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WHEN COLLABORATION LEADS TO AHEAD

MOVING AHEAD: Ronald Kosinski moderates the Family/Provider Relationship panel during October's AHEAD Symposium

BY BARBIE VARTANIAN AND DR. RONALD KOSINSKI

On Friday, October 2, 2020, the NYU College of Dentistry Oral Health Center for People with Disabilities, with the support of Project Accessible Oral Health (PAOH), Henry Schein, Special Olympics International, National Council on Disability, and other key stakeholders, held a one-day "game changing" event.

The Achieving Health Equity Through Access for All with Disabilities (AHEAD) symposium was conceptualized to address the state of oral health care for children and adults with intellectual and physical disabilities.

Determined to not have an agenda similar to many other dental and public health meetings, this event brought together experts and organizations in the areas of health care advocacy, access, and funding that would make a difference. Other important areas of discussion included the family/provider relationship, the impact of COVID-19 on the disability community, and the importance of public-private partnerships in advancing access to care, both locally and nationally. AHEAD drew in almost 500 participants that included a cross-section of academia, industry, insurance payers, providers, and parents.

The impetus behind the AHEAD Symposium was to showcase NYU's Oral Health Center for People with Disabilities. NYU has had a long legacy of addressing health disparities that exist with underserved populations. In the early 1970's, they pioneered a Special Care Clinic in which students rotated through and were exposed to the challenges that patients with special needs were present with.

Fast forward to 2017, when Dean Charles Bertolami observed a patient in a wheelchair who had their head strapped to the dental chair. He thought to himself, we can do better. That experience planted the seed which was to become NYU Dentistry's Oral Health Center for People with Disabilities. After providing President Hamilton of NYU with a Summary of Problems and Solutions, a team comprised of architects, contractors, vendors, IT and other disability experts were assembled to design and determine how to best utilize the 8,000 square foot space that was allocated to the Center.

Today, the Center houses nine large treatment rooms, a sedation area that includes two large suites, a nurse's station, recovery area, large sterilization space, as well as a spacious waiting room that includes a multi-sensory area. This innovative multi-sensory section was a collaborative effort between many of the other schools within NYU where prototypes have been developed to decrease anxiety and promote desensitization.

Our most recent collaboration was the development of a Virtual Reality Application which provides the patient with the ability to spend time virtually in the Center. NYU is the largest dental school in the nation and a leader in a paradigm shift in the way dental students are trained to embrace this patient population with the behavioral guidance options to avoid unnecessary sedation. The result has been astounding! All fourth-year dental students rotate through the Center where they are exposed to a myriad of patients with Intellectual and Physical disabilities many of whom have complex comorbidities.

The Center has a dedicated faculty and staff whose mission it is to ensure that all patients are treated with dignity and respect. The impact on the community as well as the dental students has been mutually beneficial. The hope is that graduates practicing in the community will be able to treat and triage these patients with support and confidence. Every specialty is represented in the Center, from endodontics to oral surgery. Multidisciplinary and interdisciplinary care is offered to all of the patients without needing to refer out of the Center. Even as the Center continues to evolve, it would never be where it is today had it not been for its partnerships. One which is most significant is the partnership with Project Accessible Oral Health (PAOH). PAOH is a is a global public-private partnership, and the first to nationally assemble and connect a consortium of dental and medical professionals, corporations, organizations, policymakers, educators, people with disabilities, caregivers, and other stakeholders in the pursuit of equal access to culturally competent oral healthcare. Collaboration is vital, and NYU Dentistry and PAOH are committed to ensuring that all individuals, including the disabled, have equal access to quality oral healthcare. •

ABOUT THE AUTHORS: Barbie Vartanian is Executive Director, Project Accessible Oral Health at The Viscardi Center Advisory Board, Oral Health Center for People with Disabilities. Dr. Ronald Kosinski is Clinical Director, NYU Dentistry Oral Health Center for People with Disabilities.

