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Supporting Families Impacted by Mental Health Problems, Substance Abuse, and Trauma

Protective Factors: Helping to Building Resilience

1. Protective factors that have been shown to lead to better outcomes for children include:

A. The mental health and psychological resilience of the parents or other caregivers

B. The presence of a good support system

C. The child's own social-emotional and cognitive capabilities

D. All of the above


Principles Of A Responsive Community

2. A responsive community recognizes that families are often seen at their most difficult times, but hope can be rebuilt by acknowledging the family's ___________.

A. Values

B. Strengths

C. Support System

D. Experiences


How Early Experiences Shape The Developing Brain

3. While a newborn's brain is about one-quarter the size of an adult's, it grows to about 60% by age 3.

A. True

B. False


4. The area of the brain that is responsible for infants' growing ability to soothe themselves when upset and toddlers' beginning attempts to delay gratification is the:

A. Cerebral Cortex

B. Hypothalamus

C. Limbic System

D. Sensory Strip


5. The thinking and emotional centers of a baby's brain are strengthened by consistent and nurturing relationships along with sensory stimulation from exploration and play.

A. True

B. False


What All Children Need: The Five R's

6. Which of the following is NOT one of the Five R's that all children need?

A. Respect for the child, and for the child's family and culture

B. Routines that provide comfort for the child

C. Repetition of activities to strengthen the connections between brain cells

D. Resiliency to face difficult situations


A Community Of Caregivers

7. Though psychologists in the United States have focused on the importance of the primary caregiver, there is theory and clinical evidence to suggest that having a few close attachment relationships helps a baby or toddler be more resilient.

A. True

B. False


Preventing Multiple Placements In Foster Care

8. Multiple changes in caregivers for young children can cause depression, anxiety, _______________, and other emotional changes that interfere with daily functioning.

A. Grief reactions

B. Isolation

C. Poor social development

D. None of the above


Threats To Resilience

9. Research indicates that intelligence and temperament continue to be the most important factors in ensuring a child's resiliency.

A. True

B. False


10. Of all age groups, __________________ are the most vulnerable to the destructive impact of severe stress.

A. Adolescents ages 13-17

B. Children ages 8-12

C. Children ages 4-7

D. Infants and Toddlers


Maternal Stress and Substance Abuse in Pregnancy

11. In 1994, methamphetamine use accounted for 8% of all admissions to federally funded drug treatment centers for pregnant women, but by 2006 that number was:

A. 16%

B. 20%

C. 24%

D. 28%


Types of Stress

12. Toxic stress generally occurs in response to an event or series of events that threaten serious injury or death to a child or others.

A. True

B. False


13. High levels of cortisol for long periods of time can disrupt developing circuits in the brain, leading to depression, anxiety, PTSD, behavioral and learning difficulties, and health problems in adulthood.

A. True

B. False


Tolerable Stress

14. Like positive stress, tolerable stress can actually help build later resilience to stressful situations by helping to calibrate a child's stress-response system.

A. True

B. False


15. A responsive community can offer a child a “zone of safety” which includes the presence of another adult who is aware of the importance of responding to the child's need for protection and soothing.

A. True

B. False


Toxic Stress

16. Traumatic stress is a severe form of toxic stress that is most likely to occur as a result of a horrific one-time event.

A. True

B. False


17. When children cry out for help and are either not responded to or are subjected to more abuse, they may give up and become quiet and withdrawn which is known as a defeat or _____________ response.

A. Submission

B. Cessation

C. Breakdown

D. Surrender


18. The vast majority of children who have been abused experience either the defeat or hyperarousal response, rather than a combination of the responses.

A. True

B. False


Signs Of Stress In Young Children

19. Signs of stress in infants include each of the following EXCEPT:

A. Cries more than usual

B. Becomes more responsive to stimuli

C. Sleeps all the time or has trouble sleeping

D. Eats more or doesn't want to eat


Toxic Stress From Lack Of Responsive Care

20. Studies have found that cortisol levels in neglected children can be as unstable as they are in children who are physically abused.

A. True

B. False


21. Child Parent Psychotherapy (CPP) is primarily based on _________________ although it integrates principles from multiple therapies.

A. Social-learning theory

B. Psychodynamic theory

C. Attachment theory

D. Cognitive behavioral theory


22. Studies show that reducing a mother's symptoms of depression is generally enough to enhance the well-being of the child.

A. True

B. False


Treatment For Mothers Who Abuse Substances

23. Comprehensive treatment programs for mothers who abuse substances have higher rates of program completion and lower rates relapse when they consider the role trauma plays in women's addiction and:

A. The importance of the maternal role

B. Strategies to reduce toxic stress

C. The inclusion of family and community

D. None of the above


24. Studies show that children in families with substance abuse problems are almost three times more likely to be abused and four times more likely to be neglected than other children.

A. True

B. False


Poverty Increases the Chances of Toxic Stress in Families

25. Young children are likely to display more symptoms of depression than adolescents, perhaps because they cannot express their thoughts and feelings about what they have seen and are less able than adolescents to actively seek comfort from others.

A. True

B. False


Many Caregivers Are Grappling With Effects Of Toxic Stress Themselves-Action Steps

26. Low-income mothers have been found to have especially high rates of postpartum depression, with ___ percent showing signs of clinical depression in a 2002 study.

