Grow Along with Me Supporting Families in Healthy Child Development

1
Grow Along with MeSupporting Families in Healthy
Child Development

• Mark Moland
• Manager
• Childrens CARE Services
• Sharon Myck
• Manager
• Wellness and Community Health

2
Why?

• the early years of development from conception
  to age six, particularly for the first three
  years, set the base for competence and coping
  skills that will affect learning, behaviour and
  health throughout life.
• (The Early Years Study, McCain Mustard, 1999)

3
Overview

• What is Grow Along with Me? (5)
• Developmental Checkups (10)
• Continuum of Services (20)
• Building Community Capacity
• CORE Groups
• START
• Clinical Services
• Collaboration (10)
• Summary (5)

4
What is Grow Along with Me?

• Partnership/Structure handout
• Staffing
• Developmental Checkups
• Community Capacity
• Education/Information
• On- Site Visits
• Training
• Core Groups
• START
• Evaluation
• Participatory approach
• University of Lethbridge

5
Where
What is Grow Along with Me?
6
Grow Along with Me Project Goals

• To develop a comprehensive continuum of services
  for children between 18 and 36 months of age.
  There is a strong focus on prevention as well as
  enhancing intervention services.
• To identify children (18-36 months of age) who
  may have a developmental delay as early as
  possible using a standardized instrument (i.e.,
  the Ages and Stages Questionnaire).

What is Grow Along with Me?
7
Structure

• Steering Committee
• Communications Subcommittee
• Evaluation Subcommittee
• Education Subcommittee
• Staff Committees

What is Grow Along with Me?
8
Staffing

• Original Proposal
• 5.4 FTE Grow Along with Me Educators
• 4.0 FTE Infant Preschool Development Educators
  (IPDE)
• 3.0 FTE Speech Language Pathologists (SLP)
• 0.5 FTE Occupational Therapist (OT)
• 1.0 FTE Clerical Support
• 0.8 FTE Health Analyst

It is important to acknowledge the significant
in-kind resources that have been dedicated
towards this project.
What is Grow Along with Me?
9
November 24 December 05 2008
What is Grow Along with Me?
10
Staffing

• Collaboration across professions, departments and
  organizations and Ministries

What is Grow Along with Me?
11
Evaluation Approach
What is Grow Along with Me?
12
Evaluation Approach

• Focus on process and outcomes
• Strategic approach utilizing qualitative and
  quantitative methods.

What is Grow Along with Me?
13
Developmental Checkups
14
Developmental CheckupsRecommended Frequency

• 6 Month Well Child Clinic Visit
• 18 Month Well Child Clinic Visit

Developmental Checkups
15
6 and 18 MonthWell Child Clinic Process

• Parent is scheduled to attend the appt 15 minutes
  prior to the time they will meet with the nurse
• Parent completes ASQ
• Nurse reviews completed ASQ with parent during
  visit
• Nurse provides information, anticipatory guidance
  and referrals as required

Developmental Checkups
16
Developmental CheckupsRecommended Frequency

• One time per year between 24 months and 60
  months of age.
• Community Developmental Checkup sessions in the
  spring of the year
• Parent Link Centers
• Parents as Teachers
• Home Visitation
• Some regulated child care facilities and private
  preschools

Developmental Checkups
17

• These numbers include only ASQs that were
  completed
• and received by Childrens CARE Services

Developmental Checkups
18

• There were
• 2614 more
• ASQs completed
• in 2008 than 2006
• 163 increase!

Developmental Checkups
19
Developmental Checkups
20

• I found it reassuring to know where my little
  guy was (in relation to developmental
  milestones) (Parent comment)

Developmental Checkups
21
Approximate Coverage Rate for 18 Month
Developmental Checkup October December 2009
Q3 (October December) 2008/09 Q3 (October December) 2008/09
Estimated number of Children who turn 18 months in quarter 698
of ASQs completed and returned to CARE (18, 20, 22 month intervals) 366
Estimated percentage of coverage 52
Developmental Checkups
22

• Approximate Coverage Rate for 6 Month
  Developmental Checkup October December 2009

Q3 (October December) 2008/09 Q3 (October December) 2008/09
of Children who turn 6 months in quarter 733
of 6 Month ASQs completed and returned to CARE 320
Estimated percentage of coverage 44
Developmental Checkups
23
Developmental Checkups
24
Summary of Concerns Q1-Q3 2008/09 for 18 36
Month ASQs
Developmental Checkups
25
Summary of Other Concerns in Quarter 2 2009
(n54)
Concern Number
Speech Development (e.g. delayed speech, dropped sounds, articulation 22
Behavioral Concerns (e.g. temper, biting, hitting, tantrums 10
Nutrition/eating concerns 7
Referral declined 6
Other (fine motor, flat head, persistent cough, rash, scrunching ears, sleeping) 5
Motor skills (e.g. falls, stance) 4
Developmental Checkups
26

• Phone Interview Question
• Did the ASQ provide parents with the opportunity
  to learn about activities that supported their
  childrens development at home?

• Absolutely! One example of a developmental check
  I learned was to test for putting items in a
  bottle to see if my son would turn them upside
  down to get them out. We had never spent time
  before using all the little things to be aware
  of. Another example is pouring sand from bucket
  to bucket. I guess it just changes the way we
  play nowit moves the focus onto developmental
  growth.

Developmental Checkups
27
Developmental Checkups
28
Developmental Checkups
29
Developmental Checkups
30
Continuum of Services
of
31
Building Community Capacity

• Capacity building refers to the means by which a
  community can tap into its own strengths.
  "Capacity building places the emphasis on
  existing strengths and abilities, rather than
  being overwhelmed by problems or feelings of
  powerlessness"
• (HRDC, 1999).

