1. A Look at Fond du Lac County SPROUT Partnership
Presented by:
Dr. Matt Doll, Diane Fett,
Matricia Patterson & Andrea Welsch

2. Overview of Presentation
The Early Years Matter (Matt)
A Community Plan (Diane)
Collaborative Team (Matricia)
Collective Impact (Andrea)

3. The Early Years Matter

4. 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

5. Five Things To Know 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.

6. Across the Lifespan
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.

7. Social and Emotion Health is Directly Impacted by Experiences

8. 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

9. Stunning difference between a brain with proper stimulation and one that has been deprived. - Bruce Perry, Baylor College of Medicine

10. Serve and Return (1:42 min)
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?

11. Attachment (still face 2:49)
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.

12. 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

13. 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

14. Trauma & Attachment Theory of Change (5:18 min)
Personal Responsibility? (1:01 min)

15. 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.

16. In Other Words…
Communities need to build their capacity to deliver trauma-informed 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 )
Root Cause
Return on Investment
Measurable Goals and Outcomes
Cradle to Career
Manufacturing Graph
Lean 6 Sigma Processes
“Unemployable Populations”
Skilled Worker Shortages

18. A Community Plan

19. 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

20. 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

21. 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

22. 1st Summit: October 17, 2008 Broad Sponsorship
Introduction of Infant Mental Health Concepts
85 people attended
Committees were formed

23. 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)

24. Strengthening Each Child’s Capacity
Self confidence
Curiosity
Motivation
Persistence
Self Control
Trust
Regulate and Express Emotions
Form Close and Secure Relationships
Identify Feelings
Empathy

25. The Pyramid Model Focus of Work Centers on the Social and Emotional
Foundations for Early
Learning

26. 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.

27. 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

28. 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

29. The Name: SPROUT Partnership
Supporting
Positive
Relationships so
Our Children
Under 6 can
Thrive

30. A Collaborative Team

31. 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

32. Structure, Support, Guidance
Council Representatives
Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Children & Caregivers

33. Structure, Support, Guidance
Supporters
Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers

34. Council Reps Children’s Museum Library Faith Based WIC Public Health
Early Childhood Education
Higher Education
Media
Business
United Way
Government
Legislators
Parents
Physicians / Health
Child Care
Head Start / Birth to 3
Social Services
Housing / Shelter
Domestic Violence Services
Law Enforcement
Child Welfare
Mental Health

35. Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Administrators

36. Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Executors of Plan & Embracers

37. Collective Impact Challenges Successes
Funding
Coordination & Coordinator Role
Engagement
Funding
Coordination
Engagement
Structure / Commitment
Champions / Decision Makers
100’s Impacted / Evaluation
Evidence Based
Recognition

38. Collective Impact
Effecting Change

39. 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

40. Nurturing and Responsive Relationships
N&RR
Library
Children’s Museum
Birth to 3
AHC
Aurora
Health Department
Family Resource Center
School Disctrict

41. Key Projects of N&RR Committee
Coordinated delivery of training
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
Parents, Caregivers, and Providers
Comprehensive list of resources available within our community.

42. Resource Guide Excerpt

43. 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.

44. Supportive EnvironmentsSE
Family Connections
YMCA Childcare
Health Department
Fond du Lac County
MPTC
AHC
Parent

45. 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
Goal  Periodic Screens (18 mos)
Education across Council
Creation of WIC screening sites
Critical access points (pediatricians, homeless shelters, domestic abuse)

46. 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

47. Targeted Social and Emotional Supports
TSE
Birth to 3
Health Dept
ADVOCAP Head Start
School Districts
Solutions Center
Social Services

48. 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

49. 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

50. Intensive InterventionsII
Birth to 3
AHC
Health Department
Family Court
Doll & Associates
Marian University Early Childhood
ADVOCAP Head Start
Social Services
School Districts

51. 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 months
Observing, tracking and supporting parent interactions
Affection, Responsiveness, Encouragement & Teaching

52. The Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Council
Children & Caregivers

53. 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!

54. Wrap Up Questions? Closing comments? Final thoughts?
Reference Materials
Next Steps?

55. 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

56. Presentation Reference Materials
Process by which attachment forms
Maternal Depression/Mental Illness
Impact on Attachment is across the lifespan.
Sensitive periods.
Theory of Change
Personal Responsibility?
Official Journal of American Academy of Pediatrics
Literacy Promotion: An Essential Component of Primary Care Pediatric Practice, June 2014
Zero to Three: Breaking the Cycle; Supporting Parent-Child Relationships Through the “Parents Interacting with Infants” Intervention, July 2014
Early Learning Challenge Technical Assistance: Supporting Children Through Community Based Coalitions, December 2013
The Future of Children; Princeton Bookings:
Early Stress Gets Under the Skin: Promising Initiatives to Help Children Facing Chronic Adversity