Pediatricians & Healthy Child Development

Charles Bruner, Ph.D., director of the Child and Family Policy Center and HMG National partner, has written a blog post for BUILDing Strong Foundations. In the post, he describes the critical role primary health care practitioners play in the development of young children. "Health Equity, the Triple Aim, and the First Two Years" also discusses the importance of connecting these professionals with other early childhood leaders. “The first two years of life ultimately are the most important ones to ensuring an individual’s health,” he writes. “During this time, the primary health care practitioner is the professional most likely to see and assess the child. She or he is best able also to identify and serve as first responder to conditions that jeopardize healthy development.” Read more here.

Power of Play

Play matters! This month our friends at the Alabama Partnership for Children remind us of the importance of play for young children. Lifelong fitness is something that everyone should aim for, and the best time to learn healthy habits is in early childhood.

Most parents put their children in sports to keep them active, but before doing this there are a few things to consider. Make sure that the activity is age appropriate. Toddlers and preschoolers are still mastering motor skills, so organized sports aren’t designed for them. Supervise and interact with young children while they play indoors or outdoors – it’s important to simply keep them active and safe. When children are old enough for sports (typically around age 6) make sure they enjoy the sport. If a child isn’t having fun with whatever activity she is doing, she probably won’t want to participate in it again.

Share your favorite activities for indoor or outdoor play in the comments! For more ideas for age appropriate play, check out this article from the Mayo Clinic.

Comprehensive Screening - "The Earlier the Better"

Age-appropriate developmental screening and surveillance is a gateway for at risk children to receive services. “The Earlier the Better” is a recent report from the Child Health and Development Institute of Connecticut which highlights the role of screening as part of a comprehensive approach to school readiness. In the report, we are reminded that identification of delay and subsequent intervention prior to kindergarten saves society between $30,000 and $100,000 per child in academic and social service costs. The report reasserts our understanding that parents are their child’s best caregivers, and that parents are effective and reliable when administering developmental assessments. The authors recommend that all children are screened within an integrated system, screening results are available across services, children are connected to services they need, and all involved providers are engaged in developmental promotion in partnership with families.

Visit http://www.chdi.org/devscreen-IMPACT for the full report and learn what strategies are being implemented in Connecticut.

More Than Baby Talk

Happy Thanksgiving! This week we are thankful for parents, relatives, and child care teachers who intentionally work to focus on quality interactions with young children. Nurturing an infant or toddler’s language and communication skills can have lasting effects on math, reading, and science later in life. Our Thanksgiving gift to you comes from the Frank Porter Graham Child Development Institute. The Institute has created “More Than Baby Talk: 10 Ways to Promote the Language and Communication Skills of Infants and Toddlers” (pdf). This brief guide outlines 10 research-based practices for nurturing language and communication skills among infants and toddlers.

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We hope you have a happy Thanksgiving – and share this resource (pdf) with someone you’re thankful to for impacting the life of a young child.

Friendships and Children with Disabilities

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For parents of children with disabilities, friendships for the child can sometimes be a source of worry and stress. PBS Parents offers some great ideas and helpful tips for parents to consider. Friendships are important for everyone – teaching children appropriate social skills and creating opportunities to practice them can make a big difference.

First Impressions- Saying hello to others, waving, smiling, and making eye contact are learned habits. For children who have difficulty with these, parents may need to help other children recognize their child's interest. Additionally, when a child's clothing and grooming fit in with his or her peers, this can reduce some of the initial barriers.

Identify Potential Friends- If a child is in child care or at school, the teacher can be a good resource for identifying other children who show an interest in the child. Parents of children with disabilities can reach out to the parents of other children who already indicate a willingness to interact.

Play Dates- Play dates should be intentional with careful thought towards the activities planned for the children. Parents should try to establish a space and use toys that their children are comfortable with and willing to share. Families can also meet at a public place like a museum, library, or park. Play dates can be relatively short; just one to two hours should keep things manageable.

Demonstration and Practice- Parents should purposefully model positive social skills and point them out to their child. Talking about what it means to be a good friend and praising good behavior can be powerful reinforcements. Parents should allow opportunities for children to use their skills with peers and to learn from others.

To read the whole article, get more ideas, and access resources, visit PBS Parents.

Tweet a Day for Learning & Play

The Alabama Partnership for Children (APC) is a member of the Help Me Grow National Network. The APC has recently launched its own Twitter account and Facebook page. The new social media campaign is entitled 'A Tweet a Day for Learning and Play', and will target parents, early childhood professionals, business leaders and partners in the state. APC will share early care and education tips and research, including information on initiatives and partners. Each month, the content will highlight a specific focus area related to young children and will coincide with the APC's FOCUS (Focus On Children Under Six) packet. For instance, in the month of November, APC Twitter and Facebook content is focusing on early literacy. Monthly topics include school readiness, quality early care and education, play, advocacy and more. Follow these links to check out the new Facebook and Twitter pages.

Plan for the Future to Have a Future

This 5-minute video depicts a theory of change from Frontiers of Innovation for achieving breakthrough outcomes for vulnerable children and families. It describes the need to focus on building the capabilities of caregivers and strengthening the communities that together form the environment of relationships essential to children's lifelong learning, health, and behavior.

Reading and Language Milestones

Do you ever wonder when a toddler should be speaking in simple sentences? Or how a preschooler should start reading and writing? Well, these are skills that aren't mastered all at once. Reading and language milestones start in infancy and progress through early childhood (and hopefully for life!). Check out this page from PBS to learn about listening, talking, reading, writing, and appropriate activities and games for newborns through third graders. The site can give you some great ideas for helping your child grow towards the next age-appropriate milestone. Follow this link to get started.

