Continuity of Care in Infant and Toddler Programs: Lessons Learned From Teacher Training, Program Practices and Teacher Interviews Melissa Wilhelm, M.A. Mary Jane Chainsky, M.A. Debra Pacchiano, Ph.D.

OVERVIEW What is Continuity of Care? What have we done? Lessons Learned from our Teachers Implementation

What is Continuity of Care? A program model which emphasizes minimal disruption to the relationship between teacher and child …and teacher and parent

Continuity of Care Program Models Mixed Age:  Group of children representing more than one age grouping –teaching team stays the same, in the same room –children enter and leave as age appropriate Cohort:  Group of children who are all within a relatively narrow age grouping –same children and teaching team stay together for a period of years

Why is Continuity of Care important? Early relationships are key to social- emotional development Healthy social-emotional development often determines whether a child is successful in school and life Children do not learn well when they do not feel safe and loved

Overview of Attachment Theory Bowlby: strong attachment leads to healthy social-emotional development Research shows importance of secure relationships in infancy Up to 50% of families living in poverty may have less than secure attachments (vs. 30% of all families)

Overview of Attachment Theory Stressors may lead to less secure attachments High quality child care is an effective intervention for distressed and/or disorganized families Children experience stress when moved to new classrooms Stress interferes with development and the ability to learn--especially language

Considerations for Program Design  Relationships are the basis for healthy development for children  Families, especially those under stress, also benefit from ongoing relationships  Stress, caused by change and disruptions, interferes with development

What have we done? Fall 2001: One mixed- age room Fall 2002: One cohort group Fall 2004: Six cohort groups and one mixed age group

Why is it hard to do? Licensing/logistics/ environment Staff buy-in Family buy-in

What results have we seen?  Language development isn’t interrupted  Family/staff relationships aren’t disrupted  Staff develop broader understanding of child development  Staff experience greater emotional satisfaction from longer-term relationships  Healthy emotional development for children is promoted

The Role of Family Support: What are the advantages of having family support stay with a family for the entire stay in program? What are the complications?

What’s Next? What’s Next? Lessons Learned From Teachers

Lessons Learned for Training:  Teachers want to understand why CoC is important  Teachers want reassurance they are doing the right thing

Lessons Learned for Training:  Teacher’s want to understand why children who have a difficult time leaving their classroom may be stronger later  Importance of CoC and children’s socio-emotional health  Importance of CoC and application to attachment theory

Lessons Learned For Training A child development training focused on extending teachers practicing specialty is needed: Expertise may be compartmentalized Expertise may not extend to bridge developmental stages between 0-3 & 3-5

Lessons Learned For Training There are identifiable ‘factors’ that influence the ‘within group’ CoC transition Process: Teachers want training on how to identify and work with different group dynamics Each CoC cohort is compose of ‘children that are different’ When equipped with knowledge to identify individual markers-greater success in supporting CoC process

Lessons Learned for Training: Size of group has impact Children regressed when there wasn’t a child that took the leadership role Special needs children must be given care in the group dynamics Identifying different learning styles of the children and how behavioral/learning styles manifest is critical

Lessons Learned for Training: Training Focused on engaging and fostering relationships with parents is needed –Opportunity to partner with family support

Lessons Learned for Training: Trainings on routines and limits …

Lessons Learned for Implementation Encouraging Parental Involvement of CoC is important Extra Support is needed in Lesson Planning Additional support is needed to reduce paperwork demands!

Lessons Learned for Implementation Teambuilding strategies for 0-3 & 3-5: Teaching staff is needed to foster comfort in exchanging/information about CoC children Fine balance in exchanging child’s information

Implementation: What is the Role of Leadership? Setting Expectations Building community Encouraging support

Lessons Learned for Implementation Factors influencing distressed children must be identified and processed:  Problem solving supports must be in place  Reflective Supervision

Lessons Learned for Implementation Pragmatic Preparations for 3- 5 classrooms  Encompass Developmental needs of transitioning children  Materials and processes for toilet training  Identified and incorporated PRIOR to transition  Reflective Supervision