Continuum of Services
32

• There is certainly more than just myself to rely
  on to help my child become an invaluable part of
  the community by starting him off on the right
  path. Thank U. (Parent comment regarding the
  Community Based Developmental Checkup)

• Learning the areas that I can help improve with
  my child before pre-k. (Parent comment regarding
  the Community Based Developmental Checkup)

Continuum of Services
33
Community Capacity

• Comprehensive Communication Plan
• Website www.growalongwithme.ca
• Information Resources
• Onsite Visits
• Community Education Sessions
• Connections

Continuum of Services
34
(No Transcript)
35
Quarter 3 (Q3) website utilization data reflects
a continued demand for the Grow Along With Me
website information. Nearly ¾ of hits are new
visits (69.3), reflecting an ongoing interest in
the GAWM web site
Continuum of Services
36
(No Transcript)
37
Onsite Visits
Continuum of Services
38
In-services Available

• TALKING TAKES TIME
• TAKING A CLOSER LOOK AT COMMUNICATION
• SHARING CONCERNS WITH PARENTS
• FINE MOTOR DEVELOPMENT IN TODDLERS (12-36 MONTHS)
• PARTNERING with PARENTS when using the AGES
  STAGES QUESTIONNAIRE
• AGES STAGES QUESTIONNAIRE (ASQ)
• WHEN WILL I GET A GOOD NIGHT SLEEP
• TEACHING TOOLS FOR CHILDREN WITH CHALLENGING
  BEHAVIOURS

Continuum of Services
39
Other Communication Initiatives

• Launch
• Wellness Show
• Community-Based Developmental Checkups

Continuum of Services
40
Core Education

• You Make the Difference (Hanen)
• Learning, Language and Loving it (Hanen)
• Target Word (Hanen)
• COPEing with Toddler Behavior
• Parenting the Strong Willed Child
• Responsive Teaching
• Who runs them.

Continuum of Services
41
Providing Parents and Communities with more tools

• The right time
• The right place
• The right tools
• These steps benefit everyone!

Continuum of Services
42
Families creating positive outcomes

• Good timing
• Relationship building
• Families take on many shapes and forms
• Building rich experiences

Continuum of Services
43

• Access
• Parent and Service Provider Education

Continuum of Services
44
AccessGroups

• Barriers
• Child care
• Trained Staff
• Transportation

Continuum of Services
45
Parent Video or Story
46
Quotes from parents who have attended groups

• I am grateful for childcare
• My child benefited from the opportunity to
  interact with other children
• Without childcare, I couldnt attend
• I learned what to do vs. what not to do

Home is more peaceful and positive Best
skills I learned attending and rewarding
Continuum of Services
47
Continuum of Services
48
START

• Short intervention times
• Term limited
• A broad based Assessment
• Responsive Action
• Team

Continuum of Services
49
Integration with Clinical Services
Continuum of Services
50
Pathway Audit
Continuum of Services
51
Cultural Responsiveness

• Building on partnerships and adapting services to
  reach our community

Napi Takes a Walk
By Rebecca Many Grey Horses Helen Kromm
Continuum of Services
52
Collaboration

• Coming together is a beginning. Keeping together
  is progress. Working together is success.
• Henry Ford

53
Collaboration

• Structure
• Steering Committee
• Sub Committees
• Collaborative Staff Meetings
• Evaluation and Improvement
• Survey
• Focus Group
• Priority Setting
• Synergy

• Collaboration

54
Domains Identified

• Collaboration

55
Strengths
Foundational factors Architectural factors Sustainability factors
A clear vision, mission, and goals statement Creation of three sub-committees Mutual respect
Regular meetings Establishment of terms of reference Collective problem-solving
Facilitative and supportive leadership Use of information technology Transparency of project information
Grassroots involvement Collective adherence to established project processes
Strong skill set of its members
56
Opportunities for Improvement
Foundational factors Architectural factors Sustainability factors
Collective understanding of project goals and objectives The establishment of a sustainability sub-committee Constructive approaches to feedback and consistent use of affiliation agreements
Timely and specific feedback and information sharing to committees and staff. Hiring qualified staff Develop process whereby partner organizations are regularly informed of project activities, challenges, and processes
Establishment of a problem-solving process Transparent decision-making processes and resource allocation
Shared leadership Establishment of working agreements
57
Key Areas of Focus

1. Establish a sustainability committee
2. Develop a process whereby parent organizations
   are regularly informed of project activities,
   (challenges) processes
3. Hire qualified staff

• Collaboration

58
Synergy

• You think because you understand one you must
  understand two, because one and one makes two.
  But you must also understand and (Donella
  Meadows, 1982)

• Collaboration

59
Synergy

• Grow Along with Me Launch
• 6 month ASQ
• Newsletter Hanen
• Linkage with U of L
• Dr. Kolb nursing students
• Childrens Mental Health plan ASQ-SE
• Primary Care Initiative
• Early Development Instrument
• Vision 2020 The Future of Health Care in
  Alberta Phase 1. December 2008.

• Collaboration

60
Summary
61
Key Messages

• Parents want information regarding how they can
  best support their childs development
• Collaboration is key to success
• Measurement, evaluation and ongoing improvement
  is critical

62
(No Transcript)
63
Next Steps

• End date
• Evaluation
• Sustainability

64
Taking the time to Grow Along With Me has the
power to change a community!