A Look at Fond du Lac CountySPROUT Partnership
Presented by: Dr. Matt Doll, Diane Fett,
Matricia Patterson & Andrea Welsch
Overview of Presentation
• The Early Years Matter (Matt)• A Community Plan (Diane)• Collaborative Team (Matricia)• Collective Impact (Andrea)
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 place• Patterns of behavior
are formed• A 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
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.
Across the Lifespan• Intrauterine 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.
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
Stunning difference between a brain with proper stimulation and one that has been deprived. - Bruce Perry, Baylor College of Medicine
Serve and Return (1:42 min)
http://www.youtube.com/watch?v=m_5u8-QSh6A
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?
Attachment (still face 2:49)
http://www.youtube.com/watch?v=apzXGEbZht0Maternal Depression/Mental Illness
Impact 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.
Socially deprived cohort of mothersWith High Mentalization:
10/10 secure children
With Low Mentalization: 1/17 secure children
Mentalization confers resilience: ability to recognize your own and others’ mental
states, and to see these mental states as separate from behavior
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
Trauma & Attachment
Theory of Change (5:18 min)
http://www.youtube.com/watch?v=urU-a_FsS5Y
Personal Responsibility? (1:01 min)
http://www.youtube.com/embed/RBqjZ0KZCa0?showinfo=0&rel=0&hd=0FsS5Y
Why It Matters
• Until now, these persistent effects were “hidden” from the view of both neuroscientists and public health researchers
• This 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.
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 2008-2010)
Root Cause
Return on Investment
Measurable Goals and Outcomes
Cradle to Career
Manufacturing Graph
Lean 6 Sigma Processes
“Unemployable Populations”
Skilled Worker Shortages
We finally know…
• What Nurses have known all along• What Home Visitors have long
suspected• What the Health Profession has been
trying to tell us…• This is bigger than any one of us• There are no quick fixes
Taking What We Know and Changing What We Do
• A healthy community rethinks business as usual
• Rolls up its sleeves, • Works smarter, not harder, • Works together, not alone, • Uses research and science as a guide
The Beginning: A Look at our History
• The Wisconsin Alliance for Infant Mental Health connection
• Department of Health, Division of Public Health
• 1 of 3 Communities Chosen• Small Planning Group Formed
• Broad Sponsorship• Introduction of Infant Mental Health
Concepts• 85 people attended• Committees were formed
1st Summit: October 17, 2008
Defining Infant Mental HealthInfant 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; and• Explore the environment and learn – all in the
context of family, community, and cultural expectations for young children
(Zeenah, Stafford, Nagle, & Rice, 2005)
Strengthening Each Child’s Capacity
• Self confidence• Curiosity• Motivation• Persistence• Self Control
• Trust• Regulate and Express Emotions• Form Close and Secure Relationships• Identify Feelings• Empathy
It Started With a Vision
OUR MISSION The 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.
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.
The Plan is Shared• Presentations by law enforcement, elected
officials, business and others, about the importance of the early childhood and received
• Plan endorsement from many agencies• Committee support expanded
2nd Summit: October 26, 2010
2011: The Partnership is Formed• Brown County United Way – Community Partnership
presented their model to community members at the UW-Fond du Lac Campus
• The Fond du Lac County Community Partnership for Young Children held its first meeting
• The Fond du Lac School District Comprehensive Service Integration – Element 5 Committee merged with SPROUT
• Committee work began implementation of the SPROUT Plan
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 matter• Early experiences matter• Adverse Childhood Experiences impact health and
potential
Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environments
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environment
s
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Supporters
Council Reps
• Parents• Physicians / Health• Child Care• Head Start / Birth to 3• Social Services• Housing / Shelter • Domestic Violence
Services• Law Enforcement• Child Welfare• Mental Health
• Children’s Museum• Library• Faith Based• WIC• Public Health• Early Childhood
Education• Higher Education• Media• Business• United Way• Government• Legislators
Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environment
s
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Administrators
Structure, Support, Guidance
Executive Committee
Responsive Relationships
Supportive Environment
s
Social and Emotional Supports
Intensive Interventions
Council Representatives
Children & Caregivers
Execu
tors
of Plan &
Embracers
Collective ImpactChallenges Successes
• Funding• Coordination &
Coordinator Role• Engagement
• Funding • Coordination• Engagement• Structure / Commitment • Champions / Decision Makers• 100’s Impacted / Evaluation • Evidence Based• Recognition
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
Nurturing and Responsive Relationships
N&RR
Library
Children’s Museum
Birth to 3
AHCAurora
Health Department
Family Resource
Center
School Disctrict
Key Projects of N&RR Committee
• Coordinated delivery of training• Targeting parents and caregivers • Focusing 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 Three
• Developed and distributed a County Resource Guide• Parents, Caregivers, and Providers • Comprehensive list of resources available within our community.
