Targeted Social and Emotional Supports

Report
A Look at Fond du Lac County
SPROUT Partnership
Presented by:
Dr. Matt Doll, Diane Fett,
Matricia Patterson & Andrea Welsch
Overview of Presentation
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The Early Years Matter (Matt)
A Community Plan (Diane)
Collaborative Team (Matricia)
Collective Impact (Andrea)
The Early Years Matter
The Earliest Years
Leave a Permanent Imprint
During a child’s first
three to five years:
• Up to 90% of a child’s brain
development takes place
• Patterns of behavior
are formed
• A child’s learning capacity is
firmly and broadly established
“The later in life we attempt to repair early deficits,
the costlier the remediation becomes.”
- James J. Heckman, 2000 Nobel Laureate in Economics
Five Things To Know
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Neurodevelopment Processes
Genetic predisposition exasperated by environmental
influences (Nature And Nurture)
Long term negative outcomes for physical health,
emotional health and society for bad things
happening to children.
Long term positive outcomes when good things
happen, potentially protective as well.
These issues impact us all; no social, economic or
cultural group is immune.
Across the Lifespan
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Intrauterine Experience - Heart Disease, Obesity,
Diabetes, Pollution, Mental Illness.
Adverse Childhood Experiences (ACE) - long-term
changes in brain structure and function. 67% of all of
us (87% < 1 ACE).
Mortality - Individuals with an ACE score of 6 and
higher had a lifespan almost 2 decades shorter than
seen in those with an ACE Score of 0 but who
otherwise have similar characteristics.
Social and Emotion Health is
Directly Impacted by Experiences
Adverse Childhood Experiences (ACEs)
Neuroscientists have linked childhood maltreatment
to long-term changes in brain structure and function.
Stress hormones interfere with mylenation:
impacting the connective tissue between
hemispheres - logical/emotional state lacks
integration.
Parts of brain responsible for affect regulation,
learning and memory.
Type of abuse: Verbal Abuse- Auditory Cortex;
Witnessing Domestic Abuse-Visual Cortex
Stunning difference between a brain with proper stimulation and one that has
been deprived. - Bruce Perry, Baylor College of Medicine
Serve and Return (1:42 min)
http://www.youtube.com/watch?v=
m_5u8-QSh6A
Process by which attachment forms
Can be taught.
High jacked by Media?
How would you know what to do
when you have never experienced it?
How would you know what not to do
if it was all you knew?
Attachment (still face 2:49)
http://www.youtube.com/watch?v=apzXGEbZht0
Maternal Depression/Mental Illness
Impact on Attachment is across the lifespan.
Sensitive periods.
Estimates of secure attachment in general
population between 55-65%
About 40% of children insecurely attached.
As high as 90% in some impacted populations.
Inability to form quality relationships or have
empathy for others.
Socially deprived cohort of mothers
With High Mentalization:
10/10 secure children
With Low Mentalization:
1/17 secure children
Mentalization confers resilience:
ability to recognize your own and others’ mental
states, and to see these mental states as separate
from behavior
Trauma and early attachment
patterns determine brain
development.
Clare Pain, M.D.
Bessel A. Van der Kolk, M.D.
Martin H. Teicher, M.D., Ph.D.
Marylene Cloitre, Ph.D.
Judith Herman, M.D.
National Child Traumatic Stress Network
Trauma & Attachment
Theory of Change (5:18 min)
http://www.youtube.com/watch?v=urUa_FsS5Y
Personal Responsibility? (1:01 min)
http://www.youtube.com/embed/RBqjZ0KZ
Ca0?showinfo=0&rel=0&hd=0FsS5Y
Why It Matters
• Until now, these persistent effects were
“hidden” from the view of both
neuroscientists and public health researchers
• This is no longer the case. In fact, with this
information comes the responsibility to use it.
• If we can think long term instead of short
term, our community’s social, emotional,
health and economic welfare will benefit.
