1. Module 5 Helping Children Thrive

2. Module 5 Learning Objectives Participants will: Understand importance of stable and nurturing relationships for young children especially when Child Welfare involved. Understand the concept of taking an All, Some and Few approach to service provision. Identify supports to help young children, their families and their relationships.

3. What is needed for children like Billy to thrive? What does the research tell us? Why will it help? What are the evidenced-based practices? What is the role of child welfare professionals? Who are key partners?

4. Addressing the Needs of All, Some and Few IECMH Intervention Part C Early Intervention and Targeted Supports High-Quality Early Learning Environments and Home Visiting Nurturing Relationships Stability

5. Helping Children Thrive Support and promote stability in all aspects of their lives. Ensure they have nurturing and responsive relationships with caregivers, caseworkers, child care providers, etc. Ensure ALL young children have access to high-quality early learning environments and evidence-based home visiting programs. Provide Early Intervention and Targeted Supports when identified (SOME). Provide quality, effective intensive infant and early childhood mental health interventions when needed (FEW) Engage multiple partners from the community in helping children thrive

6. Promoting Stability & Nurturing Relationships

7. Each additional placement during the first year decreases the chances of achieving permanency by another 32% National Clearinghouse on Child Abuse and Neglect Information. (2005).

8. Challenges to Stability Some evidence suggests that a single change in social workers decreases chances of permanency within 12 months by 52%. National Clearinghouse on Child Abuse and Neglect Information. (2005).

9. Frequent Visitation Supports Stability Frequent and meaningful visitation is vital for young children Evidence suggests visitation is linked to permanency and well- being Withholding visitation should not be used as a threat or punishment American Academy of Pediatrics Committee on Early Childhood, Adoption and Dependent Care (2000).

10. Benefits of Frequent Visitation Establishes and strengthens the parent-child relationship Eases the pain of separation and loss for the child and parent Enhances parents’ motivation to change Involves parents in their child’s everyday activities Helps parents gain confidence and practice new skills Allows for coaching and modeling positive parenting skills Provides information to the court on the family’s progress to determine whether reunification is the best permanency option for the child Helps with the transition to reunification American Bar Association and Zero to Three. (2007)

11. Physical Contact is Key Young children need physical contact to create and sustain relationships.

12. Nurturing & Responsive Relationships To decrease the child’s stress and increase the child’s sense of security, adults must learn how to: Read the child’s cues Comfort the child Anticipate triggers for emotional outbursts

13. Stable, Nurturing & Responsive Relationships Support Emotional Health Provide routine – all children thrive on routines (mealtimes, bedtime, daily activities) which allow them to feel more secure and in control Include consistent, familiar people who feel safe Encourage security blankets Provide reassurance Tolerate clinging behavior and the need for reassurance

14. Addressing the Needs of All, Some and Few IECMH Intervention Part C Early Intervention and Targeted Supports High-Quality Early Learning Environments and Home Visiting Nurturing Relationships Stability

15. Where do children in care spend their days? Biological home Relative home Foster home Child care Neighborhood

16. High Quality Environments Quality early childhood environments enhance development and relationships Enhance development Larger vocabularies Better reading skills Higher math competencies Higher IQ and school readiness scores Foster relationships Improved social- emotional development Reduced behavior challenges Protective factor for maltreatment

17. High Quality Environments High quality early childhood programs can produce long term benefits

18. Feds Push Relationships with Early Learning Systems Head Start and Early Start Eligibility (ACF-IM-HS-10-04) Child Care Subsidies http://eclkc.ohs.acf.hhs.gov/hslc/standards/IMs/2010/resour_ime_004_071910.html

19. Home Visiting Improves Maternal and prenatal health Infant and child health Child development and school readiness Parenting skills Knowledge of child development outcomes Referrals to community services Positive behavior management Reduce accidents and emergency room visits http://mchb.hrsa.gov/programs/homevisiting/ www.childwelfare.gov/preventing/programs/types/homevisit.cfm

20. Addressing the Needs of All, Some and Few IECMH Intervention Part C Early Intervention and Targeted Supports High-Quality Early Learning Environments and Home Visiting Nurturing Relationships Stability

21. Early Intervention for Delays and Disabilities and Targeted Social Emotional Supports Early intervention (IDEA Parts C & B) In-home supports, parenting education, and relationship focused supports Early childhood mental health consultants to child care, early intervention, home visiting and child welfare.

22. Targeted Social Emotional Supports Help parents and caregivers understand children's underlying emotional needs

23. Parenting Classes Should Help Parents to: Understand baby’s cues and respond appropriately Know baby can’t be spoiled by meeting his or her needs Have realistic expectations Support development and provide enriching experiences Ensure safe, appropriate environments Beckmann, K., Knitzer, J., Cooper, J. & Dicker, S. Supporting parents of young children in the child welfare system. February 2010. National Center for Children in Poverty.

24. What can improve parents’ capacity for nurturing? Address parents' issues so their problems do not interfere with caregiving

25. Early Childhood Mental Health Consultation Reduces children’s problem behaviors when least costly and most amenable to intervention and reduces the likelihood of later behavior problems.

26. Early Childhood Mental Health Consultants In Child Care Improve sense of job control and satisfaction Improve sensitivity and classroom management Improve classroom climate Create more positive interactions Develop more skill for handling difficult behavior Lower stress among teachers Reduce challenging behaviors www.ecmhc.org Georgetown Early Childhood Mental Health Consultation Center

27. Addressing the Needs of All, Some and Few IECMH Intervention Part C Early Intervention and Targeted Supports High-Quality Early Learning Environments and Home Visiting Nurturing Relationships Stability

28. relationships emotions learn Infant mental health is enhancing relationships to help children thrive The developing capacity of the infant and toddler to… Form close and secure relationships. Experience, regulate, and express emotions. Explore the environment and learn. …all in the context of family, community, and cultural expectations for young children. (Zero to Three Infant Mental Health Task Force).

29. Infant Mental Health and Well-Being The Capacity To: Experience, regulate, and express emotions Form close, and secure relationships Explore the environment and learn www.zerotothree.org

30. Intensive Intervention Babies can suffer and need specialized services

31. Intensive Intervention Multi-Generational Approaches to Treatment The most promising programs for preventing and treating mental health problems in young children are multigenerational approaches, which provides therapeutic intervention to address the child's needs and simultaneously address the primary needs of the caregivers. Source: National Scientific Council on the Developing Child. (2008/2012). Establishing a Level Foundation for Life: Mental Health Begins in Early Childhood: Working Paper 6. Updated Edition.

32. Summary: Applying science to help children thrive. What can you do? Provide intensive multigenerational infant and early childhood mental health interventions. (FEW) Provide early intervention and target supports as indicated. (SOME) Ensure access to early learning environments and home visiting programs. (ALL) IECMH Intervention Part C Early Intervention and Targeted Supports High-Quality Early Learning Environments and Home Visiting Nurturing Relationships Stability

33. Summary: Applying science to help children thrive. What can you do? At every juncture, ask: How can we reduce stress and increase security? Support maximal stability Support and promote nurturing and responsive relationships in the life of the child Consider the age of the child, the attachment with the biological parent, the effect of the attachment disruption and the nurturing of the foster parent or relative in all decisions

34. How can we do these 3 simple things: Reduce stress? Increase trust and security? Improve well-being?

35. We’ve learned that, really, it’s all based in relationships... Brain development Dealing with stress Learning to self-regulate Nurturing and attachment Development Repair and healing

36. Thank you for making a difference in the life of children and families