Thursday, December 27, 2012

On Moving From Reactive-only Interventions to a Proactive System of Care: Redesigning our behavioral health system


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These are challenging times. Kitsap Mental Health Services is at the forefront of a movement away from a "sick care" system to a "health care" system. A while back, Dale Jarvis came to present to KMH staff on heath care reform, as has been covered in a previous post here. Here is an op-ed that just appeared by the exec at KMHS Joe Roszak for the Kitsap Sun newspaper on the subject. -gw
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Letters to the Editor
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MY TURN | Strengthening our mental health care system
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Joe Roszak is executive director of Kitsap Mental Health Services.
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Published Wednesday, December 26, 2012
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With yet another horrific tragedy resulting in the loss of many innocent, young lives, desperate discussions are focusing on how to prevent such events from ever occurring again. Out of the fevered discussions which encompass gun limits, bulletproof backpacks, improved building security measures, better threat assessments, arming professionals with lethal responses, slowly coming to the fore is the issue of mental health services.
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The question is: "How can our community increase the capacity of our behavioral health care system?" The reasons to do so are clear. Mental Health and addictions are a public health priority. We know behavioral health prevention works. Mental illness and substance addiction is treatable. Very importantly, recovery is possible. Years of research and work in the field even tells us there are known effective individual, family, and community based strategies that can make our little corner of the world a safer and more compassionate place for all who live here. The constant challenge is being able to fiscally sustain the programs and services. The harsh economics of the past few years has taken a severe toll, not only on mental health services, but many other significant community safety net services. However, the success of behavioral health treatment and the value of prevention and early intervention have not been diminished over the years. We have the capability to provide effective treatment, what we lack is the capacity to do so.
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Perhaps of most value is the ability to provide behavioral health screening and assessments for individuals. Much like preventive cancer screening, many mental illnesses can be effectively identified through a basic mental health exam. Screening and early intervention for children, teens, adults, and older adults at schools, primary care offices, emergency rooms, and other health providers for mental health and for alcohol and other substance use concerns can identify early on, depression, anxiety, other mental illnesses and substance use before they become more deeply rooted. Such screening can and should become routine, and followed by discussions regarding possible interventions and treatment, just like any other illness.
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Friday, November 30, 2012

On Don't Take the Bait: Children's behavior that doesn't 'work' will stop


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This is science --  behavioral science, based on decades of research. Source of this excerpt: a 2011 handout for parents for distribution by therapists trained here in Washington State in Cognitive Behavior Therapy Plus (CBT Plus). -gw
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Almost all behavior is caused by an interaction between children and their environment. Humans learn by testing out different behaviors and finding out what happens—what do people do, or not do, in response? It is normal for children to want to get what they want immediately and normal for children to want to avoid unwanted situations or consequences. However, part of growing up is learning to be patient, ask nicely, share, and handle frustration or disappointment without making a huge fuss or being destructive. Children must also learn to separate from caregivers, take on age appropriate responsibilities, and consider other people’s feelings and wishes. These are the normal tasks of child development. The key teachers are caregivers and teachers, and it is NOT always easy!
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Children sometimes learn lessons that we don’t want them to. For example, almost all caregivers have had the experience of young children whining or throwing temper tantrums to get attention or something they want at home or at a store. And almost all caregivers have the experience of children dawdling, delaying or not doing what they are told because they don’t want to stop an activity such as watching TV or talking on the phone. If children’s behavior (e.g., tantrum, yelling) “works,” meaning they get what they want (or get out of doing what they do not want to do) children will keep using the behavior, hoping it will “work” again.
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There is an explanation for this pattern of behavior. The basic rule is that all behavior has a function or purpose. Behavior is intended to get something children want or get out of something children do not want. Children might want attention, power over their situation, or specific rewards (e.g., allowance, privileges). They might want to get out of chores, doing homework, or trouble. This rule is not just true for children, it is true for everyone. People go to work to get something such as a pay check and self esteem; people don’t answer the phone or sometimes tell small lies to avoid being hassled or hurting someone’s feelings. 