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First Class Pre-K

Here at Help Me Grow, we believe high quality early childhood experiences are a key factor towards a child’s long-term success. We are glad the state is expanding its First Class Pre-K program, and there have been recent events attended by many state and local officials featuring three child development programs.

A program of the Department of Children's Affairs

On September 19th there was a First Class Pre-K ribbon cutting event at Kitty Stone Elementary in Jacksonville. Del Marsh, President Pro Tempore of the Alabama Senate, State Representative K.L. Brown, and State Representative Randy Wood attended and gave insightful remarks about the importance of quality early learning. The event received media coverage from multiple news outlets including Fox 6, The Anniston Star/Jacksonville News, and AL.com.

A similar event was held on October 9th at University Daycare in Auburn. Mike Hubbard, Speaker of the Alabama House of Representatives, and State Senator Tom Whatley were both present and spoke about the high return on investment in early childhood. The Opelika-Auburn News, WSFA, and others have covered this story.

The last Pre-K classroom to hold an official ribbon-cutting in this series was at Heavenly Sent Learning Center in Foley, Alabama on October 14th. State Senator Tripp Pittman and State Representative Stephen McMillan were both on hand to join in the celebration. Both legislators serve on committees that appropriate funds which ultimately reach First Class Pre-K. Read more about the event in Foley from the Press-Register.

HMG National: Importance of Research

For those of you out there who are interested in the research behind Help Me Grow's model, you should definitely read HMG Founder Dr. Dworkin's latest blog post. He describes the importance not just of collecting data, but analyzing and presenting it in a way that is useful for discussion about policy formation and implementation. Visit his blog and learn more about why we do things the way we do them.

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HMG Utah in the News!

Our friends at Help Me Grow Utah were featured in their local news. This is a great clip that fully describes the value of Help Me Grow in just five minutes! We're excited to be bringing this service to Central Alabama and are actively looking for ways to grow it in other parts of our state.

Social Needs are as Important as Medical

The Robert Wood Johnson Foundation published a report that supports the idea behind last week’s post. We discussed that poor health outcomes are often not solely rooted in poor health inputs, but that there are frequently social influences which heavily impact wellness. In “Health Care’s Blind Side” it becomes clear that physicians frequently encounter health problems that are caused by unmet social needs. In a survey of 1,000 American physicians:

- 85% say unmet social needs are directly leading to worse health
- 85% say patients’ social needs are as important to address as their medical conditions
- 80% say they are not confident in their capacity to address their patients’ social needs

The physicians reported that if they had the power to write prescriptions to address social needs, such prescriptions would represent 1 out of every 7 they write. This study clearly illustrates that we cannot fix America’s overwhelming health concerns such as obesity, heart disease, respiratory disease, and diabetes without also addressing social concerns that play a factor.

Health Care’s Blind Side demonstrates why programs like Help Me Grow can be vitally important to bridging the gap between health concerns and social needs. A Help Me Grow care coordinator can spend time identifying a child’s physical needs and make appropriate referrals, and can also get an idea of a family’s possible social needs and help make connections to relevant services. While a Help Me Grow care coordinator’s priority is to address a child’s needs, we know that typically cannot be accomplished separate from the needs of the family. Help Me Grow and other partners are working to progressively address concerns of the health care system’s blind side.

Adverse Childhood Experiences

Early childhood obesity has been and continues to be an important issue (see our recent posts). We’ve received feedback that while improving nutrition and activity in children and adults is part of the solution, it may not be all there is to it. No one would argue that it’s easy to change a person’s lifestyle, but evidence points to the fact that we need to start earlier to better prevent obesity.

The CDC’s Adverse Childhood Experiences (ACE) Study started in 1995 with 17,000 participants and these individuals continue to be studied over time. The study asked individuals about their childhood experiences and analyzed their health. Adverse Childhood Experiences include child abuse, neglect, and household dysfunction. Ten different subcategories of traumatic stressors were identified and the results demonstrated that as an individual’s number of ACE increased, their risk for numerous health and lifestyle problems increased. One of the health problems that correlated with ACE is obesity.

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The ACE Study shows us that while we’re sending messages to parents, community leaders, politicians, and health care providers to get moving and eat well, we must also consider the very basics of family life. Our anti-obesity measures and overall health strategies need to include ways to strengthen families and nurture very young children. No social or health problem is isolated, and we must consider the entire family if we wish to grow young children into healthy adults.

TEDx: HMG

Dr. Paul Dworkin, the founder of Help Me Grow, was invited to give a TEDx talk at Bushnell Park in Hartford, CT. See the video below and feel free to visit TED.com to learn more about TED events.

7 Ways to Build Your Baby's Brain at the Grocery Story - Urban Child Institute

The Urban Child Institute recently shared this article...

"Certainly, one of any mother's least favorite errands to ever run with small children is the trip to the grocery store. Changing the focus during a shopping trip can be the ticket to salvaging the task and mom's sanity. As a bonus, it can be a time to grow your baby's brain using elements of 'Touch, Talk, Read and Play'. Read more for 7 simple things to do with baby during the standard grocery run."

Read "7 Ways to Build Your Baby's Brain at the Grocery Story" here.

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National Childhood Obesity Awareness

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On August 31st, 2013, President Barack Obama signed a proclamation declaring September as National Childhood Obesity Awareness month. We recently blogged about nationwide improvements in childhood obesity rates. While it is good news that the rate of increase has slowed, the President's proclamation draws attention to the fact that this is still a very serious concern for the nation. Michelle Obama's campaign, Let's Move! has ideas for bringing fun activities to your community this month and year round:

For Parents
Parents and caregivers can set a great example for the whole family by creating a healthy environment at home. Get updates from Let’s Move Outside! on new ideas on what and where to play outdoors with your kids.

For Community and Faith Leaders
Get involved in Let's Move Faith and Communities. We encourage you to take action to make your congregation or community a place of wellness.

