1. BUILDING SOCIAL EMOTIONAL HEALTH
This is your cover page. Please make sure to Save As and rename the presentation so you still have the template whenever you need it. Also, make sure you have the correct fonts and colors for your new brand. The fonts need to be installed on your computer in order to appear correctly on the Powerpoint.
BUILDING SOCIAL EMOTIONAL HEALTH
A Foundation for Success: The Unique Role of the Child Health Consultant

2. GOALS
To identify the unique roles and opportunities for child care health consultant to promote social emotional health
To understand the compelling case for social emotional health promotion in early childhood
To identify concrete next steps and tools to integrate into practice

3. The Foundation of a Successful Society is Built in Early Childhood
Healthy Economy
Strong Communities
Successful Parenting of Next Generation
Educational Achievement
Economic Productivity
Responsible Citizenship
Lifelong Health
Child development is the foundation for community and economic development. Brain architecture is built in a cumulative, bottom-up manner; a solid foundation is required for future skills.
The overarching message from the science you are about to see is very simple: how children develop early in life matters for them later, and for all of us. This is why early brain and child development (EBCD) is so important.
This message is not just opinion. It is proven by people who looked carefully at all of the recent advances in neuroscience, molecular biology, genomics, the behavioral and social sciences, and hard economic analysis of human capital development.
Research tells us that healthy development in the early years means children will be more successful in school. As adults they will be more productive contributors to the economy, more responsible participants within their communities, and they will lead healthier, longer lives. Therefore, when children are adults, the communities they live in will be stronger, the economy they participate in will be healthier, and they will be better parents of the next generation of children. That is the foundation of a successful society.
Source: Center on the Developing Child at Harvard University (2007). A Science-Based Framework for Early Childhood Policy.
Healthy Child Development 3
Source: Center on the Developing Child at Harvard University (2011).

4. INFANT MENTAL HEALTH
“The developing capacity of the children from birth to 3 to experience, regulate, and express emotions; form close and secure interpersonal relationships; and explore the environment and learn – all in the context of family, community, and cultural expectations for young children.”
Zero to Three, 2002

5. CHILD CARE HEALTH CONSULTANT
Access to setting including providers and parents
Trusted
There already…can you add this lens?
Pair & Share: Can you share a moment when you did or saw an opportunity to address social emotional health?

6. 700 New Neural Connections Every Second
Neural growth occurs more rapidly in early childhood than any other period of life. During the first few years of life, 700 new synapses (neural connections) are formed every second. After a period of rapid increases in connections, the brain needs to become more efficient, or it would be overwhelmed. Connections that are not used are pruned away, like cutting back an overgrown bush. Early experiences determine which circuits are reinforced through frequent use and which are pruned through lack of use. Some people refer to this as “use it or lose it.”
This process is a double-edged sword. On the one hand, positive, healthy, growth-promoting experiences help to develop brains that are efficient and capable of any challenge. However, young children who experience abusive or profound neglect, for example, may increase the neural connections dedicated to fear and anger, and prune those dedicated to reasoning, learning, and memory. These changes are then built into the architecture of their developing brains. Ensuring that all children have the right kinds of experiences can ensure that the neural connections that are growing (700 every second) are the ones they need to thrive. 6
Image source: Conel, JL. The postnatal development of the human cerebral cortex. Cambridge, Mass: Harvard University Press, 1959

7. 700 NEW NEURAL CONNECTIONS EVERY SECOND

8. FOUNDATION FOR EXECUTIVE FUNCTION SKILLS IS BUILD IN EARLY CHILDHOOD
Self-Control – ability to filter thoughts and impulses to resist temptations and distractions
Working Memory – ability to hold and manipulate information in our heads over short periods of time
Mental Flexibility – adjusting to changing demands, priorities, or perspectives

9. A safe and stable environment
CRITICAL FACTORS IN DEVELOPING A STRONG FOUNDATION FOR EXECUTIVE FUNCTION SKILLS
Children’s Relationships– consistent reliable adults who support and protect them, and model and engage them in building executive function skills
Activities – the opportunity to engage in activities that reduce stress, foster social connection, incorporate vigorous physical activity, and increase the complexity of skills at the right speed for each child
A safe and stable environment

10. WHAT’S THE BIG IDEA? WHY SO IMPORTANT
Scope of social emotional/ behavioral issues
Expulsion rates
Teacher turnover
Tools and techniques that work
Impact on school success/ failure
Lifelong health

11. BARRIERS TO EDUCATIONAL ACHIEVEMENT EMERGE AT A VERY YOUNG AGE
1200
1000
College Educated Parents
800
Working Class Parents
Cumulative Vocabulary (Words)
600
Welfare Parents
400
200
16 mos.
24 mos.
36 mos.
Child’s Age (Months)

