Ready for SchoolThe Health and

Learning Connection:Nature and Nurture?

It takes all of us

Donna LB Lowry, MDAssociate & Medical Director

Inform and Engage Parents

Goal of HTF

• To utilize the medical community as a forum for parental education and engagement

• Identify and refer children and families to community resources including Ready for School

• Assure that all children 0-5y connect with a medical home

Partners in Health

• Holland PHO

• OCHD- DHS- CMH

• Holland Community Health Center

• InterCare

• Lakewood Family Medicine

• SH Pediatrics

• SH Zeeland Physicians

• Georgetown Physicians

• Hope College

• Holland Hospital

• Spectrum Health Zeeland Community Hospital

• Lakeshore Health Partners

• Priority Health

• BCBS Michigan

• CPS

• Physician Donors

Healthcare Providers

Relationship of Trust

1990’s: The Decade of the Brain

Nature

• Critical Concepts in Early Brain Development

• Proportional brain growth

• Neural plasticity

• Critical periods

• Sequential development

• Role of experience

Early Brainand Child Development

Nurture

• The human brain is shaped by experience

• Experience, in turn, leads to changes in the brain

• Birth: 50 trillion synapses

• 1 year: 1,000 trillion

• 20 years: 500 trillion

• These changes in the brain make new experiences possible

Early Brainand Child Development

SERVICE IMPLICATIONS

Early Brain Development

• For optimal effectiveness, services must begin as early as possible

• Stimulation during the first three years is particularly critical to ensure optimal development

• “use it or lose it”

• Services must be comprehensive and aligned with children’s developmental stages and needs

Birth

Early Infancy

Late Infancy

Early Toddler

Late Toddler

Early Preschool

Late Preschool

Prenatal 6 mo 12 mo 18 mo 24 mo 3 yrs 5 yrs

“Re

ad

y t

o L

ea

rn”

“School Readiness Trajectories”

“At Risk” Trajectory

“Delayed/Disordered ” Trajectory

“Healthy” Trajectory

Parental educationEmotional healthPrenatal care

Family social connections

Quality ECE

Positive parenting

Neighborhood violence

Inaccessible health services

Poverty

Graphic Concept Adapted from Neal Halfon , UCLA Center for Healthier Children, Families, and Communities

Health services

• Children with developmental/behavioral problems are eluding early detection

• Many initiatives exist to provide services to young children, their families

• A gap exists between child health and child development/early childhood education programs

• Children and their families would benefit from a coordinated, region-wide system of early

detection, intervention for children at developmental risk

ASSUMPTIONSCreating a Healthy Beginning

Goals

• Identify critical concepts in early brain development and early child development that inform health services delivery

• Explain the benefits of children’s health services focusing on promoting the optimal development of at-risk children

• Identify the importance of whole community cross-sector collaboration in strengthening child health service delivery

Healthy Beginnings

Healthcare Provider Participation

Reach Out and Read

ASQ Assessment & Referrals

Healthcare Coordination

RN Case Manager

Community Health Worker

Healthcare Outcomes

Data Management

Data Reporting

Partnership participation

ROAR Outcomes

4 million children worldwide

Parents are up to 4x more likely to read aloud to their children.

@ age 2 developmental gains in language & literacy with a six month developmental edge over peers.

Kindergarteners score higher on vocabulary tests and school readiness assessments.

Reach Out and ReadHolland Community Health Center

Mary Bosscher, Reach Out and Read coordinatorShe reads, educates and encourages kids and parents to read.

Reach Out and ReadHolland Community Health Center

“Bringing my son to the Holland Community Health Center was a very good thing because here they taught us to read to him and teach him at home and that would prove to be very helpful because he is now a 1st grader and top of his class.

We are extremely grateful that they had Reach out and Read program in his physicians’ office. And will continue to use this method at home with our future children.”

HCHC Father, November 2012

Developmental Surveillance

• Developmental and social-emotional delays can be subtle and can occur in children who appear to be developing typically so most children who would benefit from early intervention are not identified until after they start school.

• Pediatricians don’t detect delays more than 70% of the time when they rely on clinical judgment alone.

ASQ 3

The ASQ looks at strengths and trouble spots,

educates parents about developmental milestones,

relies parents’ expert knowledge about their children.

Healthy BeginningsCare Coordination

ASQASQSE

Well child visits

ER/Urgent Care

Immunizations

Partners in OutreachHolland Rescue Mission

Read to EatHope College’s Community Health Nursing Student,

Kaylee Marcinkus @ Stepping Stones Preschool

Community Health NursingImpacting Health and School Readiness

Read to EatLena Jaynes & Kaylee Marcinkus @ Stepping

Stones Preschool

2012 Accomplishments

• 100% increase Organizational Partners in Health

• Restructured the Health Task Force

• Healthy Beginnings: Unified program, built team

• 50K BCBSM Community Partners Grant

• Health Outcomes: Public Health Research Intern

• Reached all Providers of pediatric care

• Expanded Hope College relationships• Nursing Department, English Department, Pre Health Professions

2013 Ready Set Talk

• Speech Pilot over summer 2013-2014

• Target children 24 3 ½ -5y per summer

• 6 week program, 2 ½ hours for 18 session

• Total of 45 hours of intervention

• Build partnerships

• With Parents

• With Parent Educators

• With Kindergarten Teachers

2013 ROAR Lakeshore Initiative

Goal

To support all health care providers in the Holland, Zeeland & Hamilton area who desire to participate in the Reach Out and Read program

What Ready for School will offer

• Provision of funds for books until 2015

• Volunteer coordination and support

• Highlighting your work in the community

What Next? Things to consider

• How do we sustain these efforts?

Local support

The Affordable Care Act

Insurance Companies

Large employers