For Local Elected Officials
No city, town or county is the same, and each one needs its own approach for solving childhood obesity. Let’s Move! Cities, Towns and Counties engages local elected officials by focusing on their unique ability to promote improved nutrition and increase physical activity at the local level.

Child Care Providers and Early Education Programs
Helping children learn healthy habits early, through child care and early education programs, is critical to solving the problem of childhood obesity within a generation. Let's Move! Child Care is a voluntary initiative to empower child care and early education providers to meet 5 goals: increasing physical activity, reducing screen time, improving food choices, providing healthy beverages, and supporting breast feeding.

For Health Care Providers
Health care professionals directly impact children’s health. Let’s Move! in the Clinic is a voluntary effort by health care providers address childhood obesity. Working together with children and their families in clinics, practices, homes, schools and neighborhoods, health care professionals can make a real difference in solving the problem of childhood obesity.

For more ideas like these, check out this page!

AL Baby Facts

Zero to Three recently released National and State Baby Facts to "provide information for early childhood professionals and policymakers about the status of infants, toddlers, and families in their state." In Alabama's factsheet we learn:

• more than half (52%) of children ages zero to three in Alabama live in low-income families
• 27% of children who are maltreated are younger than three years old
• Early Intervention currently serves 1.67% of the population under age three

Download the Alabama factsheet here (pdf) and check out other states and the nation here.

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Our Pal at PAL

In our last post we highlighted one of our partner agencies, Parenting Assistance Line (PAL). Valerie Thorington is the Assistant Director of Child Development Resources at the University of Alabama, the home of PAL. She has a passion for helping parents and children and provides call center guidance for Help Me Grow Alabama’s implementation. Let’s hear it from her perspective…

Working in the field of Child Development and Family Studies in various states for over 35 years, I have continued to see a growing need to support parents and families, not only with information and tools, but to “walk alongside” each other with encouragement and validation. Children’s lives and futures depend on it! PAL serves as a strong, viable prevention technique believing that families benefit when parents understand child development and the skills needed for effective parenting. As parents anticipate children’s milestones, we can help parents guide their children through developmental stages more confidently and more successfully. Parents feel less stressed, more capable, less isolated, and better able to cope as they have the opportunity to talk through their specific parenting situation or concern.

I think some of the parents of the 13,000 calls received say it best:
- “Thank you for taking the time to talk with me. I feel better and think I have a plan of action now. I just felt so lost and did not know where to turn.” 
- “I wasn’t sure how to handle the situation with my son but you have provided me with several ideas I’m going to try. I really had no idea how complicated parenting can be!”
- “I have been calling PAL since my son was born 4 years ago. Whenever I call with a problem, you help me figure it out. Thank you!” 

I have worked with Child Development Resources for 14 years and part of my responsibilities have been providing daily oversight of PAL since it began in 2007. PAL can be reached at 1-866-962-3030. Free brochures and magnets are available to share with families and/or colleagues by calling or contacting PAL through the website.

Parenting Assistance Line

One of Help Me Grow’s statewide partners is Alabama’s Parenting Assistance Line (PAL). PAL staff serve on the leadership team and bring years of experience in listening and responding to the needs of Alabama’s parents.

PAL is a statewide phone service (1-866-962-3030) that was launched in March of 2007 to provide free information, support, and practical tools to parents and caregivers across Alabama. PAL’s vision continues to be to assist parents in making parenting more manageable as well as to become more confident and successful in their parenting role. Children do not come with instructions and we recognize that sometimes parenting can be tough!

Because of PAL, parents have a free, confidential, and anonymous source to call where they find a compassionate, listening ear to “talk it out” rather than “take it out” on their children. Professional Parent Resource Specialists can then offer developmental information to assist parents in developing and utilizing their own appropriate parenting strategies. If appropriate and requested, referrals are made for specific services in the caller’s own county that can meet the need of the parent and child, and/or a customized PAL Pack can be mailed with information related to specific concerns or questions.

The PAL Call Center can be reached at 1-866-962-3030 and is located at Child Development Resources at The University of Alabama, and operates Monday-Friday, 8 a.m. – 8 p.m. Anyone who leaves a message after hours will receive a call back the following business day. The website is available anytime and provides over 120 Parent Tip Sheets on a wide variety of parental and developmental issues, as well as an opportunity to contact a Parent Resource Specialist with specific questions.

Improvement in Childhood Obesity - Alabama Unchanged

According to the Centers for Disease Control and Prevention, "obesity rates among preschoolers are improving, but there is more work to be done to continue this downward trend. Among low-income preschoolers (ages 2-4 years) from 2008-2011:
- Obesity rates decreased slightly in 19 of 43 states and territories (including Mississippi, Georgia, and Florida).
- Obesity rates increased slightly in 3 of 43 states and territories (including Tennessee).
- Obesity rates did not change in 21 of 43 states and territories (including Alabama, Arkansas, and North Carolina).

The Facts:
- 1 in 8 (12%) preschoolers is obese.
- About 1 in 5 (19%) black children and 1 in 6 (16%) Hispanic children between the ages of 2 and 5 are obese.
- Obese children are more likely to be obese later in childhood and adolescence. In these older children and adolescents, obesity is associated with high cholesterol, high blood sugar, asthma, and mental health problems.
- Children who are overweight or obese as preschoolers are 5 times as likely as normal-weight children to be overweight or obese as adults."

Read Jim Marks' post about how we can continue making good progress. He comments, "Declining obesity rates among preschool-age children in programs like WIC are the result of a similar focus. The research released today did not pinpoint the exact causes of progress, but two factors likely had an impact:

- The 2008 overhaul of the WIC “food package”—Five years ago, WIC changed the mix of foods covered by the program. The changes encouraged families to buy more fruits and vegetables, with the goal of improving children’s health and nutrition. They increased allowances for whole grains and cereals while reducing reliance on high-fat dairy products. Grocery stores serving WIC moms and children changed their inventories to meet the new standards, benefiting not only WIC families but all members of the local community.

