Health is long understood to be critical to children’s well-being. Social workers who are skilled in integrating different systems can play pivotal roles in engineering new and improving existing health-care infrastructures and can act as advocates for fusing health-service systems with other social infrastructures to optimize outcomes for children. This entry reviews trends in children’s health throughout the world, particularly in the United States. It describes the dramatic improvements in reducing infant mortality, child mortality and morbidity from many infectious diseases as well as accidental and environmental causes, and the unequal progress in realizing children’s health. The challenges that lie ahead that pose risks to children’s health are discussed, including the health inequities created among and within countries by social, economic, and political factors. An argument for a comprehensive, integrated, evidence-based, and cross-disciplinary approach to improve children’s future health is presented.

Article

Deaf and Hard-of-Hearing People  

Martha A. Sheridan and Barbara J. White

Effective social work practice with deaf and hard-of-hearing people requires a unique, and diverse, collection of knowledge, values, skills, and ethical considerations. Salient issues among this population are language, communication, and educational choices, interpreting, assistive devices, cochlear implants, genetics, culture, and access to community resources. Competencies at micro, mezzo, and macro levels with a deaf or hard-of-hearing population include knowledge of the psychosocial and developmental aspects of hearing loss, fluency in the national sign language, and an understanding of deaf cultural values and norms. In the United States, the use of American Sign Language (ASL) is the single most distinguishing factor that identifies deaf people as a linguistic minority group. This entry presents an overview of the practice competencies and intervention approaches that should be considered in working with deaf and hard-of-hearing people, their families, communities, and organizations. It introduces the knowledge base, diversity in community and cultural orientations, social constructions, and international perspectives, current research and best practices, interdisciplinary connections, trends, challenges, and implications for effective social work practice with this population. An integrative strengths-based transactional paradigm is suggested.

Article

Deinstitutionalization  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as transinstitutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, while it has expanded admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase/model programs illustrating what can be done, yet it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. Deinstitutionalization policy has motivated political, economic, legal, and social change in the care and control of six populations—older adults, children, people with mental illness, people with developmental disabilities, people under correctional system supervision, and, more recently, individuals without a home. A truer implementation of deinstitutionalization’s initial aspirations requires reconsideration of these changes.

Article

Deinstitutionalization in Macro Practice  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Article

Early Brain Development for Social Work Practice  

Terri Combs-Orme

Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.

Article

HIV/AIDS: Children  

Larry D. Icard, Jacqueline J. Lloyd, and Gisoo Barnes

HIV/AIDS has introduced an array of issues and needs for children, youth, and their families. Family-focused interventions have emerged as a viable strategy for researchers and practitioners seeking effective and appropriate responses for the prevention, treatment, and care of children, youth, and families affected by HIV/AIDS. This discussion provides an overview of the epidemiology of HIV infection among children and youth, and highlights common elements and trends in the development, implementation, and testing of family-focused interventions. The discussion concludes with a commentary on areas for future attention.

Article

Home-based Interventions  

Susan F. Allen and Elizabeth M. Tracy

Home visiting and home-based intervention are two strategies used by social workers when working with individuals or families in direct practice. The basic rationale for home-based work is the benefit to social workers’ assessments and understanding of clients, as well as the benefit of more relevant practice with families who are seen in the setting where difficulties are occurring. Home-based interventions have been shown to be effective in improving health and decreasing family discord. When visiting the home, the social worker has the added responsibility of respecting the privacy of families as a guest in their homes.

Article

Improving the Self-Esteem and Social Skills of Students with Learning Disabilities  

James C. Raines

Learning disabilities (LD) are the most common disability in public schools. Since 1975, students with learning disabilities have been eligible for a free appropriate public education, including special services such as school social work. Students with LD may be diagnosed via standardized achievement measures and clinical assessment. Despite 40 years of progress, the evidence suggests that students with LD still feel stigmatized and finish college and enter the workplace at a rate much lower than their nondisabled peers. School social workers can assist students with learning disabilities by assessing their self-esteem and social skills and then providing appropriate intervention. Self-esteem interventions should target students with LD, their parents, and their peers in the least restrictive environment. Social skills interventions may target students with LD as a separate group or provide those skills as part of universal inclusive education aimed at all children in the classroom.

Article

Intellectual Disabilities  

Leah Igdalsky

Social workers working with individuals with intellectual disabilities and their families require an understanding of the disabilities themselves as well as the larger context of disability in society. Individuals with disabilities face particular risks for poverty and poor healthcare, and it is essential for social workers to understand the complex web of social services available. Furthermore, social workers often work not only with the person with a disability but also with their caregiving families.

Article

Maternal and Child Health  

Valire Carr Copeland and Daniel Hyung Jik Lee

Social reform efforts of the settlement-house movement have provided, in part, the foundation for today’s Maternal and Child Health Bureau’s policies, programs, and services. Planning, implementing, and evaluating policies and programs that affect the health and well-being of mothers and children require a multidisciplinary approach. Social workers, whose skills encompass direct services, advocacy, planning and research, community development, and administration, have a critical role to play in improving the health outcomes of maternal and child populations.

Article

Pediatric Palliative Care  

Stacy S. Remke

As a relatively new arena of practice, social work in pediatric palliative care (PPC) is evolving and being shaped by social work practitioners, as well as physician leaders, clinicians from other disciplines, and institutions. PPC practice requires a wide array of social work skills, knowledge, and insights to accomplish the many tasks and address the many issues that can arise when caring for children with life-threatening conditions. Family-centered, team-based care is the standard approach. Knowledge of childhood diseases, family systems, health care delivery, mental health assessment and interventions, child development, and bereavement care is required for best practice. The provision of effective care over time, across sites, and in the context of team-based specialty care requires skilled social work intervention.