12. **RICHNESS OF LANGUAGE
CARING FOR OUR CHILDREN STANDARD INTERACTIONS WITH INFANTS AND TODDLERS
Caregivers/Teachers should provide consistent , continuous and inviting opportunities to talk, listen to and otherwise interact with young infants throughout the day (indoors and outdoors) including feeding, changing, playing with, and cuddling them
**RICHNESS OF LANGUAGE
The social and emotional communications and the atmosphere and essential

13. SERVE & RETURN BUILDS BRAINS & SKILLS
Ongoing, reliable interaction with trusted adults is essential for the development of healthy brain circuits
Systems that support the quality of relationships in early care settings, communities, and homes help build brain architecture

14. KEY FACTORS A language rich environment
Warm, responsive interactions between caregivers/ staff and children
Video clip examplehttp://csefel.vanderbilt.edu/resources/inftodd/mod1/1-1.mpg

15. PAIR AND SHARE
Example of when this went right or wrong during your observation
Strategies for promoting serve and return/ language rich interactions

16. EARLY CHILDHOOD STRESS INFLUENCES DEVELOPMENTAL OUTCOMES
Brief increases in heart rate, mild elevations in stress hormone levels; important to development in the context of stable and supportive relationships
Serious and temporary, but impact buffered by supportive relationships and safe environments
Prolonged activation of stress response systems in the absence of protective relationships; disrupts brain architecture, increases the risk of stress-related physical and mental illness
Positive Stress
Response
Tolerable Stress
Response
Toxic Stress
Response
Harvard center on the Developing Child

17. PREVELENCE OF ADVERSE CHILDHOOD EXPERIENCES (ACE)
Girls Boys Total
Abuse (n=9,367) (n=7,970) (17,337)
Emotional 13.1% 7.6% 10.6%
Physical 27.0% 29.9% 28.3%
Sexual 24.7% 16.0% 20.7%
Household Dysfunction
Mother Treated Violently 13.7% 11.5% 12.7%
Household Substance Abuse 29.5% 23.8% 26.9%
Household Mental Illness 23.3% 14.8% 19.4%
Parental Separation or Divorce 24.5% 21.8% 23.3%
Incarcerated Household Member 5.2% 4.1% 4.7%
Neglect *
Emotional 16.7% 12.4% 14.8%
Physical 9.2% 10.7% 9.9%
*Wave 2 data only (n=8,667)
Source: Kaiser ACE Study, Data from :

18. PREVELENCE OF ADVERSE CHILDHOOD EXPERIENCES (ACE)
100%
80%
60%
Children with Developmental Delays
40%
20%
Number of Risk Factors
Data Source: Barth, et al. (2008)
Graphic adapted from 2011, Center on the Developing Child at Harvard University

19. 3:1 ODDS OF ADULT HEART DISEASE AFTER 7-8 ADVERSE CHILDHOOD EXPERIENCES
3.5 3
2.5
Odds Ratio 2
1.5 1
0.5 1 1 2 2 3 3 4 4
5,6
5,6
7,8
7,8
Adverse Experiences

20. UNDERSTANDING IMPACT OF ADVERSE CHILDHOOD EXPERIENCES
Death
Conception
Early
Death
Disease &
Disability
Adoption of
Health-Risk Behaviors
Social, Emotional, and
Cognitive Impairment
Adverse Childhood Experiences
Freely reproducible slide from the Centers for Disease Control and Prevention.

21. RELATIONSHIPS BUFFER TOXIC STRESS
Learning how to cope with moderate, short-lived stress can build a healthy stress response system
Toxic stress (when the body’s stress response system is activated excessively) can weaken brain architecture
Without caring adults to buffer children, toxic stress can have long-term consequences for learning, behavior, and both physical and mental health
Harvard Center on The Developing Child

22. CFOC 2.1.2.1 PERSONAL CAREGIVER/TEACHER RELATIONSHIPS FOR INFANTS AND TODDLERS
Hold and comfort children who are upset
Engage in frequent, multiple and rich social interchanges such as smiling, talking, touching, singing and eating
Be play partners as well as protectors
Be attuned to children’s feelings and reflect them back
Communicate consistently with parents/guardians
Interact with children and develop relationship in the context of everyday routines (diapering/feeding etc.)

23. HELPING CAREGIVERS UNDERSTAND TEMPERAMENT
Activity level – always active or generally still
Biological rhythms – predictability of hunger, sleep, elimination
Approach/withdrawal – response to new situations
Mood – tendency to react with positive or negative mood, serious, fussy
Intensity of reaction – energy or strength of emotional reaction
Sensitivity – comfort with levels of sensory information; sound, brightness of light, feel of clothing, new tastes
Adaptability – ease of managing transitions or changes
Distractibility – how easily a childʼs attention is pulled from an activity
Persistence – how long child continues with an activity he/she finds difficult
From csefel handout on temperament traits

24. ADDRESSSING CAREGIVER STRESS
Check in
Acknowledge
Empathize
Reframe
Commit to Plan
Video clip portraying caregiver perceptions:

25. STRATEGY FOR EARLY CHILDHOOD SETTINGS AND PARENT EDUCATION
Read together every day (your)
Rhyme play and cuddle with your child every
Routines
Reward your child with praise for successes to build self-esteem and promote positive behavior
Develop a strong and nurturing Relationship with your child as the foundation for their healthy development

26. PROGRAM SUPPORT FOR STRENGTHENING RELATIONSHIPS
Adequate adult to child ratios
Small group sizes
One primary caregiver per child
Continuity of care; one caregiver over time
Time for parents/guardians to share information
Time for caregivers to get to know the child through observation
The National Training Institute for Child Care Health Consultants

27. MAKE DAILY ROUTINES PREDICTABLE
Post pictures or other visual cues about what comes next.
Alternate small and large group activities, as well as quiet and high-energy activities.
Allow clear choices between activities.
Create rules and rituals that are easy to follow.
The National Training Institute for Child Care Health Consultants

28. STRATEGIES TO SUPPORT ROUTINES FOR INFANTS AND TODDLERS
Use first/next or first/then words
Display an item, such as a new toy, photo or plant, that children and families can explore together during arrival
Sing or play lullabies
Involve children in routines – for example, invite toddlers to help pass items to the next person during mealtimes

29. WHAT IS EMOTIONAL LITERACY?
It is the capacity to:
Identify, understand and express emotion in a healthy way
Recognize, label, and understand feelings in self and others
Adapted from Craddling Literacy 2007

30. STRATEGIES TO DEVELOP EMOTIONAL LITERACY IN INFANTS AND TODDLERS
Use the adult/child relationship to expand children’s awareness of emotions or feelings:
Verbally acknowledge and label emotions expressed by children in care
Assist infants and toddlers with regulating their emotions
Talk about the fact that feelings can change
Use questions about feelings to see if and how a child responds
CSEFEL MODULE 2

31. STRATEGIES TO DEVELOP EMOTIONAL LITERACY IN INFANTS AND TODDLERS
Use enriching language tools:
Choose books, music, finger plays with a rich vocabulary of feeling words
Use puppetry or felt board stories that retell common social experiences and emphasize feeling vocabulary and conflict resolution
Read stories about characters that children can identify with who express a range of feelings
CSEFEL MODULE 2

32. SOCIAL EMOTIONAL HEALTH PROMOTION: CURRICULUM
Building Executive Function
Building Health

33. DEVELOPMENT OF PLAY SKILLS FOR INFANTS AND TODDLERS (CSEFEL MODULE 2)
Age
Play
13 to 24 Months
Enjoys play with objects
Increased interest in watching other
children play (onlooker)
Primarily plays alone (solitary)
May offer toys to caregiver or other
children
May choose independent play close to
other children (parallel) but not
interact with them
25-36 Months
May play with other children but in an occasional or limited way (associative)
Some cooperation and talking with other children
May take leader/follower roles in play
Some pretend play
Still plays alone frequently
Interactive level moving toward (cooperative play)

34. SETTING UP THE ENVIRONMENT FOR DEVELOPING PLAY AND FRIENDSHIP SKILLS
Evaluate the physical space to ensure that there is enough space for infants and adults to engage in social activities
Evaluate the physical environment for spaces for two or more children to enjoy side-by side activity and for adults to be close for supervision
Evaluate the daily schedule for opportunities to develop play skills each day
Provide enough materials and equipment that allow and encourage two or more children to interact

35. PROMOTING THE DEVELOPMENT OF FRIENDSHIP SKILLS
Encourage toddlers to help each other and do routines together
Provide positive verbal support for play between children
Read books about friends, playing together, helping each other, etc.
Practice turn-taking and sharing

36. DEALING WITH CHALLENGING BEHAVIOR
Not addressing sufficiently here: a separate talk
This Opens a dialogue and highlights promotion
Many Resources for challenging behavior
Including (identify/explore/action and care plans/effective in class interventions/supports/community resources and referrals/communication with medical home)
Other core area communication with parents: further training
This was meant to be an overview to promote opportunities and a promotion approach….more to follow

37. PAIR AND SHARE
What is one thing you are going to do differently to enhance your promotion of social emotional health?
What is a challenge that you would like to address around promoting social emotional health?
What is a next step in supporting your ability to address the challenge? Action step
What is a long term goal in promoting social emotional health? And an action step to get there

38. WHAT NEXT? Let’s build bridges! Let’s build systems! Common vision
Next steps

39. CHILDCARE HEALTH CONSULTANT NETWORK BUILDING
Bridges Between Health and Early Childhood Systems (focus on childcare health consultants as key stakeholder group/target audience)
Docs For Tots Plan to support ECCS/ Build online Resource Center/Training/ Listserv/TA
What are your thoughts? What would be helpful?

40. TO BUILDING AND SHARING THE PYRAMID!

41. CSEFEL A TREMENDOUS RESOURCE
Explore website: make it a GO TO RESOURCE
Training Modules:
Unlimited practical caregiver resources/ classroom tools/ Strategizing tools/ parent handouts

42. Thank you!