-Improved nutrition and reduced screen time in child care centers—More and more cities and states have required child care providers to improve the nutritional quality of foods and drinks served to young children. Just as important, major early education providers like the Y of the USA and Bright Horizons, have made major changes on their own, promoting physical activity, eliminating sugar-sweetened beverages, and reducing TV time for children in their care..."

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Care Coordination for ALL Children

As we know, the earliest identification of developmental delays and concerns can lead to improved outcomes for children. The longer a delay goes unnoticed or untreated, the more deeply embedded it becomes in a child's makeup. This is true for ALL children.

Unfortunately, this CNN article highlights a disturbing trend:
Minority children with autism lack access to specialists

"African-American and Hispanic children are far less likely to be seen by specialists - for autism, but also other medical conditions - and also less likely to receive specialized medical tests than their white peers, according to a new study published Monday in the journal Pediatrics."

Help Me Grow and our partners are committed to care coordination for ALL children. Read more to learn details of the study and remember that it's important to act early on concerns for a child's development.

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One Year

Kids grow up quickly - check out this video of a second a day in the life of a child. It's amazing to see him turn from an infant to a toddler!



"Meet our son Indigo who was born on the 9th July 2012. From that day my wife and I videoed Indigo at least once a day, every day up to a year old. For his first birthday we've spent some time putting together a video of his entire first year. He doesn't quite appreciate it yet, but we hope that in a few years he will." -Sam Christopher Cornwell

Champion for Help Me Grow

You may remember that Help Me Grow got to participate in the Alabama Chapter of the American Academy of Pediatric's (AL-AAP)’s Quality Improvement/Maintenance of Certification training last year and in May of this year we featured Linda Lee, the Executive Director of AL-AAP. Now we’d like you to meet Linda Champion! Linda is the Project Coordinator for AL-AAP and she oversees the chapter’s quality improvement initiatives. Her work focuses on enhancing knowledge of specific pediatric best practices and building capacity for improved care of children and youth throughout the state. Currently, Linda is coordinating efforts centered on asthma as well as developmental screening and is working with pediatric specialists at the UAB Department of Pediatrics to improve practice processes to prevent and manage childhood obesity. Linda is very involved around the state and serves on numerous task forces and committees relating to children’s health and pediatric care.

Linda has experience in successfully infusing quality improvement practices into pediatric offices. She currently coordinates with Help Me Grow – Central Alabama to ensure pediatricians in Jefferson, Blount, Shelby, St. Clair, and Walker counties are implementing universal, standardized developmental screenings (ASQ-3). Linda helps track clinic progress towards ensuring every child gets screened at the 9-, 12-, 18-, 24-, and 30-month intervals. Pediatricians receive guidance from Linda to ensure they are doing everything they can according to AAP to best serve children and families.

The project’s goal is to use a standardized developmental screening for earlier identification of and intervention for developmental delays. Linda aids with care coordination in the pediatric office and improves linkages for parents to appropriate community resources. Within a medical home model, the project provides peer-to-peer learning, education, and technical assistance to:

• Provide patient/family-centered care in medical home settings. 
• Improve clinical skills using standardized developmental screening tools to achieve measurable improvements in health outcomes of children. 
• Implement and evaluate quality improvement practice-level, system-based changes. 
• Network with community and state agencies to enhance referral relationships and increase appropriate referrals to Help Me Grow, Alabama’s Early Intervention System, care coordination services, and other providers of developmental and social-emotional services in the community. 
• Improve parental communication with providers regarding concerns about their child’s development and behavior. 

The first year of Help Me Grow – Central Alabama involved five pediatric practices who took part in collaborative conference calls to share successes and ideas on how the process is unfolding in their practices. Help Me Grow staff attended the calls, provided information on how to connect to services, and even visited the practices on-site. During Year 2, the group will continue this process and expand to include more pediatricians and their practices. If you’d like to know more about how a pediatric office can connect to Help Me Grow, contact Linda at 334-324-9307 or lchampion@alaap.org.

Autism News

We've gathered some autism spectrum disorder news and opportunities to learn more:

- This story comes from Thrive by Five in Washington: A breakthrough in autism research holds both the potential for earlier diagnosis of the disorder (a core component of Help Me Grow) and a better understanding of the important role social interactions play in early childhood development. The new study from the University of Washington's Institute for Learning & Brain Sciences (I-LABS) found brain activity among toddlers with autism can predict later cognitive, linguistic and adaptive development.

"Infants use social cues, such as tracking adults’ eye movements to learn the names of things, and must be interested in people to learn in this way. Paying attention to people is a way for babies to sort through all that is happening around them and serves as a gate to know what is important. But with autism, social impairments impede children’s interest in, and ability to pick up cues. They find themselves paying attention to many other things, especially objects as opposed to people."

- NPR reviewed new research about autistic children's response to human voice. Additionally, this story describes the strides museums are taking to respond to the needs of visitors with ASD.

- To find out more about making your business more autism-friendly or if you're looking for autism-friendly events and other supports, contact Autism Society of Alabama (1-877-4AUTISM).