Thursday, November 8, 2012

On 'God Don't Make No Junk': Most 'junk' DNA consists of regulatory proteins

A repudiation of the idea of "junk DNA" has been all over the science news recently. (Music lovers may remember the a certain music album linked below that incorporates the idea in a well-known colloquial expression.) Speaking on maternal mental health, here is Shawn Elmore, PhD, Associate Professor, Psychology and Community Health, University of Washington, speaking on "junk DNA" at the Symposium on Infant Mental Health in Mukilteo WA last month. -gw
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God Don't Make No Junk (1994) is the name of the first album recorded by the American group The Halo Benders.

Wednesday, November 7, 2012

On Glen Cooper Presenting for the WA-AIMH Meeting: An originator of Circle of Security

The Washington Association for Infant Mental Health (WA – AIMH) has four general meetings a year, free to members. Membership is $40. The next meeting is Nov. 14 from 7 to 8:30 p.m. at Wellspring Family Services; 1900 Rainier Avenue South, Seattle, WA 98144 (map). -gw+

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Glen Cooper, MA is one of the originators and trainers of Circle of Security International, an early intervention program for parents and children. He will present a Circle of Security case with video footage. Glen and his colleagues received the Governor’s Child Abuse Prevention Award in Washington State for their work in the Circle of Security® Project. He has presented workshops throughout the U.S., and in Canada, England, Uganda, New Zealand, Germany, and Australia. National and international audiences rate Glen highly for his warmth, kindness, humor, and ability to present complex material in a manner that is engaging and accessible.

Wednesday, October 31, 2012

On the Peninsulas Consultation Group Takes a Field Trip: Building camaraderie

The ride to the Mukilteo conference and back was noteworthy for the sight-seeing and the relaxation it afforded. There is something about a ferry ride that makes any journey special. Before embarking we stopped at at creperie, and on our way back we were treated to a beautiful sunset, great for mental health.  -gw

Tuesday, October 30, 2012

On the Emergence of Screen Time As an Issue of Concern: What is best for baby's brains

Valuable screen time for junior youth
Valuable junior youth screen time

When I was a little kid the only screens I knew of were those over a window. Screen time was looking through one.
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Then we got TV, although we were the last on the block. TVs have screens. I've spent a lot of time in front of a TV screen.
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Junior youth recoil at the vulgarity of modern American TV

Then I started watching football and I began to hear of screen plays. At one point I was watching WAY too much football and, by percentage, way too many screen plays.
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Then computers came along. Computers have screens. I'm looking at a screen right now. I would be scared to know how much time I spend looking at PC screens at work and at home. No wonder my eyes are going.
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Then cell phones were invented with screens that started small but have gotten bigger. I got the small kind of screen still, I'm not smart enough or willing to pay for getting a phone with a bigger screen.
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So today we live in a world filled with screens. If we are raising children, we are asked to monitor screen time, especially with young children. Watch TV with your children and interpret along the way -- provide "scaffolding" for them to understand what it is they are watching. That is best for brains, because their experience with the screen is in the context of their relationship with you. as this brief snippet from the recent symposium in Mukileteo on infant mental health suggests -gw
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Monday, October 22, 2012

On Being on High Alert: The reality of the dangers of vicarious trauma for clinicians


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Vicarious trauma, or compassion fatigue, was a subject that came up at our last consultation group meeting Friday. A backdrop of Halloween decorations hardly enlightened the serious tone. I must say, our participants are very compassionate people. There is a impact that hearing the stories of others can have on clinicians. -gw
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Wednesday, October 3, 2012

On Some Answered Questions About Childhood Anxiety: When the world is scary

Children have always endured hardship and stress. Do you believe childhood stress and anxiety is on the rise, and if so, why now?

What is the likely effect on a child when adults dismiss fears by saying, “That’s silly” or “Be a big boy”?
Can you describe one or two important coping skills you recommend for fearful or anxious children?\
It seems when parents rely on their instincts, often the problem gets worse. In what ways might common sense fail to help anxious or fearful children, and why?
You write about age-appropriate fears—can you give a few examples parents need not be overly concerned about?

What are the implications of the interaction of genes and experience in helping children suffering from anxiety and phobias?

What are your feelings about medicating anxious children?

Is it a good idea to shield children from sad or frightening events in the news? 