THE FOURTH EDITION OF DEVELOPMENTAL DISABILITIES IN ONTARIO

BY SHIRLEY MCMILLAN, RN, PHD, CDDN

This is a review of the 4th edition of Developmental Disabilities in Ontario. I would like to acknowledge from the outset that I have co-authored Chapter 32 (Physical Health and People with Developmental Disabilities) with the late Dr. Thomas Cheetham. Despite the book's title of Developmental Disabilities in Ontario, the reader will discover throughout the chapters the book is a valuable resource for anyone working in the field of Developmental Disabilities.

It should be noted the term developmental disabilities is used, and this is due to the legislation in Ontario. In other jurisdictions, the term intellectual disabilities and learning disabilities may be used. The central issue of this book is on the most relevant and up-to-date information and research that will assist in the work of those in the field to support individuals with developmental disabilities.

I will not comment specifically on a chapter, however will review the quality and breadth of the topics that are covered in this book. The forward of the book is written by Mark Benner, who began his career in the field of developmental disabilities as a social worker in a provincial institution, and currently is a professor in the Developmental Services Worker Program at Fanshawe College in London, Ontario. Developmental Services Worker is the title given to workers who support individuals with developmental disabilities in Ontario. However, the term is synonymous with direct support professional, as may be found in the United States. The role of these individuals is very similar and vital in the care of individuals with developmental disabilities.

The first edition of this book was published during the time I was teaching in the Developmental Services Worker program at the college level in Ontario. This was the first textbook that was specific to the work in Ontario, and when the book became available, it was placed on the required list of textbooks used in the majority of college programs in the field.

In total, as the reader will find in this edition, there are 50 chapters that speak to the issues throughout the lifespan. As an example, there is a chapter on the first 1000 days of fetal and infant development, and the final chapter is devoted to aging in people with developmental disabilities. The book's first chapter provides a definition of developmental disabilities, thus setting the stage for the reader regardless of where he/she is working in the field in the world.

The book covers, as identified above, a wide range of topics, and the editors sought to have the experts who have extensive knowledge, as well respect in their specific area in the field, to contribute content that reflects their expertise. It should be noted, as one browses the book, the authors of the chapters are not limited to Ontario and represent knowledge across Canada, the United States, and the United Kingdom. The main focus of this book is to update the reader on a wide variety of topics that are pertinent to enhance their support of individuals with developmental disabilities.

Each chapter covers the particular subject in a balanced fashion and there is effective presentation of the theme. The subject of the chapter is approached in a topical analytical and descriptive manner as possible. It provides the reader with an unbiased understanding of the topic being covered in the chapter. The argument in each chapter offers evidence to the reader in the form of the most recent literature review, and the evidence is convincing.

Title: Developmental Disabilities in Ontario – 4th Edition

Editors: Ivan Brown and Maire Percy

Publisher: Delphi Graphic Communications

Publication Date: August 2020

Paperback: 833 pages

ISBN-13: 978-1-7771637-0-9

Available at: oadd.org

In summary, this book offers information that is relevant to a wide range of individuals in the field of developmental disabilities at whatever level of knowledge, ranging from novice to expert. This this book is of assistance to the student in the Developmental Services Worker field who is beginning his/her career there, to those who are teaching in the education field of developmental disabilities, to the clinicians in the field. I have each edition sitting on my book shelf and often will refer to a chapter for information or guidance, not only for my own knowledge, but also for a nursing student I may be mentoring. I encourage anyone in the field to peruse this book and appreciate the knowledge and experience that is shared by the authors. •

ABOUT THE AUTHOR: Shirley McMillan, RN, PhD, CDDN is Clinical Nurse Specialist - Adult Program, Surrey Place, Toronto, Ontario.

ABOUT THE ONTARIO ASSOCIATION ON DEVELOPMENTAL DISABILITIES:

The Ontario Association on Developmental Disabilities (OADD) is a professional organization of people working and studying in the field of developmental disabilities, throughout Ontario. OADD's members include agencies and organizations; university and community college students and instructors; service provider direct care staff and managers; family support workers; case managers; psychologists; social workers; and other dedicated individuals. Developmental Disabilities in Ontario, fourth edition, is the new edition of the preeminent comprehensive text specifically for Ontario readers. This complete book of 50 chapters – covering a broad range of topics and issues about developmental disabilities in Ontario today – is an essential resource for both professional and everyday use.