- If you're interested in autism spectrum disorder and want to know more, you should register for this post-conference autism workshop as part of the 29th Annual Early Intervention and Preschool Conference at the Birmingham Jefferson Convention Center in November:

Evidence-based Intervention for the Young Child with Autism: Making the strategies work for you
Little Champions....Big Dreams
November 20, 2013; 8:30 AM – 4:30 PM
2101 Richard Arrington Jr. Blvd, N, Birmingham, AL 35213

Workshop Content:
· Review the most recent research in evidence based models of intervention for very young children with autism spectrum disorder
· Discuss similarities and differences among models in order to highlight key strategies
· Overview “key strategies”
· Discuss strategies drawn from research with case examples and audience participation

Elizabeth McMahon Griffith, PhD is an Assistant Professor in the section of Neurodevelopmental Behavioral Pediatrics at the University of Colorado and a practicing Psychologist on the Child Development Unit at Children’s Hospital Colorado. She received her doctorate from the University of Denver and completed her clinical training at the University of Alabama Birmingham School of Medicine in the LEND program. She has extensive experience in evaluation and intervention with individuals with developmental disabilities. Her primary areas of interest are in working with very young children with autism and their families, and in dissemination of ‘best practices’ into community settings. She is trained in a variety of intervention models, and is both a certified provider and a trainer in the Early Start Denver Model (ESDM).

For hotel reservations, call 205-324-5000 or follow this link. Sheraton Hotel Room rates: $113 for single/double plus tax (cut-off date is October 19, 2013). For conference registration and more information, go to http://www.ucpalabama.org/.
$100 Registration fee (or $50 if also attending the regular conference)

Pregnancy Prevention

When it comes to supporting strong families and healthy children, we care about all ages! The Adolescent Pregnancy Prevention Branch of Family Health Services is hosting their 2nd Annual Professional Development Conference on June 27-28, 2013 at the Alabama Activity Center (201 Dexter Avenue, Montgomery). Keynote speaker will be David Walsh, PhD, one of the world's leading authorities on children, teens, parenting, family life, and the impacts of technology on children's health and development. Additional speakers will cover topics related to early brain development, youth at risk, bullying and human trafficking. The Conference fee is $25 and this includes lunch and snacks. Seating is limited and the registration deadline is June 21st, so register now!

According to The National Campaign to Prevent Teen and Unwanted Pregnancy, the national teen pregnancy and parenting rate has plummeted over the past two decades, but few Americans are aware of this great success. Their infographic, The Greatest Story Never Told (pdf), reflects data collected from a national telephone survey conducted by Social Science Research Solutions for The National Campaign. We hope you'll share the good news and continue to support Adolescent Pregnancy Prevention.

Alabama Quality Child Care

The Alabama Department of Human Resources (DHR) is excited to launch the pilot for the Alabama Quality STARS Quality Rating and Improvement System (QRIS). QRIS is a process for supporting and recognizing child care centers for providing high-quality child care. Because so many of Alabama’s young children participate in early learning programs, it is important to make sure these programs provide children with the best possible start.

DHR is offering a series of Awareness Sessions, which are meetings conducted in various regions of the state to provide more information about Alabama Quality STARS. The Awareness Sessions will help child care program leaders (child care administrators, directors and owners) understand QRIS, the program components and requirements, and the tools that will be used to evaluate program quality. The Awareness Sessions will also provide an opportunity for program leaders to ask questions and to volunteer their site to be a part of the pilot project.

Those who attend an Awareness Session and complete a form to volunteer as a potential pilot site will be mailed the Environment Rating Scales (ERS) booklet(s) that is appropriate for your provider setting and a Program Administration Scale (PAS) booklet.

See schedule and note all sessions are limited to 50 participants each.

Thursday, June 13, 2013
1:00 P.M. – 3:00 P.M. & 5:00 – 7:00 P.M.
Gadsden State Community College, Gadsden State CC Library, 1801 Coleman Road, Anniston, AL 36207
Registration: 256-362-1390

Tuesday, June 18, 2013
2:00 P.M. – 4:00 P.M. & 5:00 P.M. – 7:00 P.M.
Calhoun Community College-Huntsville Campus, 102 Wynn Dr. NW – Room #47, Huntsville, AL 35805
Registration: 256-551-7016

Wednesday, June 19, 2013
1:00 P.M. – 3:00 P.M.
Fort Payne CRN Resource Library, 651 Wallace Ave., NE, Fort Payne, AL 35967
Registration: 256-845-8238

Friday, June 21, 2013
9:00 A.M. – 11:00 A.M. & 2:00 P.M. – 4:00 P.M.
Child Care Resource Center, 510 South 7th Street, Opelika, AL 36801
Registration: 334-749-8400, Ext.222

Monday, June 24, 2013
9:00 A.M. – 11:00 A.M. & 1:00 P.M. – 3:00 P.M. & 6:00 P.M. – 8:00 P.M.
Childcare Resources, 1904 1st Avenue North, Birmingham, AL 35203
Registration: 205-252-1991 Ext. 300

Tuesday, June 25, 2013
9:00 A.M. – 11:00 A.M. & 1:00 P.M. – 3:00 P.M.
Childcare Resources, 1904 1st Avenue North, Birmingham, AL 35203
Registration: 205-252-1991 Ext. 300

Thursday, June 27, 2013
9:00 A.M. -11:00 A.M. & 1:00 P.M. – 3:00 P.M. & 4:00 P.M. – 6:00 P.M.
Family Guidance Center of AL, 2358 Fairlane Drive, Building D, Montgomery, AL 36116
Registration: 334-270-4100 Ext. 235

Tuesday, July 9, 2013
9:00 A.M. – 11:00 A.M. & 1:00 P.M. – 3:00 P.M. & 6:30 P.M. – 8:30 P.M.
GRCMA Early Childhood Directions, 3100 Cottage Hill Road, Bldg. 4, Suite 400, Mobile, AL 36606
Registration: 251-473-1060 Ext. 115

Tuesday, July 16, 2013
1:30 P.M. – 3:30 P.M. & 4:00 P.M. – 6:00 P.M.
Wallace Community College, Rane Hall, 1141 Wallace Drive, Dothan, AL 36303
Registration: 334-712-7777 or 1-800-290-0933 Ext.225 or 224

Should you have questions please contact Clementine McGinnis, Quality Enhancement Coordinator at (334) 353-5207.