When it comes to fears and anxieties, how much influence do children, siblings or playmates, have on one another?

Your book has some fascinating examples of children who develop rituals to cope with stressful situations. When should parents be concerned?

Can you explain how child-directed interaction works to help reduce anxiety?

In an online interview, a Boston University professor answers these questions about childhood anxiety, subject of her recently published book. -gw

On a Field Trip to Mukilteo: Infant mental health symposium with Barnard, Hill, Solchany & others


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There is still time to sign up for this Infant Mental Health Symposium in Mukilteo. Several of us from the Peninsulas are going. -gw
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Please join us to help celebrate Nurse Family Partnerships One Year Partnership with Little Red School House!  Snohomish County Sheriff, John Lovick will welcome guests to this all day celebration and Infant Mental Health Symposium.  There will be several presenters on hand, including key note speaker, Kathryn Barnard, Ph.D, FAAN, Professor Emerita, Family and Child Nursing.  Below is a list of our guest speakers.  If you have any questions please contact Gina Veloni @ gina.veloni@littlered.org or (425) 775-6070.
Relationships and the Brain  - Sheri Hill, PhD
Recent neuroscience has highlighted the critical importance of relationships to early brain development.  Join Dr. Hill for a brief look at the following questions: What does the brain science tell us about the importance of focusing on infants and toddlers? How do relationships shape the baby’s brain?  Why do relationships between adults matter to the baby brain? What are the possible consequences of ignoring early relationships?
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Learning, Language & Love: Connecting the Keys to a Strong Start in Life  - Gina Lebedeva, Ph.D, CF-SLP
All learning happens in the context of relationships. From infancy through early childhood, from babbling to storytelling, children’s intellectual accomplishments are inspiring: they acquire language, learn to “read” social situations and solve cognitive problems. How children accomplish this is central to characterizing the interactive roles of nature and nurture in human development, and has practical implications in preparing children for school and for life. This presentation will focus on key features of early input and interactions that happen in everyday situations, highlighting how ‘high quality’ stimulation is the brain food that shapes our capacity to learn not only language, but also how to love.
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Understanding the Impact of Parental Mental Illness on the Infant and the Parent Child Relationship - JoAnne Solchany, Ph.D.
What is the impact a parent's mental illness can have on an infant and the relationship that parent establishes with the child?  Axis I diagnoses, including depression, anxiety disorders, schizophrenia and other psychotic related disorders as well as trauma related disorders, will be explored.  In addition we will explore the personality disorders from Axis II.  Patterns of risk, behaviors, interactions, and outcomes for the various disorders will be explored.  
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Maternal Mental Health During Pregnancy - Shawn Elmore, Ph.D.
This presentation examines current information on the effect of the mother's mental health during pregnancy and the implications of this impact for the lifelong, mental health of the infant.  Critical mechanisms discussed include neuroendocrine and epigenetic perspectives. 
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Sensory Affective Inter-Action – Rosemary White, OTR/L, Director of Pediatric Physical and Occupational Therapy Services
This presentation will explore how relationships that are sensitive to the unique Neurobiological profile of the infant, toddler and child supports their sensory processing and perception in concert with their physiological and emotional regulation.

On From Classrooms to Home: A webinar on extension of the use of the Pyramid Model


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Special Event Announcement!
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Webinar on Using Family Coaching to Bring the Pyramid Model into Homes
+Erin E. Barton, Regina Woodcock
October 11, 1-2:30 ET
(12-1:30 CT, 11-12:30 MT, 10-11:30 PT)
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Please join us for an overview of the major components, tools, and practices for implementing the Pyramid Model with families with infants and toddlers in homes. The presenters will use a question and answer format to describe how West Virginia implemented the Pyramid Model across multiple home visiting programs, including within the Part C system. There will be opportunities for audience members to submit questions to the presenters. There are limited seats available to participate in the live webinar, so be sure to register early! If you can’t attend, don't worry. We will record and post the webinar for continual access to the recording and accompanying resources. + To register for this free webinar, please visit the TACSEI website.
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I keep up with the news from the Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) by getting their email updates. This item came in today. -gw

Thursday, September 20, 2012

On Topics of Interest: The stuff we talk about at our meetings

Projects 011

What are you reading to keep up with the infant & early childhood mental health field? These are some of the items that the Peninsulas group have shared at recent meetings.

