This article clarifies the nature of 'service integration' and 'service co-ordination' and discusses how these aspects relate to the fundamental goal of providing co-ordinated care for children with disabilities and their families. Based on a review of the service delivery literatures in the fields of health, social services and rehabilitation, a framework is presented that outlines the scope of the co-ordination-related functions and activities encompassed in three common types of approaches to the delivery of co-ordinated care. These are a system/sector-based service integration approach, an agency-based service integration approach and a client/family-based service co-ordination approach. The functions outlined in the framework include aggregate-level planning of services (designed to map out the scope and plan for service provision in a community or geographical area), administrative functions (designed to ensure wise and equitable access to resources) and client-specific service delivery functions (designed to link clients/families to needed services). The framework is a tool that can be used to support policy making and decision making with respect to the design of efforts to provide co-ordinated care. It provides information about commonly used approaches and the essential elements of these approaches, which can be used in making choices about the scope and nature of an approach towards service integration/co-ordination.
Important differences were found among children in a number of areas as a function of overall physical health status. The findings emphasize the importance of measuring activity limitations distinctly from chronic conditions and impairments, and, perhaps, of measuring impairments distinctly from chronic conditions, and of comparing children with such health problems to children without health problems in order to obtain a more accurate picture of the impact of health on children's lives. The World Health Organization's distinct definitions of health condition and disability facilitate a dimensional approach for describing child health that can serve to clarify this field of study and improve comparability of data across countries.
This study examined the relationship between the broader autism phenotype (BAP) and depressed mood in mothers of children with and without autism spectrum disorders (ASD). One hundred and sixty-five mothers (71 with an ASD child and 94 with a non-ASD child) completed a survey of child autism severity (ASD mothers only), parenting stress, BAP, and depression. Mothers of children with ASD reported greater depressed mood, higher parenting stress, and more characteristics associated with the BAP than mothers of children without ASD. For mothers of children with ASD, the BAP uniquely predicted number of depressive symptoms after controlling for child autism severity and parenting stress. In the full sample, the relationship between group status and depressed mood was no longer significant after controlling for parenting stress and maternal BAP. These findings suggest that the higher rate of depression found in mothers of children with ASD may be attributed both to the increased stress of raising a child with ASD, as well as a greater number of autistic features in the mothers that may place them at higher risk for developing depression.
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