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Promoting Community Systems of Care to Foster Young Children’s Social and Emotional Development

Promoting Community Systems of Care to Foster Young Children’s Social and Emotional Development. WELCOME!. Introductions What brought you here today? What are you most excited about learning? Is there someone you are hoping to make a connection with while you are here?. Today’s Goals.

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Promoting Community Systems of Care to Foster Young Children’s Social and Emotional Development

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  1. Promoting Community Systems of Care to Foster Young Children’s Social and Emotional Development

  2. WELCOME! • Introductions • What brought you here today? • What are you most excited about learning? • Is there someone you are hoping to make a connection with while you are here?

  3. Today’s Goals • Focus on early childhood (birth to age 5) • Heighten awareness about the importance of social and emotional development • Encourage the importance of self-care & colleague support • Provide state and national resources related to social and emotional development • Allow time to consider your community system of care related to early childhood social and emotional development

  4. Guiding Principles • Child and family focus • Healing occurs in supportive relationships • Professionals must care for themselves and support one another in order to care for others • Shared responsibility across professionals sectors is essential • Children receive support according to their level of need, as offered by a spectrum of care within the community

  5. The Core Story • CHILD DEVELOPMENT IS THE FOUNDATION OF PROSPEROUS COMMUNITIES. • Brains are built over time, from the bottom up (skill begets skill) • Genes and experiences together build brains (serve and return relationships) • Cognitive, social and emotional development are inextricably intertwined • Toxic stress damages brain architecture • Resilience is not an internal character strength, but rather is built through combined impact of genes and experiences of a child • For many functions, the brain’s capacity for change decreases over time (cost-effectiveness factor) - but not all P.Levitt, 2013

  6. The Challenge • Social and emotional development is foundational, and impacted by internal and external forces • Early traumatic experiences are common • In Wisconsin (2010) • 4,839 child victims of maltreatment • Represents 3.7 children per 1,000 children in the State WI Department of Children and Families, Wisconsin Child Abuse and Neglect Report, 2011

  7. The Challenge: Child Maltreatment U.S. Dept. Health and Human Services, 2010

  8. The Challenge: Childhood Mental Illness • >14 million children and adolescents in the US (1 in 5) with a diagnosable mental health disorder • Only 20-25% of affected children receive treatment or support US DHHS Surgeon General’s Report (1999); AACAP Committee on Health care Access and Economics, Pediatrics (2009) reference

  9. Community System of Care • What is a community system of care? • Who should be a part of a community system of care? • Families • Professionals

  10. Community Systems of Care Goal Expedited and enhanced care for children and families to promote optimal outcomes

  11. Community System of Care: Pyramid Model for Supporting Social Emotional Competence in Infants and Young Children

  12. For Consideration • Where are you in the spectrum of care? • Who are your community partners in the other parts of this spectrum? • How successful are your efforts to connect with other community partners on this spectrum? • How might this connection be improved?

  13. Social and Emotional Development

  14. What is Social and Emotional Development? Zero To Three : National Center for Infants, Toddler and Families – Infant Mental Health Task Force The developing capacity of a young child to: • Experience, regulate and express emotion • Form close and secure interpersonal relationships • Explore the environment and learn All within the context of family, community and cultural expectations for young children

  15. Infant and Early Childhood Mental Health Develops through relationships with parents and other caregivers. • Is fostered through nurturing and supportive relationships. • Teaches the child that she/he has an impact on her/his environment.

  16. Relationships are the Basis of a Child's Stress Response System Calm High Arousal Adapted from B. Perry, MD, PhD. (2009)

  17. Relationships are the Basis of a Child's Stress Response System Calm High Arousal Adapted from B. Perry, MD, PhD. (2009)

  18. “There is no such thing as a baby, there is a baby and someone else…” -D.W. Winnicott

  19. Think of a child you know who is socially/emotionally skilled. What does that look like? Think of a child who struggles and is hard to reach. What does that look like? Social and Emotional Skills

  20. Social Emotional Competence • Trust • Self-Confidence • Motivation • Persistence • Self-Control

  21. Stress Impacts Social and Emotional Development

  22. Stress Responses in Childhood AAP, Helping Foster and Adoptive Families Cope with Trauma, 2013

  23. Some Stressors in Childhood AAP, Helping Foster and Adoptive Families Cope with Trauma, 2013

  24. Other Factors Influencing Stress AAP, Helping Foster and Adoptive Families Cope with Trauma, 2013

  25. Traumatic Alterations • Experience • Epigenetic modifications • Changes in brain structure and function • Behavioral attempts to cope • May be maladaptive in other contexts AAP, Helping Foster and Adoptive Families Cope with Trauma, 2013

  26. Epigenetic Changes • Alterations in the way the genetic program is read • Can cause structural changes in developing brain • Can influence the stress response