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Interested in this stuff? Join us. -gw

On Monthly Updates from TACSEI & CSEFEL: A click away

Blogged about 
Current issue: http://eepurl.com/ouIK9
Get monthly updates from TACSEI and CSEFEL. You can sign up for the Pyramid Model Update here. -gw

On Time Out, Camping Out & Controlled Comforting: Working with older children

Daniel and Charlie
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Tony emailed me with follow-up about about the sleep techniques post. In the psychiatric residential setting where he worked, both  "camping out" and "controlled comforting" were effective in helping older children to get to sleep. He also addressed the question of, do you talk to a child, when he is in time-out? -gw
It may be of interest that the techniques described for infants ended up being the same ones we used in residential treatment for kids who had never had secure attachments. It worked.
Yes both methods could be effective but they had to be "discovered" for each client. I am not sure that there was a set criteria but I do know that there were general categories of difficulties that led to one or the other.
There was an issue with "time out" with insecurely attached children [at the residential facility] .... The general rule was that children were not talked to when they were in time out. However, it also became clear, over time, that some children were simply too disorganized to be in the room by themselves. With these children staff would go into the room to organize them. The effectiveness of this had to do with the experience of the staff. We had a few staff who were so grounded that when they got close to a child the child just got quieter -- if they had to hold the child it would turn out to be quite brief (as opposed to what would happen with staff who were not that grounded).
In general I had the rule "talk is cheap," and it doesn't buy much when it comes to engaging children. When talk is an extension of a "calm and assertive" presence it usually doesn't have to "say" much - the body, the presence, does the talking.

Monday, September 10, 2012

On Behavioral Sleep Techniques to Help Infants Sleep Better: The news gets out

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Below is a link to a fascinating article that came out online five days ago. Maybe you are reading about this news for the first time here. The reality is that there are already 463 sites that are touting this information --  in just 5 days -- my Google search informs me. That is the power of the Internet. Science can inform parenting practices. There is tremendous curiosity about how to be effective with children. Infant mental health need not be considered an esoteric subject. Its truths are of interest to the general public. -gw 
A new study by researchers from Murdoch Childrens Research Institute claims that "controlled comforting" and "camping out" (behavioral sleep technique) not only helps infants sleep better, it also reduces depression levels in mothers.Researchers, who conducted the first ever study of its kind to have looked into the long term effects of these sleep techniques, say they are safe to be used in the long-term.

Tuesday, August 14, 2012

On Infant Mental Health Intervention For Preterm Infants in Japan: Promotes maternal mental health and mother-infant interactions

 
 
There are formal infant mental health programs in place in countries all around the world. In this example, Japan. -gw
 
Abstract
 
The aim of this study was to investigate the effectiveness of the Japanese Infant Mental Health Program (JIMHP) for preterm mother–infant dyads until the infants reached 12 months of corrected age. Mothers in the JIMHP group (n = 26) received one hospital visit in addition to standard care in the Growing Care Unit (GCU) and five home visits based on the principles of infant mental health (IMH) after discharge from the hospital, until the infant reached 12 months of corrected age. In contrast, mothers in the control program group (n = 40) received standard care in the GCU and three conventional home visits during the same period. The dyads were then compared across groups, revealing that the JIMHP dyads showed less maternal depressive symptoms, better maternal interaction, increased social support by medical workers and healthcare professionals, a high persistence rate for attending the program, and a more positive perception toward the program (p < .05). However, there were no significant differences in the impact of parenting stress or in child development. These results are discussed in terms of their significance and the practical/clinical availability of IMH principles and the JIMHP as a new support model for preterm infants in Japan.
 

