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 placePatterns of behavior are formedA 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 LifespanIntrauterine 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 formsCan 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 IllnessImpact 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 childrenWith Low Mentalization:1/17 secure childrenMentalization 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 MattersUntil now, these persistent effects were “hidden” from the view of both neuroscientists and public health researchersThis 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 CauseReturn on InvestmentMeasurable Goals and OutcomesCradle to CareerManufacturing GraphLean 6 Sigma Processes“Unemployable Populations”Skilled Worker Shortages
19 We finally know… What Nurses have known all along What Home Visitors have long suspectedWhat the Health Profession has been trying to tell us…This is bigger than any one of usThere are no quick fixes
20 Taking What We Know and Changing What We Do A healthy community rethinks business as usualRolls 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 connectionDepartment of Health, Division of Public Health1 of 3 Communities ChosenSmall Planning Group Formed
22 1st Summit: October 17, 2008 Broad Sponsorship Introduction of Infant Mental Health Concepts85 people attendedCommittees 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; andExplore 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 confidenceCuriosityMotivationPersistenceSelf ControlTrustRegulate and Express EmotionsForm Close and Secure RelationshipsIdentify FeelingsEmpathy
25 The Pyramid Model Focus of Work Centers on the Social and Emotional Foundations for EarlyLearning
26 It Started With a Vision OUR VISIONEvery 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 MISSIONThe 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 receivedPlan endorsement from many agenciesCommittee 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 CampusThe Fond du Lac County Community Partnership for Young Children held its first meetingThe Fond du Lac School District Comprehensive Service Integration – Element 5 Committee merged with SPROUTCommittee work began implementation of the SPROUT Plan
29 The Name: SPROUT Partnership SupportingPositiveRelationships soOur ChildrenUnder 6 canThrive
31 KEEP FOCUSEDOUR 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 matterEarly experiences matterAdverse Childhood Experiences impact health and potential
32 Structure, Support, Guidance Council RepresentativesExecutive CommitteeResponsive RelationshipsSupportive EnvironmentsSocial and Emotional SupportsIntensive InterventionsChildren & Caregivers
34 Council Reps Children’s Museum Library Faith Based WIC Public Health Early Childhood EducationHigher EducationMediaBusinessUnited WayGovernmentLegislatorsParentsPhysicians / HealthChild CareHead Start / Birth to 3Social ServicesHousing / ShelterDomestic Violence ServicesLaw EnforcementChild WelfareMental Health
39 Base of PyramidNurturing 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&RRLibraryChildren’s MuseumBirth to 3AHCAuroraHealth DepartmentFamily Resource CenterSchool Disctrict
41 Key Projects of N&RR Committee Coordinated delivery of trainingTargeting parents and caregiversFocusing 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 ThreeDeveloped and distributed a County Resource GuideParents, Caregivers, and ProvidersComprehensive list of resources available within our community.
43 The Second LayerHigh 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 Environments SEFamily ConnectionsYMCA ChildcareHealth DepartmentFond du Lac CountyMPTCAHCParent
45 Key Projects of SE Committee Coordinated delivery of training to childcare centersBreast Feeding Friendly Centers Targeting training for 14 centers in 2014Quality Focus: Activities to support Young Star RatingsPBIS - Behavioral System (originated in school district)Promoting effective use and access to ASQ screensGoal Periodic Screens (18 mos)Education across CouncilCreation of WIC screening sitesCritical access points (pediatricians, homeless shelters, domestic abuse)
46 Third LayerTargeted 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 TSEBirth to 3Health DeptADVOCAP Head StartSchool DistrictsSolutions CenterSocial Services
48 Key Projects of TSES Committee Coordinated delivery of Conscious Discipline CurriculumTargeting child care centers and parents80 participants, 6 child care centers, 1 in home providerEvidenced BasedTargeted Parental SupportsParents going through Paternity CasesAccess to ASQ screens to homeless & families experiencing domestic abuse
49 The Top of the PyramidIntensive 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 Interventions IIBirth to 3AHCHealth DepartmentFamily CourtDoll & AssociatesMarian University Early ChildhoodADVOCAP Head StartSocial ServicesSchool Districts
51 Key Projects of II Committee Dr. Navsaria Reach out and Read (Oct 16th)Targeting cross sector business, physicians,SPROUT partners and parentsJune 2014 Journal of American Academy of PediatricsPICCOLO TrainingParenting Interactions with Children: Checklist of Observations Linked to OutcomesTargeting Practitioners working with children monthsObserving, tracking and supporting parent interactionsAffection, Responsiveness, Encouragement & Teaching
52 The Executive Committee Responsive RelationshipsSupportive EnvironmentsSocial and Emotional SupportsIntensive InterventionsCouncilChildren & Caregivers
53 Key Projects of Exec Committee Coordination of Plan Goals Across CommitteesFunding & SustainabilityCouncil Surveys Monitor & RespondCommunity Wide Awareness, beginning with:It matters to all of us!
54 Wrap Up Questions? Closing comments? Final thoughts? Reference MaterialsNext 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 formsMaternal Depression/Mental IllnessImpact on Attachment is across the lifespan.Sensitive periods.Theory of ChangePersonal Responsibility?Official Journal of American Academy of PediatricsLiteracy Promotion: An Essential Component of Primary Care Pediatric Practice, June 2014Zero to Three: Breaking the Cycle; Supporting Parent-Child Relationships Through the “Parents Interacting with Infants” Intervention, July 2014Early Learning Challenge Technical Assistance: Supporting Children Through Community Based Coalitions, December 2013The Future of Children; Princeton Bookings:Early Stress Gets Under the Skin: Promising Initiatives to Help Children Facing Chronic Adversity