  27. Disruptions in Brain Architecture with Toxic Stress Three important brain structures: Amgydala Hippocampus Frontal cortex Prefrontal Cortex

  28. The Impact of Early Adversity on Children's Development

  29. Disrupted Brain Architecture Can Influence Behavior Behavior changes seen in young children Additional behavior changes seen in older children, adolescents and young adults

  30. Maladaptive Behavior Can Be Misleading • Potential misdiagnoses • Attention Deficit Hyperactivity Disorder • Oppositional Defiant Disorder • Bipolar Disorders Behaviors that worked previously, continue to result in some gain

  31. Adverse Childhood Events (ACEs) • ACEs (before age of 18) • Physical abuse • Emotional abuse • Sexual abuse • Alcohol and/or drug abuser in household • Incarcerated family member • Household member chronically depressed, mentally ill, institutionalized or suicidal • Violence between adults in the home • Parental separation or divorce • Original Study (1995-1997) • Wisconsin Behavioral Risk Factor Survey (BRSFS) (2010)

  32. http://www.cdc.gov/ace/

  33. Significant Adversity Impairs Development in the First 3 Years Barth 2008, Center on the Developing Child at Harvard University

  34. State and National Resources

  35. There is Good News… Identifying toxic stress and social and emotional development concerns and referring children and families to supports and services have the potential to positively impact the child’s life- long health and prosperity. AAP, Helping Foster and Adoptive Families Cope with Trauma, 2013

  36. Spectrum of Care Resources: Workforce Resources

  37. Resources for effective workforce development • Infant and Early Childhood Mental Health Providers • Wisconsin Alliance for Infant Mental Health • Infant, Early Childhood and Family Mental Health Certificate Program • Early Care & Education • YoungStar • Supporting Families Together Association • Clinicians & Care Team Members • American Academy of Pediatrics & The Wisconsin Chapter • General Development Promotion • Trauma-Informed Care • Self & Colleague Care and Reflective Supervision

  38. Wisconsin Alliance for Infant Mental Health • To stay connected with other early childhood professionals and to find out more about professional development opportunities, visit us at: www.wiaimh.org.

  39. UW Infant, Early Childhood and Family Mental Health Certificate Program Applications are currently being accepted for this interdisciplinary academic program: http://infantfamilymentalhealth.psychiatry.wisc.edu/

  40. YoungStar http://dcf.wisconsin.gov/youngstar/default.htm

  41. Supporting Families Together Association https://supportingfamiliestogether.org/ Offers training and technical assistance support to Child Care Resource and Referral Centers, Family Resource Centers throughout the State

  42. Wisconsin Chapter of the American Academy of Pediatrics Mental Health Webinar Series Collaboration between Wisconsin Chapter of American Academy of Pediatrics & Wisconsin Council of Child and Adolescent Psychiatry https://www.wiaap.org/wiaap-foundation/wacpp/

  43. American Academy of Pediatrics (AAP) Mental Health Toolkit • Focus Areas • Community resources • Health care financing • Support for children and families • Clinical information systems/delivery system redesign • Decision support for clinicians

  44. American Academy of Pediatrics (AAP) Trauma Guide Helping Foster and Adoptive Families Cope With Trauma Webinar Helping Foster and Adoptive Families Cope With Trauma: A Guide for Pediatricians Coding TipsVisit Discharge and Referral Summary for Family Parenting After Trauma: Understanding Your Child’s Needs http://www.aap.org/traumaguide

  45. Child Psychiatry Consultation Program • Call-in line for primary care clinicians to support them in caring for children with mental health needs • Staffed by child and adolescent psychiatrists • Support available Monday-Friday, during office hours • Pilot program beginning January 2015

  46. Birth to 5: Watch Me Thrive Resources for • Early Intervention Service and Early Childhood Special • Education Providers • Families • Primary Care Providers • Communities • Child Welfare • Home Visitors • Behavioral Health Providers • Housing and Homeless Shelter Providers • Parents http://www.acf.hhs.gov/programs/ecd/watch-me-thrive

  47. Trauma-Informed Care When faced with challenging behavior… “What happened to this child?” or “What is this family’s story?” Rather than “What’s wrong with this child or family?”

  48. Trauma-Informed Care Resources in Wisconsin Resources on Trauma Informed Care including an active listserv http://www.dhs.wisconsin.gov/tic/ Children’s Trust Fund :Wisconsin Adverse Childhood Experience & Trauma Workgroup http://wichildrenstrustfund.org/index.php?section=adverse-childhood

  49. Wisconsin Trauma Project • Introduce evidence-based trauma screening, assessment and treatment • Train parents and agency social workers on childhood trauma • Create a more trauma-informed & responsive system of care

  50. National Child Traumatic Stress Network (NCTSN) The NCTSN Mission To raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States http://www.nctsn.org/

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