Monday, August 13, 2012

On Tickling and Teasing: Disrespecting young children

Salishan Children Say Thank You 083
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"We've all seen this at the beach" -- this month we spend so much time outdoors and in public recreational areas -- "screaming toddlers and preschoolers ... carried to be thrown into the water" to their intense distress. This is not how to play with a child. -gw
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How does one follow the lead of the child? By respecting that young children need to explore, discover, and construct their own learning and understanding, and by allowing them opportunities to do so.
Adults need to remember that they should not over-stimulate their children. Observation is key. The clearest example of over stimulation is tickling. Kids love to get tickled. But then they reach a point where they become over stimulated and it's no longer fun for them. You have to watch for physical signs and cues that kids have reached their breaking point. Babies will turn their gaze and their bodies away, older kids will say "no," "stop" or "no more." Crying, tantrums, any behavior - even laughing - where the child's emotion is escalated indicates over stimulation. It's just another reason observation skills are so important.
... it’s certainly common for adults or older kids to tease young children unmercifully, to justify their actions by saying they’re “just teasing”, and to become angry and even punish the child who displays distress when teased intensely. School-age children exposed to this treatment usually learn how to evade the adult’s attention, but younger ones naturally respond to distress by approaching the people who ought to be protecting them--  the very ones who are tormenting them.  We’ve all seen this at the beach, as screaming toddlers and preschoolers are carried to be thrown into the water, or in other situations where an adult picks up a child and won’t put her down, or threatens to throw away a toy or harm a pet. These situations often conclude with some type of punishment of the child, who is then characterized as a “wimp” or a “sissy”.

Thursday, July 5, 2012

On Enthralled Babies: Thomas suddenly stopped breastfeeding to join in the singing

I was putting baby Thomas (13 months old) to sleep and was singing our usual bedtime prayer, when Thomas suddenly stopped breastfeeding to join in the singing. 
 
 
A mother's song is far more powerful than any professional musical recording. So the advice to mothers is, sing to your baby. It's good for the brain and does wonders for attachment. The folks at Zero to Three, the National Center for Infants, Toddlers and Families devoted an issue of their journal to the subject. -gw
 
[I]nfant development researchers (known to each other as “baby watchers”) [know] that babies seem to be much more enthralled by their mothers’ singing than by the voice of a trained performer.
 

Monday, June 25, 2012

On New Name for U of W's Center on Infant Mental Health & Development: The Barnard Center

 
Our proximity to the U of W has given many of us the opportunity to hear live presentations by leaders in Infant Mental Health, one of whom is Kathryn Barnard. -gw
 
The University of Washington School of Nursing has announced the re-naming of its Center on Infant Mental Health & Development to the Barnard Center, in honor of renowned nurse and researcher Kathryn Barnard.  A longtime School of Nursing faculty member, Barnard is known for her pioneering research on the importance of early caregiving relationships for infant development and well-being.  

At a June 7th reception announcing the name change, Barnard remarked, “naming of the Center on Infant Mental Health and Development to the Barnard Center, after my family, means a great deal to me as the last person in my Barnard clan.  With my never marrying or having children myself, naming of the Center gives me a legacy.”

Barnard recognized that caring for infants and young children is challenging in the best of circumstances. Even when adults do their best, babies may cry inconsolably, sleep erratically, feed with difficulty or develop poorly. When they have concerns, parents turn to many kinds of professionals to help their babies.  These professionals may be very knowledgeable about infant development, but rarely know how to treat the baby within the context of the child-parent relationship. At the Barnard Center, professionals from many disciplines learn how to help parents have the warm, happy relationships with their children that support maximum growth, regulation and learning. In turn, babies are given the best possible start in life. Research indicates that nurturing relationships are vital to child development, and, as Barnard says, “the first three years last a lifetime.”

Monday, June 18, 2012

On What It Takes to Stay in Relationship: Despite the best firetrucks, they play for two seconds and they're gone


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Some more tantalizing clips of Tweety Yates at the all-day pre-conference training she provided at the Early Childhood Conference in Tacoma early last month. She is such a gem of a teacher! -gw

On Supporting Relationships for Infants and Toddlers With Two Homes: Available guidance

Mark Rains and Betty Tableman, Authors

This second edition booklet summarizes what infants/toddlers who live between care giving families, due to divorce or placement in foster care, need for sound social and emotional development. Intended for judges and court personnel, child welfare and mental health professionals and parents, the booklet includes guidelines for visitation, suggestions for parenting across two homes, resources for parents and a bibliography for professionals. The material was originally developed for families experiencing divorce. The new edition has been reworked to include information for infants and toddlers separated from parents because of abuse/neglect, as well as those experiencing divorce.