Relevant Research

May has been a busy month in the world of early childhood research. We've created a short list of some newly released resources!

- Dr. Dworkin, Director of the Help Me Grow National Center, has updated his blog again. This time it's filled with links to interesting brain research as presented by Jack Shonkoff and others regarding the impact of early adversity on young children and the importance of strong communities! Visit his post and explore the latest in baby brain science.

- Charles Bruner, executive director of the Child and Family Policy Center, has shared a brief summary that covers the existing and potential opportunities for financing from Medicaid for Help Me Grow. In the summary, he illuminates opportunities for expansion and sustainability for Help Me Grow affiliates around the nation. See the description here or download the summary (pdf) directly here.

- The Urban Institute's latest report, Disconnected Mothers and the Well-Being of Children (pdf), synthesizes research related to low-income mothers disconnected from both work and welfare. The research shows that many of the circumstances disconnected mothers face pose major risks to children's development. As shared by Zero to Three, this paper provides potential interventions to help disconnected families, including increasing and stabilizing family income, enhancing parenting skills, supporting children directly, and reaching out to disconnected mothers who are not citizens.

- We hope you'll participate in the Early Learning Day of Action on June 5th. The day is a call to action to emphasize the importance of early learning from birth to five. You could plan and participate in a community rally, or simply send out a tweet. Every action, great or small, is a step in the right direction of bringing attention to the needs of young children! Learn more and get ideas from this online toolkit.

Alabama Chapter - AAP

Linda Lee has served since 2007 as Executive Director of the Alabama Chapter of the American Academy of Pediatrics (AAP), where she oversees administration of the 700-member state society of pediatricians. During her tenure, she has grown the Chapter’s capacity to meet pediatric goals in numerous child health priority areas. As part of her role, Linda serves on numerous task forces, coalitions and committees including the Help Me Grow Alabama leadership team. We asked Linda to share a little with us about the work she has done and how AAP’s goals overlap with Help Me Grow.

Linda Lee, Executive Director
Alabama Chapter - American Academy of Pediatrics

Since 2007, in conjunction with Alabama’s Blueprint for Zero to Five initiative, the Chapter has co-led efforts to increase the percentage of children who receive standardized developmental screening in the medical home. We started this with the Alabama Assuring Better Child Health and Development (ABCD) project, which developed pilots in pediatric practices to train pediatricians on how to implement and score the Ages and Stages Questionnaire and refer for appropriate follow-up. In partnership with Alabama Medicaid Agency and ALL Kids, one of our goals was to establish state policy for third-party payment for standardized screening in the medical home. These efforts paid off, as Medicaid, ALL Kids, and Blue Cross Blue Shield of Alabama have all developed policy around and now pay pediatricians and family physicians for developmental screening (limited). 

Since the ABCD pilots, AAP’s strong alliance with partners at Alabama Department of Public Health, Alabama Partnership for Children, and Alabama Department of Mental Health has happily evolved to the Help Me Grow model, a natural step for this work. We have been pleased to join forces with the United Way of Central Alabama/Success By 6 in expanding standardized screening further in a five-county area in Central Alabama. HMG & AAP trains pediatricians on use of the Ages and Stages Questionnaire, coupled with the important benefit of having a connection to community resources via the HMG call center. We are excited about this partnership and the work that UWCA has done to make this a reality. In addition, this initiative has married AAP’s early literacy program, Reach Out and Read-Alabama, with HMG by connecting practices in the five-county area with new books for children from six months to five years of age. We owe a lot to the Community Foundation of Greater Birmingham for its support of HMG-Central Alabama.

Linda can be reached at 334-954-2543 or llee@alaap.org.

National Children's Mental Health Awareness Day

Thursday, May 9th is National Children's Mental Health Awareness Day

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) is the nation's leader for children's mental health services. SAMHSA's "Caring for Every Child's Mental Health" public awareness effort was created in 1994 with the mission to increase awareness around children's mental health. Every year there is a renewed public awareness effort and theme.

This year SAMHSA focuses on the importance of social connectedness—a sense of community—in enhancing resilience in young adults with mental health and substance use challenges at home, school, work, and in accessing health care services.

Watch this year's video here

Follow these links for more SAMHSA resources:
2013 - Social Connectedness Virtual Event
2012 - Juvenile Justice and Child Welfare Report

2011 - Child Resilience PSA
2010 - School Readiness PSA
2009 - Mental Health as a Priority PSA

Brain Growth

"It is widely accepted that the most critical time in a person’s life are the first few years. During the first year a child doubles in size both height and weight, but most importantly, the child grows immensely in brain power. It is that power that will decide their entire future..."

Help Me Grow Utah is a fellow Help Me Grow affiliate, their post last week is a great description of why HMG staff are passionate about serving families and helping babies grow.

Follow the link to find out why we (and HMG Utah) put such a priority on baby brain development.

Family Outreach - Books, Balls, and Blocks

Last month we featured Robin Mackey and her work with Strengthening Families. Today she shares her experiences with us in light of a recent Books, Balls, and Blocks event...

As a social worker I have worked with families in a variety of settings. I have found my recent work, focused on early childhood, to be especially rewarding. I have seen firsthand, the difficulties families face in addressing challenges experienced by older children. The fact is that when a teenager is experiencing social, emotional or behavioral difficulties, families often find themselves struggling to find the right help. Those fortunate enough to get the help they need still face a steep uphill battle to achieve the change they hope for.

In contrast, the early childhood world is all about bright beginnings. We know that when families get what they need when children are young, those children are set on a positive trajectory toward excellent outcomes. When challenges are identified, families of young children have an opportunity to take steps to prevent problems from escalating and, in many cases, reverse any negative effects.

