Child-Psychiatric Consultation for the Development of Camping Programs for Children with Special Needs

Sigalas I.M., Christoforou L., Kontos K., Polychronis P.

Mutual Health Fund of the Personnel of the National Bank of Greece.
III European Congress of Consultation,
Athens, September 26 - 28, 1996.
 

The Mutual Health Fund of the Personnel of the National Bank of Greece (TYPET) is an autonomous, self-administered Health Care Organization. The Summer Camping Programs for children and adolescents are among the many activities, which TYPET has developed for its members. Camping Programs for handicapped children also belong to those activities since 1994. Two kinds of such programs have been developed:

• "Exclusive" for children with serious mental, developmental and neurologic disorders.
• "Transactional", in which participate both healthy children and children with similar, but milder problems than those of the previous program.

In the summer of 1994 the Social Worker (L. Christoforou) and the Child Psychiatrist (P. Polychronis) of TYPET suggested that a camping period for children with special needs should be carried out in the Health Fund's camp in Kokkinaras (near Athens). It was a tentative activity and lasted 10 days (the half duration of the normal periods). 15 children with disorders of varied seriousness participated in this camping period. 15 specialists worked as children's animators, among whom there was a Consultant Child Psychiatrist. This program had great success, it fulfilled its goals, while children and their families were very satisfied. Thus it was decided that the two above mentioned programs should be developed next year. 30 children took part in those programs. Among them there were 5 children of the employees of another Greek Bank (the Agricultural Bank of Greece - ATE), with which TYPET started a cooperation.That time we mainly paid attention to the organization of the Transactional Program, because we considered that the transaction between the different groups of children and camping personnel could become a useful and satisfactory experience for all.

Also, during the winter 1995-96, two meetings took place between the officials of TYPET, the camping personnel and the children with their families. During those meetings: a) the development of the two programs was discussed. b) the wish of all participants for the repetition of the programs was declared. and most importantly c) it became clear that a very desirable grouping process between children, parents and specialists was developing.

In the summer of 1996 the two programs were repeated as follows:

• The Transactional Program took place in Kokkinaras, as before. It lasted ten days and was incorporated in the third camping period for healthy children 6 - 13 years old. During that period there were about 150 children in the camp. Children with special needs and their companions came at the camping in the middle of the "normal" period.

  In that program participated 30 handicapped children, 6 - 20 years old. Most of them had also taken part in previous programs. They had the following disorders:

  • Mild or moderate mental retardation. In three children mental retardation was a manifestation of Down's syndrome.
  • Pervasive Developmental Disorder of mild degree, with relatively sufficient mental function and language development.
  • Kinetic problems (paraplegia or tetraplegia) in the context of a neurologic disorder, with or without normal mental function.
  The children's "animators", as we called them, had the following characteristics:
  • Professionally they were physical trainers, occupational therapists, social workers, psychologists, speech therapists or special school teachers.
  • They were experienced in the education of children with special needs.
  • They had camping experience, organizational capabilities, enthusiasm and intention to understand and care for those children in a 24-hour basis.
  The Program had the following goals:
  • The children's recreation. We set this as our first goal, because all these children are students of special schools during the school - year, while they also have special education, physiotherapy, speech therapy, occupational therapy etc. Thus we thought that it could be very useful for their physical, mental and emotional development, if they could participate in some recreational activities during those few days in the summer.
  • The separation from parents for a few days, which, for some children was difficult, and their socialization in peer groups.
  • The training in self-help skills and the reduction of self-injuring, hyperactive and stereotyped behaviors. Personal goals for each child's training were set and the progress of each one was evaluated at the end of the program. Children had to be trained in dressing and undressing, eating manners, tooth brushing, toilette habits etc. Also the limitation of unproper behaviors of some children was necessary in order to be able to take part in many camping activities.

  • The development of creative transactions between healthy and handicapped children, so that the emotional and mental development of all could be promoted. The handicapped children participated in all camping activities, with the exception of those, who clearly could not take part in some of them. For example a tetraplegic adolescent could not swim in the swimming pool. During the swimming time he used to play table games with great skill. In the first days he played with his animator, but soon a group of healthy children shaped around him. Those children liked to play with him and to learn from him and at the same time they helped him to satisfy some of his other needs, as was movement.

    The participation of handicapped children in many camping activities was very succesful. They won prizes in sports, they took part in short theatrical plays, in children's choirs, in dancing proups etc. They became an active part of the normal camping life.

    • The confrontation of social prejudice towards persons with special needs.
    • To give to parents the opportunity for rest and vacation. The care of these children frequently demands from the whole family much time and skill. Thus this opportunity for vacation was welcome by many parents. Also this was an occasion for the parental couple to work on their relationship. This work is underestimated in many Greek families and is given frequently as a task to the couple during family consultation.

   

• The "Exclusive" Program took place in the camp of the Agricultural Bank of Greece in Perachora - Loutraki. It lasted ten days and was set in the fourth camping period for healthy children, 7 - 15 years old. A limited transaction developed between the two groups of children, because the serious disorders of the handicapped children did not permit more substantial relating. Anyhow the two groups lived together without problems and the participation in common activities, where it was possible, was successful.