 
Available through the Michigan Association for Infant Mental Health website, by clicking on the above link.. - gw

Monday, June 11, 2012

On States Respond to the Need for Early Childhood System Collaboration: Washington and Colorado

  • We license and monitor Washington's 7,400-plus licensed child care settings in family homes and centers that serve about 174,000 children. Our licensors support child care business owners and their staff in offering safe, healthy care, and take action if settings are found to be unsafe for Washington's children.
  • We oversee the Early Childhood Education and Assistance Program (ECEAP), the state-funded preschool program that helps prepare low-income 3- and 4-year-olds for success in school and life. Since 1985, ECEAP has focused on the well-being of the whole child by providing in-depth nutrition, health, education and family support services.
  • We set policy for child care subsidy programs, which let parents know their children are well cared for while they are working, in school or looking for work. We partner with the Department of Social and Health Services, the state agency that decides who is able to receive subsidy benefits and makes the payments to child care providers.
  • We coordinate early intervention services for children birth to age 3 who have disabilities and/or developmental delays through the Early Support for Infants and Toddlers (ESIT) program . These services may include specialized instruction, speech therapy, occupational therapy, or physical therapy that can help young children. The program also supports parents as the most critical influence on their child’s early learning and development.
  • We partner with the Office of Superintendent of Public Instruction (OSPI) to oversee the Washington Kindergarten Inventory of Developing Skills (WaKIDS), which helps ensure smooth transitions into kindergarten.
  • We lead the statewide effort to deliver home visiting services to vulnerable children and families.
  • We oversee the state professional development system to help ensure that for those who care for and teach young children continue to increase their skills and education levels.
  • We work to boost the quality of early learning programs around the state and share information with families about quality through our state.
http://www.del.wa.gov/about/what.aspx

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    Washington State has it's Department of Early Learning. The state of Colorado has its new Office of Early Childhood. -gw
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    DENVER — Thursday, June 7, 2012 — Gov. John Hickenlooper today announced the creation of an Office of Early Childhood (OEC) to consolidate and better administer early childhood programs in Colorado. This consolidation of programs and services in the Colorado Department of Human Services (CDHS) will support parents by strengthening collaboration and coordination between the state-level early childhood system and local delivery systems.
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    “Colorado families and children deserve the opportunity for a fair start,” Hickenlooper said. “This change will create a high-quality early childhood system that streamlines early childhood services to help ensure all children are healthy, valued and thriving.”
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    The new office will bring together seven programs that currently exist in four divisions within CDHS:
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    • Child Care Licensing
    • Child Care Quality Initiatives
    • Colorado Child Care Assistance Program
    • Early Childhood Councils
    • Early Childhood Mental Health Consultation
    • Early Intervention Colorado Program (Part C/Early Intervention)
    • Promoting Safe and Stable Families
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    The move will maximize available resources without incurring additional expenses. Additionally, the OEC will continue to work with many partners, including parents, schools, child care, early intervention, businesses, community organizations and other stakeholders to provide high-quality early childhood programs and effective prevention strategies.
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    Sunday, June 10, 2012

    On Expanding Services for Infants and Toddlers: Reaching out to more rural programs

    You can always count on the meetings of the Peninsula's Early Childhood Mental Health Consultation Group to keep you up on new developments affecting services for infants and toddlers in our region. Here Chris gives a run-down on one expansion of services. -gw

    On Having an Appropriate Protest Board: What a concept!

    Taking a cue from this video, it seems to me that all of us could benefit from having an Appropriate Protesting Board to point to when people don't understand what we are feeling. Behavior is a form of communication, and we are all trying to be understood. -gw
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    What's it like to be in preschool?
    There is something missing in the telling of this joke, but I don't think you'll mind. 