I recently had the opportunity to see just how important it is to get information and support to families. At a recent community event called Books, Balls and Blocks (which was piloted by HMG Utah) parents had an opportunity to complete the Ages and Stages Questionnaire 3 (ASQ-3) while their children engaged in developmentally enriching play. Of the 28 parents who came through the event, 4 identified some type of developmental concern when they completed their ASQ-3. Those families immediately received referrals for support, including information on how to connect to Help Me Grow. It helped me to remember how important this work is. We can’t give up in reaching out to families and helping them to understand what healthy child development looks like and how to find help if they have concerns.

Jane and ADMH

Jane Duer is the Early Intervention (EI) Coordinator for the Alabama Department of Mental Health (ADMH), one of many state partners with Help Me Grow. Jane joined ADMH in November 2012 after working at Children’s of Alabama for 21 years. In January 2013, Jane attended a Help Me Grow meeting of southeastern state leaders. We’re excited to have Jane as part of our team and wanted to share her perspective on HMG in Alabama…

Through my work at Children’s and now at ADMH, I know firsthand that many families of young children face difficulties in finding the resources, supports and services to help their children. While there are great resources available in Alabama, children and families still get lost and don’t know how to find their way. I’m passionate about Help Me Grow and ADMH EI because they have similar missions - to identify and connect developmentally delayed children and their families to services and other resources, provide outreach to physicians, and increase awareness regarding the importance of early screening and intervention to improve a child’s developmental outcomes. 

ADMH EI participates in Alabama’s Early Intervention System (AEIS) by contracting with 27 local community agencies across the state to provide direct EI services to infants and toddlers with special needs and their families. An infant or toddler in Alabama under the age of three may be eligible for EI services if they are experiencing at least a 25% delay in any of the five areas of development: cognitive, communication, physical (includes motor, hearing, and/or vision), adaptive/self-help, or social/emotional, or have a medical diagnosis that has a likelihood of leading to developmental delay during early childhood.

I am proud to coordinate ADMH’s EI service providers and to deliver much-needed services to children and families across the state. While Help Me Grow is still in its own “early childhood,” it has the potential to make incredible improvements in the lives of Alabama’s youngest children and families. HMG is something we as Alabama residents and stakeholders can be proud of and should help support in any way possible.

To find out more about Early Intervention in Alabama or to refer a child for screening and evaluation, click here.

Dr. Dworkin: Informing the National Discourse

Dr. Paul Dworkin is the founder of Help Me Grow and Director of the Help Me Grow National Center. He writes a monthly blog updating state affiliates and the public regarding HMG at a national level. In the excerpt below, he shares positive news from a recent meeting of national leaders.

On March 5, 2013, Joanna Bogin and I had the honor of representing the Help Me Grow National Center when federal officials came together with community leaders in Washington, D.C., at a meeting hosted by the Center for the Study of Social Policy.

The focus of the meeting, titled “Community-Based Assessment, Services and Supports for Young Children,” on community pathways for early identification, referral, and linkage to developmental services and supports for young children led to a lively, productive discussion. While we look forward to sharing with you a comprehensive review of the dialogue, two aspects of the session merit special attention...

Finish reading here and check out Dr. Dworkin's entire blog here.

HMG Washington Video

Take 5 minutes and enjoy this powerful video from Help Me Grow Washington. Consider the impact HMG is having on families in central Alabama already!

 

Robin on Strengthening Families

Robin Mackey has worked with Alabama Partnership for Children (APC) for the past two and a half years and she coordinates Strengthening Families for the state. Prior to joining APC, Robin worked in a variety of settings with children, youth, and families as a licensed social worker. We posted about Strengthening Families back in January, but we wanted to hear Robin’s vision for the initiative...

Through my work at APC, I’ve been involved in communities across the state to implement the Strengthening Families Protective Factors framework within agencies and early care and education settings. I enjoy this work, and its connection to Help Me Grow, because I believe in the power of families. I see Strengthening Families and Help Me Grow as strategies which families can parlay into a customized support network.

Strengthening Families is not a program, but it is a framework of Protective Factors that can be embedded into any organization. The five Protective Factors are:
- Parental Resilience
- Social Connections
- Concrete Support in Times of Need
- Knowledge of Parenting and Child Development
- Social and Emotional Competence of Children

HMG services such as developmental screening and surveillance reinforce Strengthening Families Protective Factors within a family’s daily life. Help Me Grow provides a much needed in-road for families to access developmental screening, surveillance, and services. It promotes all five Protective Factors for families who engage with Help Me Grow, fortifying families, and extending the impact of the Strengthening Families Initiative.

If you have any questions, I hope you’ll contact me at rmackey@smartstartalabama.org or (256) 310-6621.

Harvard: Early Childhood Mental Health

The framework for stable mental health is constructed when we are all very young. As infants and toddlers form connections regarding people and the world around them, their mental health is developing. When there are unhealthy relationships or adverse experiences, a child's brain can be negatively impacted.

Harvard University's Center on the Developing Child continues to produce sound research to explain why it's important to protect all children's early life experiences. The newest publication in their InBrief series presents a solid case for why investing in young children's early development can help prevent many common problems in the future. The research presented supports the very core of Help Me Grow.

Learn more and download InBrief: Early Childhood Mental Health.

Help Me Grow in Central Alabama

Courtney Nix is the Program Manager for Help Me Grow Central Alabama (HMG-CA) and he works directly with each family connected to Help Me Grow. The Central Alabama site reaches five counties through United Way of Central Alabama: Blount, Jefferson, Shelby, St. Clair, and Walker. Courtney's been working hard to serve these communities. Read on to find out more about his work...