A. 56

B. 48

C. 40

D. 32


Five Protective Factors: Building Opportunities for Responsive Caregiving in Families and Communities

27. Which of the following is NOT one of the conditions that helps determine whether caregivers parent effectively, even in stressful situations:

A. A support system for the family

B. Parenting tips, information, and skills courses for caregivers

C. The child's social-emotional and cognitive capacity

D. Physical resilience of the caregiver


Protective Factor #2

28. ROAD (Reaching Out About Depression) is a mental health care program that uses an individualized strength-based approach to improve methods for understanding issues of poverty, powerlessness, or depression.

A. True

B. False


Protective Factor #3

29. Motivational interviewing is a counseling technique that has been applied to a wide range of problem behaviors related to alcohol and substance abuse as well as:

A. Health promotion

B. Medical treatment adherence

C. Mental health issues

D. All of the above


Protective Factor #4

30. According to the Centers for Disease Control, there are approximately 50,000 cases of Shaken Baby Syndrome (SBS) each year, with about 4800 cases reported, and 18% of those babies dying.

A. True

B. False


Protective Factor #5

31. Parents struggling with substance abuse or mental health problems may be less patient with a child's natural curiosity about the surrounding world and may limit the child's healthy need to explore.

A. True

B. False


32. Developing _____________ skills is particularly important for children in families of abuse or neglect since parents at risk for child maltreatment may not have had the opportunity to develop these skills themselves.

A. Cognitive-sensory

B. Personal self-care

C. Social-emotional

D. Expressive-affective


Strong Communities Project

33. The Strong Communities Project of South Carolina targets neighborhood institutions as the key players in childhood abuse reduction, and focuses on family cohesiveness as the principal strategy in preventing child maltreatment.

A. True

B. False


34. Which of the following statements correctly describes outcomes of home visiting programs in helping children and families?

A. The Nurse-Family Partnership (NFP) has been shown to cut incidences of child abuse and neglect up to 59% compared to similar families in control groups

B. One study showed that at age 6, children who participated in the NFP program had higher cognitive and vocabulary tests than children who did not have the opportunity to have comprehensive support

C. At age 9, NFP children scored higher on achievement tests in writing and social studies than non-NFP children

D. At least eight national home visiting models have been shown to positively affect outcomes for both the mother and the child


A Strategic Framework For Action

35. The five steps in the Strategic Prevention Framework include assessment, planning, implementation, evaluation, and:

A. Target

B. Motivation

C. Capacity

D. Coordination


Cultural Competency & Sustainability

36. Becoming culturally competent includes gaining an awareness of “cultural scripts” that dictate behavior in a fixed and rigid way.

A. True

B. False


Assessment: Determining Your Community's Needs

37. Prevalence refers to the rate of new occurrences of a studied condition in a set period of time, such as the number of people who hurt their back in a month.

A. True

B. False


Identify and Learn About Your Population

38. Once community needs have been assessed and a focus population has been chosen, it is important to learn more about the factors that might motivate them to seek support and treatment as well as those that may prevent them from doing so.

A. True

B. False


Gather New Information as Needed

39. Focus groups may help develop an action strategy by gaining insight into the participants' past experiences with interventions and by learning how best to engage caregivers who may feel stigmatized.

A. True

B. False


Improving Your Community's Capabilities-Partnership At Six Levels Of Engagement

40. Coordination partners are those who publicly endorse each other's programs to broaden appeal or lend credibility.

A. True

B. False


41. Coalitions may be beneficial as a way to allow single organizations and individuals to maximize their time, resources, reach, and impact on the community by helping to create a shared vision with agreed upon goals.

A. True

B. False


Tips for Building and Maintaining a Coalition

42. Strategies for building and maintaining a coalition include each of the following EXCEPT:

A. Engage a broad group of key stakeholders, including people you already know

B. Shape a collective identity tied to the goal of reducing mental health or substance abuse problems or trauma in your community

C. Talk about roles and responsibilities of the coalition up front but wait to acknowledge and address turf issues until the coalition has been well established

D. Re-examine the process for decisionmaking and shared rules of engagement


43. While program goals often take a long time to achieve, objectives are the short-term and intermediate changes in ___________, attitudes, and smaller behavior changes that lead to desired major behavior changes.

A. Awareness

B. Responses

C. Perspective

D. Approaches


44. An increase in the number of early childcare workers who are trained to recognize the signs and symptoms of trauma in young children is an example of a community program goal.

A. True

B. False


Determine Your Strategies

45. A public advocacy strategy was used successfully in New Jersey to mandate that health care professionals educate and screen new mothers for postpartum depression, making it the first state to do so.

A. True

B. False


46. When developing a program it is important to learn about shared values, ideals and beliefs of the population as well as their cultural context and:

A. Expectations

B. Needs

C. Priorities

D. Readiness


Implementation: Getting to Action

47. Good program evaluation means carrying out components of an action plan and keeping track of how the activity is delivered, which is known as procedural appraisal.

A. True

B. False


How to Evaluate Your Program

48. Most outcome evaluation methods involve collecting data about participants through observation or a questionnaire.

A. True

B. False


Refining Your Program

49. Since the program planning process is circular, the end of evaluation is not the end of the process but the step that takes program planners back to the beginning in order to identify areas that should be changed, deleted or augmented.

A. True

B. False


50. Which of the following is an evaluation question that addresses program accountability?

A. Do the assessment results show a need for new activities that would require partnerships with additional organizations?

B. Are there strategies or activities that did not succeed?

C. What are the barriers you are encountering?

D. Should successful activities be continued and strengthened because they appear to work well or should they be considered successful and completed?


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