    Friday, June 8, 2012

    On Kids Who Hurt Other Kids: A story from the Early Childhood Conference

     
     
     
     
    More from Colleen Nolan, M.A., NW Regional ESD, Oregon,who presented on "Understanding and Addressing Challenging Behaviors," at the Infant and Early Childhood Conference in Tacoma in early May 2012. --  a story about a preschool kid who hurts other kids, Below is the rest of the story. -gw
     
     
     
     
     

    Thursday, June 7, 2012

    On Promoting the Health of Girls and Women of Child-Bearing Age: Peer orientation stunts healthy development

     
    “If our society were truly to appreciate the significance of children’s emotional ties throughout the first years of life, it would no longer tolerate children growing up, or parents having to struggle, in situations that cannot possibly nourish healthy growth.”
     
    (Stanley Greenspan, M.D., Child Psychiatrist and Former Director, Clinical Infant Development Program, [U.S.] National Institute of Mental Health).
     
    An ADD forum participant cites an outline by Gabor Maté M.D.that includes the above quote by Greenspan, and reposts its salient points to consider for promoting the health of girls and women of child-bearing age. -gw
     
    How Attachment Supports Parenting and Child-rearing
     
    1. Arranges the parent/adult and child hierarchically
    2. Evokes the parenting instincts
    3. Commands the child’s attention
    4. Keeps the child close to the parent/adult
    5. Makes a model out of the parent/adult
    6. Designates the parent/adult as the primary cue giver
    7. Makes the child want to be good for the adult
     
    Peer Orientation Stunts Healthy Development
     
    1. The flight from feeling
    2. Immaturity, lack of individuality
    3. Aggression
    4. The making of bullies and victims
    5. Precocious, inappropriate sexuality
    6. Unteachability
     

    Wednesday, June 6, 2012

    On Barriers to Provision of Infant and Early Childhood Mental Health: Analysis by Zero to Three

     
    Barriers in Brief
     
    A. The evidence base for I-ECMH is not reflected in public policy for mental health, early learning and development, or health care reform (including Medicaid and managed care).
    B. Systemic reimbursement issues hinder the ability to pay for I-ECMH.
    C. Eligibility determination and diagnosis impede appropriate I-ECMH services.
    D. There are not enough providers with training in I-ECMH.
    E. The broader system that serves young children does not adequately incorporate I-ECMH services.
     
    The bottom line is that states and communities don’t have the I-ECMH services that infants and young children need, don’t have the people to provide them, and don’t have a system that will pay for them. These issues need to be taken up by federal and state decision-makers so that the early foundational development of all infants and young children will enable them to realize their full potential.
     
     
    This monograph by Zero to Three puts forth the argument for policy-makers to beef up support for infant and early childhood mental health. -gw
     

    Tuesday, June 5, 2012

    Promoting Mental Health in School Settings: From early childhood through high school

    School based mental health challenges:
    • School - family - community disconnect
    • Variable use of data-based decision-making
    • Variable use of evidence-based practices
    • Poor implementation fidelity
    • Reactive exclusionary consequences
    • Non-evidence-based practices
    • Special education v. mental health v. general education



    How is this for covering all the bases?  Start early, but don't give up. There are promising practices that can be employed at any educational level. -gw

    On Autism Treatment Through Parent Child Interaction Therapy: Study results

     
    The results from parents who participated in PCIT therapy with their children also represented  a 44.4% improvement in these externalizing (or disruptive) behaviors overall, when compared to the group not participating in the PCIT program.
     
    Children with a severe ASD seemed to make the greatest gains during the Child-Directed Interaction portion of the treatment (which focuses on play), while the behavior of children with milder forms of the disorder improved during both this phase and the Parent-Directed portion (which focuses on behavior management).
     
    The study was presented during the International Meeting for Autism Research May 17-19 in Toronto, Canada.
     
     
    Another study that demonstrates the broad application of Parent Child Interaction Therapy. -gw
     

    Monday, June 4, 2012

    On Links of Special Interest to Teachers: Getting on the same page


    I had opportunity to consult with a group of dedicated elementary teachers this morning and this afternoon to pull together this list of links that I thought might be useful to them. -gw