Alabama is in its infancy as a Help Me Grow state affiliate, so there is a lot of exciting development regionally and statewide. We have begun building a solid foundation by focusing on the following five goals:
1. Creating parent and physician brochures and other marketing materials
2. Building infrastructure: policies and protocols for data collection, processes for referrals, etc.
3. Training local pediatric offices in Help Me Grow
4. Data tracking and database management
5. Recruitment of new pediatric offices

Everything we are doing in the beginning stages of HMG-CA is focused on the four components of the Help Me Grow national model:
· Child Health Care Provider Outreach
· Community Outreach
· Centralized Telephone Access Point
· Data Collection

These components guide HMG-CA's emphasis on early detection and early intervention for children at risk of developmental and behavioral problems by using the ASQ-3 developmental screening tool. We provide and promote the use of this tool in medical homes, with child care providers, and to parents. HMG-CA is currently partnering with the Alabama Chapter of the American Academy of Pediatrics to reach out to physicians. This important collaboration is funded by the Community Foundation of Greater Birmingham.

We are also utilizing the 2-1-1 Connects Alabama resource database along with BeeLocal to assist us with connecting children and their families to local resources. In addition to building a great foundation for statewide expansion, we have begun intake for Help Me Grow cases. We currently have approximately 40 open cases. If you would like any additional information on Help Me Grow and how we can assist you or someone you know, please call 205-458-2070 or email HelpMeGrow@uwca.org.

Success By 6 & HMG

Beth Johns is an assistant vice president at United Way of Central Alabama and she leads the Success By 6 program. Take a look at what she has to say about her passion for young children and how she thinks Help Me Grow fits in Alabama.

Success By 6 is the umbrella for early childhood initiatives at United Way of Central Alabama covering 5 counties- Blount, St. Clair, Jefferson, Walker and Shelby. Since its inception, Success By 6 has worked with preschoolers in a variety of settings with our quality preschool initiative. One component of our work is developmental screening onsite and linking children to appropriate services in the home, community, school, and/or health system.

Before joining the team at Success By 6 as the part time Health and Developmental Specialist, I practiced in Alabama, Tennessee, and North Carolina as an occupational therapist. I personally saw the impact of late identification of behavioral or developmental issues on families who felt left behind by the system. This was an ongoing issue with the families I worked with and I was driven then and am now to link families to what they need and to assure children are identified and connected to services as early as possible.

For years, Success By 6  has provided child care provider training on child development, developmental screening, resources, and empowering the child care and early childhood professionals to trust their instincts based in experience. The Success By 6 team works with child care providers, families, and community service providers to identify children's developmental delays using Ages and Stages Questionnaire-3. The team then links them to preschool special education or community based services for further assessment and possible services.

Early identification is a priority at Success By 6 and we believe strongly that through Help Me Grow efforts in physician outreach, community outreach, data collection, and our centralized call center that assesses needs and connects resources, we will be able to reach MORE children and assure they have a great start in school and in life. We are thrilled to be the regional implementation site of Help Me Grow in Alabama and to help strengthen a system which enables children and families to be successful.

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Do you have a question for Beth? Leave it in the comments or visit http://www.uwca.org/successby6/index.htm to find out more.

Congratulations, Alabama Act Early Ambassador!

Congratulations to Anna McConnell, State Autism Coordinator and new Alabama Act Early Ambassador! Anna is with the Alabama Department of Mental Health and serves as a leader on the Help Me Grow Alabama state team. We are very proud of Anna and excited about the Learn the Signs, Act Early materials and information that she will gain.

The Act Early Ambassador program is funded by the Centers for Disease Control and Prevention (CDC)  and the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau.  The 15-month program allows Ambassadors to help promote the goals and objectives of Learn the Signs, Act Early (LTSAE), to improve early identification of autism and other developmental disabilities, to work closely with the LTSAE national program and Act Early Alabama state team, and to utilize and help promote the “Autism Case Training: A Developmental Behavioral Pediatrics Curriculum.”

This opportunity will make more resources available to further the progress that has already been made by the Act Early Team by continuing to strengthen and expand relationships with the medical community to improve developmental monitoring and to provide resources and training.  These activities are in line with the mission and charge of the Alabama Interagency Autism Coordinating Council (AIACC), which already participates in LTSAE initiatives.  Anna's ambassadorship will strengthen partnerships around the state, like Help Me Grow, as these initiatives continue to expand.

Families and Services: New Research

One of the major goals of Help Me Grow is to provide support and connections for young children when developmental concerns are identified.  Alabama’s Early Intervention System (AEIS) provides services to children birth to three who are eligible.  Alabama has one of the broadest eligibility definitions in the country – serving children with a 25% delay in any developmental area or a diagnosed condition likely to lead to delay.  Help Me Grow is designed for those who will not qualify for EI services but are identified as “at risk” of a delay.  Alabama’s EI system does not serve the “at risk” population, therefore there are children who need support and services but who do not quality for EI services in our state. 

There may be times when health care and early childhood professionals assess children and feel that they need services but do not qualify for AEIS OR a family decides they do not want EI services. EI is completely voluntary and a parent may choose not to participate even if a child is determined eligible. 

Recently a national research foundation, The Commonwealth Fund, implemented a study that revealed some staggering information about what hampers children that have “fallen through the cracks”. Five barriers the study found may surprise you. The barriers were identified based on interviews with parents of children who had been through an EI evaluation, parents of children who hadn't, and EI staff. The researchers also make recommendations for improving the referral process. Follow this link to see the barriers and recommendations.

Alabama HMG stakeholders continue to collaborate in an effort to identify all children who need help as early as possible and to coordinate with the services they need. Anyone concerned about a child's development can refer that child for an EI evaluation. If you'd like to know more about Alabama's Early Intervention System, click here.  To fill out the fax-back form to refer a child for EI services, download this PDF.

Did you know you could refer a child in your life for evaluation if you were concerned about his or her development? Find out more about developmental delays here and together, we can all make a difference for Alabama's children!