1. 1 Birth to Six Initiative Topic One: Introduction to Birth to Six

2. 2 Getting to Know Each Other Introductions Activity: –Share name, position, and one memory from your childhood between birth and six years old.

3. 3 Learning Objectives Gain understanding of the unique needs of young children Understand the benefits of the Birth to Six Initiative Learn how trauma impacts young children’s development Value the practice and systemic changes needed to best meet the needs of these children

4. 4 Pre-Test

5. 5 Overview of Birth to Six Initiative Acknowledges that young children require special attention in the child Welfare system Addresses developmental needs of young children Creates system change to align with values and goals of Initiative

6. 6 Goals of Birth to Six Initiative: 1.Meet the developmental needs of children in foster care 2.Minimize the impact of separation and trauma on development 3.Decrease the number/rate of children in foster care 4.Decrease the length of stay of children in foster care

7. 7 Benefits of the Initiative Increased awareness by staff and caregivers of the importance of attachment and the impact of separation and loss on a young child’s bonding process. Increased caregiver capacity to nurture and care for the young child who has been impacted by neglect, abuse and separation trauma. Increased identification of foster children who are impacted by trauma and loss and need early intervention.

8. 8 Benefits (continued) Increased number of children receiving developmental assessments. Increased number of children who receive appropriate referrals and services that meet their health, dental, education, mental health and developmental needs. Improved child- parent/caregiver visitation protocol developed. Increased timeliness for child reunification with family. Increased timeliness to permanency by way of adoption and guardianship. Decreased re-entry into foster care after reunification. Increased child well being in health, mental health and in attachments. Decrease in number of children entering foster care. Decrease length of stay for children who enter foster care.

9. 9 Unique Needs of Young Children Brain is growing and developing “The capacity and desire to form emotional relationships is related to the organization and functioning of specific parts of the brain. Just as the brain allows us to see, smell, taste, talk and move, it is the organ that allows us to love – or not.” Bruce D. Perry, M.D., Ph.D.

10. 10 Unique Needs of Young Children Attachment and bonding are occurring –“special enduring form of emotional relationship with a specific person.” Rapid growth in physical, cognitive and emotional development

11. 11 DATA What do we know….?

12. 12 California Foster Care In October 2010, there were 19,467 children under the age of six in foster care –3313 children under age 1 –7,586 1-2 year olds –8,747 3-5 year olds 34% of all the children (57,954) in foster care

13. 13 Impact of Trauma and Abuse In the United States, approximately 5 million children experience some form of traumatic event each year.

14. 14 Trauma is… … a psychologically distressing event that is outside the range of usual human experience. Trauma often involves a sense of intense fear, terror, and helplessness. Not the same as stress.

15. 15 Trauma … … Overwhelms a person’s capacity to cope

16. 16 How does trauma affect young children? The type of traumatic event will affect its impact on a child The child’s age and developmental stage will influence how powerful and dangerous the traumatic event feels to him The child’s care giving environment and social supports shape the way in which the child reacts and copes with the traumatic event.

17. 17 Trauma Impact Causes developmental delays Causes eating problems (hoarding, swallowing problems, throwing up food, failure to thrive) Poor emotional functioning Inappropriate modeling of adult behavior Aggression

18. 18 The Problem is… …social problems manifest later in life -Teen age pregnancy -Drug abuse -School failure -Victimization -Anti-social behavior

19. 19 Traumatized Children Behaviors can be out of control, fearful, disruptive, or excessively aggressive Children may be “flooded” with feelings of fear and anxiety.

20. 20 Neuropsychiatric Conditions Develop –Dissociative Disorder –Post-traumatic Stress Disorder –Conduct Disorders

21. 21 Dissociation Mental process of disengaging from the stimuli in the external environment and attending to inner stimuli. –Inner fantasy world –Disorientation –Loss of identity –Perceptual disturbances

22. 22 Post-Traumatic Stress Disorder (PTSD) PTSD is a neuropsychiatric disorder that may develop following a traumatic event. It is characterized by three key sets of symptoms: 1) re-experiencing and re-enactment, 2) avoidance, and 3) physiological hyper-reactivity

23. 23 Hallmark Symptoms of PTSD : RE-ENACTMENT Play Drawing Nightmares Intrusive ideations AVOIDANCE Being withdrawn Daydreaming Avoiding other children PHYSIOLOGICAL HYPERREACTIVITY Anxiety Sleep problems Hyper vigilance Behavioral impulsivity

24. 24 What are some of the losses young children have experienced?

25. 25 Young Children in Foster Care Have experienced abuse and/or neglect in the primary home Have not received healthy parenting experiences in the primary home Experience separation from primary caregiver, usually the mother Experience multiple caregivers Experience placement instability May not experience necessary nurturance to develop and attach

26. 26 Young children in foster care 80% of young children placed in out-of-home care were exposed prenatally to substance use. Nearly 40% were born premature or low- birth weight and over half had a chronic health condition and/or developmental delay.

27. 27 Young Children in Foster Care 4-6% of the general child population have developmental delays As high as 60% of children in foster care have developmental delays: –57% language delays –33% cognitive problems –31% gross motor delays –10% growth problems

28. 28 Young Children in Foster Care 25-40% of children younger than six entering out of home care have significant behavioral problems as compared to 3-6% of the general preschool population

29. 29 Developmental and behavioral impairments are correlated with longer lengths of stay in care and reduced likelihood of family reunification or adoption

30. 30 Theoretical Framework for Birth to Six Initiative Attachment Theory Optimal child development occurs when a spectrum of needs are consistently met over an extended period. Having at least 1 adult who is devoted to and loves a child unconditionally, who is prepared to accept and value that child for a long time, is key to helping a child overcome the stress and trauma of abuse and neglect.

31. 31 Wrap Up Next Session – The Emotional and Developmental Needs of Young Children