  Ten children participated in the program. They were 10 - 25 years old and had similar, but more serious, disorders than above. For example all children had marked impairment in language development, while a few children could not speak at all. Most of them had participated in previous years' camping programs. Eight of the animators of the previous program worked here also. The goals of this program were:

  • The training in self - help skills.
  • The reduction of self-injuring, hyperactive and stereotyped behaviors.
  • The recreation whenever possible. It was noticed that children, who had participated in previous years' programs, looked to have a good time this year also.
  • The physical recreation and training with walks and swimming.
  • The rest of the parents.

The contribution of the Child Psychiatrist in the organization and development of the special camping programs of TYPET had a multifocal - multilevel character. His goals were:

• To support the persons, who conceived the idea of the programs (mainly the transactional one), during their negotiations with TYPET.
• To clarify the criteria for the selection of children and personnel.
• To prepare the camping for the reception of handicapped children.
• To provide all the medical and psychiatric informations for the children's problems, where it was needed.
• To help personnel to set goals for children, so that they could actualize all their physical, mental and emotional capabilities.
• To provide education.
• To facilitate the development of functional relations and creative transactions among all persons and groups in the camping.
• To contribute in the evaluation of the programs.
• To help the staff, children and parents of the "normal" camping program to consider the "transactional" program as an opportunity for actualization and not simply as a necessity.

The specific activities, which the Child Psychiatrist developed, were the following:

• Before the beginning of the programs:
  • Participation in the choice of children with such criteria as the age, the kind and seriousnes of disorders, the general functional level of each child, the results of participations in previous camping programs and the level of cooperation with family.
  • Participation in the choice of personnel.
  • Preparation of the camping for the reception of the handicapped children. As was mentioned above, the transactional program was incorporated in a camping for healthy children, while the children with special needs and their animators came in the camp in the middle of the period. Thus the Child Psychiatrist had enough time to do the following:
    • To cooperate with the leader, the director and the medical staff of the camping.
    • To organize discussion groups with the staff of the camping (group leaders, instructors), most of whom were young girls 18 - 25 years old. During those discussions the personnel was informed about the goals and the nature of the special program and doubts and iquiries were answered. Also the staff had the oportunity to discuss with the Child Psychiatrist about their work with the healthy children, as for example about their relations with the children's families, the relations between members of the staff, the role of hierarchy for the function of the camping, the role of the child who counteracts the rules of the group, the management of symptoms (enouresis, encopresis, sleeplessness, bulimia etc.).

    • Also the Child Psychiatrist worked diagnostically with some groups of children and discussed with their leaders about the development of their functioning.

      Thus, in addition to the preparation of the camping, an educational process started between the Child Psychiatrist and the staff of the whole camping, which was continued, as it is mentioned below.

• During the special programs' operation:
  • Regular collaboration with the higher members of the staff for the supervision of the program's process and the timely solving of problems.
  • Individual or group counselling meetings with the staff for the solving of children's problems and the promotion of cooperative relations in the camping. We considered that presuppositions for the pleasant and fruitful stay of children in the camp were: a) the development of cooperative relations among the members of the staff. b) the respect of hierarchy. c) the satisfying and productive living of the staff in the camping.

  • Organization of educational group meetings with the staff (of both programs). Those meetings were about the social facing of persons with special needs, family and group dynamics etc. They were done always after 11 p.m., because that was the personnel's free time, and had experiential and recreational character, because the place and time were not suitable for lengthy psychiatric lectures.

    Also during those meetings the members of the special program discussed with and helped the staff of the "normal" program to solve problems in their work.

  • Psychiatric examination of children, who showed behavioral or emotional difficulties, and collaboration with their parents and staff. The examination of children was done informally during their usual activities, so that the normal function of the camp would not be disturbed. Also we wished to avoid giving to the camping's operation a medical character.
  • Informing and discussion about the children's mental, emotional and organic disorders, when needed.
  • Coping with emergencies in collaboration with the medical staff of the camping.
• After the end of the program:
  • Contribution to the evaluation of the program.
  • Collaboration with TYPET officials and making recommendations about the future development of the programs.
  • Reporting every useful information, about the children's functional status in the camping, to the Child Psychiatrist and the Social Worker of TYPET, who have the responsibility of family consultation.
  • Participation to the planned meetings with children, parents, specialists and TYPET officials.

• The participation of mentally handicapped children in specially planned camping programs may be very useful for their mental, emotional or physical development and for their socialization.
• The living together of healthy and handicapped children may be very useful for both, because:
  • Handicapped children are encouraged to develop their mental, physical and social capabilities.
  • Healthy children learn to communicate directly and sincerely and to express genuine and warm feelings. The same holds for the staff.
• Specially trained personnel may contribute to the education of not trained personnel.
• The Child Psychiatric Consultation in a camping program for mentally handicapped children, should have the following characteristics
  • It should be adapted to the recreational character and the other functional rules of the camping.
  • It should have a multilevel - multifocal character. Namely:
    • It should contribute to the organization, development and evaluation of the program.
    • It should be applied to the organizers and the personnel, as well as the children, who participate in the program.
  • It should aim to the promotion of cooperative relations among all the members and groups of the staff, in any level of hierarchy, because this is a necessary presupposition for the pleasant and productive living of children in the camping.
  • It should be educational in an experiential manner.
• Further consultation was asked by TYPET to the Child Psychiatrist, for the development of its camping programs for healthy children.