    Positive Behavior Support is outlined here: http://www.challengingbehavior.org/explore/pbs/process.htm
    The Pyramid Model is described here: http://www.challengingbehavior.org/do/pyramid_model.htm
    A Pyramid Model slideshow: http://www.challengingbehavior.org/explore/camtasia/pyramid_overview/pyramid_overview_captions.html
    The Individualized Interventions page is here: http://www.challengingbehavior.org/explore/pbs/pbs.htm
    The Buddy System is outlined here: http://www.challengingbehavior.org/do/resources/teaching_tools/toc/folder2/2a_buddy.pdf
    Social story tips here: http://www.challengingbehavior.org/explore/pbs_docs/social_story_tips.pdf
    Tips and ideas for making visuals: http://www.challengingbehavior.org/explore/pbs_docs/social_story_tips.pdf
    And on the CSEFEL site, these strategies for teaching social skills: http://csefel.vanderbilt.edu/resources/strategies.html#teachingskills
    Tools for developing behavior plans: http://csefel.vanderbilt.edu/resources/strategies.html#toolsplans
    Please note that, although the TACSEI website focuses on young children, the model can certainly be applied to elementary aged children as well.
    Materials specifically for older children can be found on the Positive Behavior Interventions and Support site: http://www.pbis.org/default.aspx
    Materials outlining PCIT skills for teachers can be found in this PDF, the specific pages listed below.
    http://pcit.phhp.ufl.edu/Presentations/PCIT%20Integrity%20Checklists%20and%20Materials%204-13-06.pdf
    Page 20: Child-directed interaction skills, the basic skills for use in creating warmth of relationship, are outlined here. These skills are used during times when the child can have the lead.
    Pages 70-71: Essential elements of parent-direct interaction, eight rules for effective commands, should govern the language used during those times when adults have to be in charge.
    Pages 198-199: Differential social attention for ADHD
    Page 211: Praise handout for teachers
    Page 212: How to create great labeled praise
    Pages 213-217: Discipline handout for teachers
    At the heart of it all, the skills that would put teachers and parents -- and all caregivers who work with children -- “on the same page,” can be found on just three pages: 20, 70 and 71.

    Friday, June 1, 2012

    On PCIT: Improving the Lives of Traumatized Children

    Above is Shannon Dorsey from the U of W speaking on the use of Parent Child Interaction Therapy with traumatized children. Many therapists in my department know her for her work on Trauma Focused - Cognitive Behavior Therapy (TF-CBT), but before that her primary work was with PCIT. -gw

     

     

    Tuesday, May 29, 2012

    On Integrated Care for Crying Infants: Team troubleshooting baby's distress

     
    Adults go to a sleep clinic. Now babies can, too. -gw
     
    For two years, researchers at the Infant Behavior, Cry and Sleep Clinic at Women & Infants Hospital of Rhode Island followed 61 families whose babies had problems with colic, excessive crying and poor sleep.

    All the families kept their scheduled pediatric visits, but half were also given regular appointments at the infant behavior clinic, where they received integrated care in three sessions over 10-week periods. In this case, integrated care refers to tag-team intervention that includes a developmental pediatrician, a mental health clinician, social workers and clinical and developmental psychologists, who collaborate to troubleshoot both the baby’s distress and the impact that colic has on the parents and their relationship with their newborn.

    Read more: http://healthland.time.com/2012/05/29/help-for-colic-individual-tlc-for-both-babies-and-parents/#ixzz1wId5tB42

    Wednesday, May 23, 2012

    On Why the U.S. Has a Sick Care System Not a Health Care System: Underuse of prevention and early intervention

     
    I'll be drawing on more of Dale Jarvis' presentation to Kitsap Mental Health employees recently than just the few slides in this set, but this is good for starters. Note that, according his analysis, adverse childhood experiences are at the root of the following problems.
    1. disrupted neurodevelopment,
    2. social emotional and conigitive impairment,
    3. adoption of health-risk behaviors,
    4. disease, disability and social problems,
    5. and early death.
    -gw
     

    On an Incredible Answer to Violence in Our Society: Prevention

     
    At our April meeting Ellen from Port Angeles brought to our consultaton group the pamphlet above which describes how children and their parents are supported through programs in her community. She also spoke with great knowledge and enthusiasm about The Incredible Years, an evidence-based practice for addressing behavioral problems in children 3 to 8. Address aggressive behavior in young children and you won't have to address aggressive behavior when they grow up. Prevention matters. -gw