The Second Layer
High 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.
Supportive Environments
SE
Family Connections
YMCA Childcare
Health Department
Fond du Lac County
MPTC
AHC
Parent
Key Projects of SE Committee
• Coordinated delivery of training to childcare centers• Breast Feeding Friendly Centers Targeting training for 14
centers in 2014• Quality Focus: Activities to support Young Star Ratings • PBIS - Behavioral System (originated in school district)
• Promoting effective use and access to ASQ screens• Goal Periodic Screens (18 mos)• Education across Council • Creation of WIC screening sites• Critical access points (pediatricians, homeless shelters,
domestic abuse)
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
Targeted Social and Emotional Supports
TSE
Birth to 3
Health Dept
ADVOCAP Head Start
School Districts
Solutions Center
Social Services
Key Projects of TSES Committee
• Coordinated delivery of Conscious Discipline Curriculum• Targeting child care centers and parents• 80 participants, 6 child care centers, 1 in home provider• Evidenced Based
• Targeted Parental Supports• Parents going through Paternity Cases• Access to ASQ screens to homeless & families
experiencing domestic abuse
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
Intensive Interventions
II
Birth to 3
AHCHealth
Department
Family CourtDoll &
Associates
Marian University Early
Childhood
ADVOCAP Head Start
Social Services
School Districts
Key Projects of II Committee
• Dr. Navsaria Reach out and Read (Oct 16th)• Targeting cross sector business, physicians,SPROUT
partners and parents• June 2014 Journal of American Academy of Pediatrics
• PICCOLO Training• Parenting Interactions with Children: Checklist of
Observations Linked to Outcomes• Targeting Practitioners working with children 10-47
months• Observing, tracking and supporting parent interactions• Affection, Responsiveness, Encouragement & Teaching
The Executive CommitteeExecutiv
e Committee
Responsive
Relationship
s
Supportive
Environ
ments
Social
and Emotional
Support
s
Intensiv
e Intervention
s
Council
Children & Caregivers
Key Projects of Exec Committee
• Coordination of Plan Goals Across Committees
• Funding & Sustainability
• Council Surveys Monitor & Respond
• Community Wide Awareness, beginning with:
It matters to all of us!
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
Presentation Reference Materials
http://www.youtube.com/watch?v=m_5u8-QSh6AProcess by which attachment forms
http://www.youtube.com/watch?v=apzXGEbZht0Maternal Depression/Mental IllnessImpact on Attachment is across the lifespan.Sensitive periods.
http://www.youtube.com/watch?v=urU-a_FsS5YTheory of Change
http://www.youtube.com/embed/RBqjZ0KZCa0?showinfo=0&rel=0&hd=0FsS5YPersonal Responsibility?
Official Journal of American Academy of PediatricsLiteracy Promotion: An Essential Component of Primary Care Pediatric Practice, June 2014
Zero to Three: Breaking the Cycle; Supporting Parent-Child Relationships Through the “Parents Interacting with Infants” Intervention, July 2014
Early Learning Challenge Technical Assistance: Supporting Children Through Community Based Coalitions, December 2013
The Future of Children; Princeton Bookings:Early Stress Gets Under the Skin: Promising Initiatives to Help Children Facing Chronic Adversity