Two Eyed Seeing Diagnosis

• The Diagnostic Team
• The Eastern Door Process Step by Step
• Referrals to the Team



• Eastern Door Centre – Screening, Diagnosis and Post – Diagnostic Process
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The Diagnostic Team

The ED diagnostic team provides trauma informed TES diagnostic services for FASD and related disorders. At this time the ED offers regular centre services to youth (ages 3-18+) who live in Elsipogtog although we will help others access diagnosis. The team consists of a traditional healer, physician, nurse practitioner, and family outreach social workers, as well as multi-disciplinary specialists—psychologist, occupational therapist, speech and language pathologist, physiotherapist, and the school resource and methods coordinator. Team members are leveraged from the staff of NB provincial health and the Elsipogtog Health and Wellness Center (EHWC), and the Elsipogtog Education Authority (EEA) Office space is provided by the EHWC and the EEA.

The Eastern Door Process Step by Step

Half of the professionals on the team are Indigenous or married into the community. These team members speak Mi'kmaq, the language of the community. The family’s voice, particularly the birth mothers, is brought into the diagnostic clinic meeting by information gathered by the workers at the ED Family Outreach Program (EDFO). EDFO staff meet with the families of the referred youth, explain to them the clinic process and facilitate their active participation in the process. Youth voice is entered into the diagnostic clinic process through the use of the MW Difference Game Cards as they identify issues they feel are interfering with their well-being. The ED team uses a Two Eyed Seeing (TES) interdisciplinary diagnostic process that includes standardized assessments, medical examination, standardized diagnostic measurements, and a MW evaluation by the traditional healer. A Two-Eyed Seeing Assessment Wheel was developed at the ED inspired by Mi'kmaq Elders. This tool widens the lens of the mainstream FASD diagnostic process and allows diagnosis of other neurodevelopmental disorders related to adversity and trauma. Half of the TES wheel is a template to record the measurements needed for diagnosis using medically accepted diagnostic criteria of the Canadian FASD Guidelines and the DSM-5. The other half looks at these conditions as life-time disorders, reflecting other factors that might contribute to how prenatal alcohol or drug exposure might be expressed in an individual, family and community system. For instance there is a consideration of paternal alcohol use, secondary conditions, residential schooling, and a generational family trauma component extending back three generations. FASD is seen in the context of system adversity and transgenerational trauma rather than the simple result of PAE.

Referrals to the Team

Referrals to the ED clinic can come from physicians, parents, schools and community service agencies. Individuals can also self-refer. A referral form for the ED is available and may be sent to the Eastern Door.

Most ED referrals come through the school and are are based on an annual Elsipogtog school screening. This is a whole-system screening that occurs at the classroom level with classroom teachers as informants using the Medicine Wheel Student Index. This tool is now embedded in the Elsipogtog’s Educational Information System and is also available to any school that uses the Dadavan Outcomes Educational Information System. The MWSI data provides referral lists for individual specialists as well as for the ED. The goal is early identification and assessment.