In Other Words…
Communities need to build their capacity to deliver traumainformed care services to achieve safety, permanency and well
being for their children and families and develop community
building activities to reduce ACES over the long term
(Trauma Exposure Among Select Wisconsin Families in the Child Welfare System 2008-2010)
Root Cause
Return on Investment
Measurable Goals and Outcomes
Cradle to Career
Manufacturing Graph
Lean 6 Sigma Processes
“Unemployable Populations”
Skilled Worker Shortages
A Community Plan
We finally know…
• What Nurses have known all along
• What Home Visitors have long
suspected
• What the Health Profession has been
trying to tell us…
• This is bigger than any one of us
• There are no quick fixes
Taking What We Know and
Changing What We Do
• A healthy community rethinks business as
usual
• Rolls up its sleeves,
• Works smarter, not harder,
• Works together, not alone,
• Uses research and science as a guide
The Beginning: A Look at our History
• The Wisconsin Alliance for Infant
Mental Health connection
• Department of Health, Division of
Public Health
• 1 of 3 Communities Chosen
• Small Planning Group Formed
1st Summit: October 17, 2008
• Broad Sponsorship
• Introduction of Infant Mental Health
Concepts
• 85 people attended
• Committees were formed
Defining Infant Mental Health
Infant Mental Health is synonymous with
healthy social-emotional development
including the developing capacity of a
child to:
• Experience, regulate, and express emotions;
• Form close interpersonal relationships; and
• Explore the environment and learn – all in the
context of family, community, and cultural
expectations for young children
(Zeenah, Stafford, Nagle, & Rice, 2005)
Strengthening Each Child’s
Capacity
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Self confidence
Curiosity
Motivation
Persistence
Self Control
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Trust
Regulate and Express Emotions
Form Close and Secure Relationships
Identify Feelings
Empathy
The Pyramid Model
Focus of Work
Centers on the
Social and
Emotional
Foundations for
Early
Learning
It Started With a Vision
OUR VISION
Every Fond du Lac County child will have his/her social and
emotional developmental needs met within the context of
family, culture, education, and community.
OUR MISSION
The Infant and Early Childhood communities of Fond
du Lac County will strengthen its ability to support the
social and emotional health of young children with
Nurturing and Responsive Relationships, High Quality
Supportive Environments, Targeted Social and
Emotional Supports and Intensive Interventions.
2nd Summit: October 26, 2010
The Plan is Shared
• Presentations by law enforcement, elected
officials, business and others, about the
importance of the early childhood and received
• Plan endorsement from many agencies
• Committee support expanded
2011: The Partnership is Formed
• Brown County United Way – Community Partnership
presented their model to community members at the
UW-Fond du Lac Campus
• The Fond du Lac County Community Partnership for
Young Children held its first meeting
• The Fond du Lac School District Comprehensive
Service Integration – Element 5 Committee merged
with SPROUT
• Committee work began implementation of the
SPROUT Plan
The Name: SPROUT Partnership
Supporting
Positive
Relationships so
Our Children
Under 6 can
Thrive
A Collaborative Team
KEEP FOCUSED
OUR GOAL:
All Fond du Lac County children are healthy, nurtured, safe
and successful from birth to school entry.
• In turn, we build a strong community, a strong work force,
and reduce crime and poverty.
• Science finally catches up with what we have known all
along:
• Relationships matter
• Early experiences matter
• Adverse Childhood Experiences impact health and
potential
Structure, Support, Guidance
Council Representatives
Executive
Committee
Responsive
Relationships
Supportive
Environments
Social and
Emotional
Supports
Children & Caregivers
Intensive
Interventions
Structure, Support, Guidance
Council Representatives
Children & Caregivers
Supporters
Council Reps
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Parents
Physicians / Health
Child Care
Head Start / Birth to 3
Social Services
Housing / Shelter
Domestic Violence
Services
• Law Enforcement
• Child Welfare
• Mental Health
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Children’s Museum
Library
Faith Based
WIC
Public Health
Early Childhood
Education
Higher Education
Media
Business
United Way
Government
Legislators
Structure, Support, Guidance
Council Representatives
Administrators
Children & Caregivers
Structure, Support, Guidance
Council Representatives
Children & Caregivers
Collective Impact
Challenges
• Funding
• Coordination &
Coordinator Role
• Engagement
Successes
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Funding
Coordination
Engagement
Structure / Commitment
Champions / Decision Makers
100’s Impacted / Evaluation
Evidence Based
Recognition
Collective Impact
Effecting Change
Base of Pyramid
Nurturing and Responsive Relationships: People who touch
the lives of infants, young children and their families know
how to foster healthy social and emotional development.
Supportive responsive relationships among adults and
children is an essential component to promote healthy
social and emotional development
Nurturing and Responsive
Relationships
Library
School
Disctrict
Family
Resource
Center
Children’s
Museum
N&RR
Health
Department
Birth to 3
AHC
Aurora
Key Projects of N&RR Committee
• Coordinated delivery of training
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Targeting parents and caregivers
Focusing on healthy interactions for social emotional
development.
