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 Early Years Matter

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.

Social and Emotion Health is Directly Impacted by Experiences

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

A Community Plan

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

The Pyramid Model

Focus of WorkCenters on theSocial and EmotionalFoundations for EarlyLearning

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

The Name: SPROUT Partnership

SupportingPositiveRelationships so Our ChildrenUnder 6 canThrive

A Collaborative Team

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

Collective ImpactEffecting Change

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.

Resource Guide Excerpt

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!

Wrap Up

• Questions?• Closing comments?• Final thoughts?• Reference Materials• Next Steps?

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