Embedded skills such as literacy, resiliency, language, and
learning through sensory-motor activities.
Breaking the Cycle: July 2014 Zero to Three
• Developed and distributed a County Resource Guide
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Parents, Caregivers, and Providers
Comprehensive list of resources available within our
community.
Resource Guide Excerpt
The Second Layer
High Quality Supportive Environments: All
children will have high quality supportive
environments, including their own homes.
High quality early childhood environments
promote positive outcomes for all children.
Supportive Environments
Family
Connections
YMCA
Childcare
Parent
SE
AHC
MPTC
Health
Department
Fond du Lac
County
Key Projects of SE Committee
• Coordinated delivery of training to childcare centers
• Breast Feeding Friendly Centers  Targeting training for 14
centers in 2014
• Quality Focus: Activities to support Young Star Ratings
• PBIS - Behavioral System (originated in school district)
• Promoting effective use and access to ASQ screens
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Goal  Periodic Screens (18 mos)
Education across Council
Creation of WIC screening sites
Critical access points (pediatricians, homeless shelters,
domestic abuse)
Third Layer
Targeted Social Emotional Supports: There will be a
coordinated community approach for teaching
social and emotional skills to ensure children’s
school readiness.
Systematic approaches to teaching social skills can
have a preventive and remedial effect
Targeted Social and Emotional
Supports
Birth to 3
Social
Services
Health
Dept
TSE
ADVOCAP
Head
Start
Solutions
Center
School
Districts
Key Projects of TSES Committee
• Coordinated delivery of Conscious Discipline
Curriculum
• Targeting child care centers and parents
• 80 participants, 6 child care centers, 1 in home provider
• Evidenced Based
• Targeted Parental Supports
• Parents going through Paternity Cases
• Access to ASQ screens to homeless & families
experiencing domestic abuse
The Top of the Pyramid
Intensive Interventions: Children with emerging mental health
symptoms will receive evidence based treatment by trained and
knowledgeable providers in partnership with parents and other
caregivers resulting in optimal development. Families and
children will feel supported by competent, knowledgeable and
sensitive professionals and caregivers.
Assessment based intervention that results in individual
behavioral support plans
Intensive Interventions
Birth to 3
School
Districts
AHC
Social
Services
Health
Department
II
ADVOCAP
Head Start
Family Court
Marian
University
Early
Childhood
Doll &
Associates
Key Projects of II Committee
• Dr. Navsaria  Reach out and Read (Oct 16th)
• Targeting cross sector business, physicians,SPROUT
partners and parents
• June 2014 Journal of American Academy of Pediatrics
• PICCOLO Training
• Parenting Interactions with Children: Checklist of
Observations Linked to Outcomes
• Targeting  Practitioners working with children 10-47
months
• Observing, tracking and supporting parent interactions
• Affection, Responsiveness, Encouragement & Teaching
The Executive Committee
Council
Children &
Caregivers
Key Projects of Exec Committee
• Coordination of Plan Goals Across Committees
• Funding & Sustainability
• Council Surveys  Monitor & Respond
• Community Wide Awareness, beginning with:
It matters to all of us!
Wrap Up
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Questions?
Closing comments?
Final thoughts?
Reference Materials
Next Steps?
Thank you for coming!
Piglet sidled up to Pooh from behind.
“Pooh”, he whispered.
“Yes, Piglet?”
“Nothing,” said Piglet, taking Pooh’s paw.
“I just wanted to be sure of you”.
A.A. Milne
Presentation Reference Materials
http://www.youtube.com/watch?v=m_5u8-QSh6A
Process by which attachment forms
Official Journal of American Academy of Pediatrics
Literacy Promotion: An Essential Component of
Primary Care Pediatric Practice, June 2014
http://www.youtube.com/watch?v=apzXGEbZht0
Maternal Depression/Mental Illness
Impact on Attachment is across the lifespan.
Sensitive periods.
Zero to Three: Breaking the Cycle; Supporting
Parent-Child Relationships Through the “Parents
Interacting with Infants” Intervention, July 2014
http://www.youtube.com/watch?v=urU-a_FsS5Y
Theory of Change
Early Learning Challenge Technical Assistance:
Supporting Children Through Community Based
Coalitions, December 2013
http://www.youtube.com/embed/RBqjZ0KZCa0?sh
owinfo=0&rel=0&hd=0FsS5Y
Personal Responsibility?
The Future of Children; Princeton Bookings:
Early Stress Gets Under the Skin: Promising
Initiatives to Help Children Facing Chronic Adversity

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