1. Vermont Department of Health October 2018
Connecting families to existing resources
and building resiliency
*Greeting.* Thank you for this opportunity to share with you about HMG VT and how this innovative system can support you and your practice to promote the healthy development of children and strengthen families by connecting them to resources and community-based services.
Vermont Department of Health October 2018

2. Objectives
Describe key components of Help Me Grow Vermont to emphasize and incorporate in your courses/training
Learn about free resources available from Help Me Grow that can be used as part of your courses/training
Learn about the the Universal Developmental Screening (UDS) Registry and how this tool might connect to the work you do 2

3. Developmental Trajectories
Toxic Stress
“Healthy” Trajectory”
Socioeconomic disparities
Parental substance use
Domestic violence
Neighborhood Safety and Support
Medical Home
“At Risk” Trajectory
Protective Home Environment
“Ready to Learn”
Quality Early Learning and Development Programs
Parent education
Emotional health
“Delayed/Disordered ” Trajectory
In Vermont, intentional support of Every Child’s development is a whole population strategy to buffer against some of the environmental factors that can affect the course of development.
This is a graphic from the public health sector which illustrates the various risk and protective factors related to developmental outcomes for children. We know that education around child development reduces stress on families. In addition, having a child in an ECE setting where intentional, parent engaged developmental monitoring and screening is done can make the difference between that At Risk Trajectory and the Healthy Trajectory.
These strategies improve school readiness trajectories for all children: parent responsiveness, appropriate discipline, reading to child, home visiting, specialized services, pre school.
Nationally 1 in 4 children experiences a developmental, behavioral or social delay. 1 in 6 children has a developmental disability
Nationally, only 20% to 30% of these children are identified as needing help before school begins.
Intervention prior to kindergarten has huge academic, social, and economic benefits. Children who receive early treatment for developmental and behavioral delays are more likely to graduate from high school, hold jobs, live independently, and avoid teen pregnancy, delinquency, and violent crime, which results in a savings to society of about $30,000 to $100,000 per child. (ASQ website)
Birth
Early Infancy
Late Infancy
Early Toddler
Late Toddler
Early Preschool
Late Preschool
Prenatal mo mo mo mo yrs yrs
Graphic Concept Adapted from Neal Halfon , UCLA Center for Healthier Children, Families, and Communities
Graphic Concept Adapted from Neal Halfon , UCLA Center for Healthier Children, Families, and Communities

4. Opportunities to Optimize Child Development
This slide illustrates 3 key places to support children’s healthy development – in their home, their medical home, and in child care programs.
Child’s Home: Our society does not give much to support to the most important (and often toughest) job of all – parenting! Most brain development occurs in first year of life with 95% by age 3.
Early Care and Learning Programs: National research recognizes that high quality ECE programs support children’s developmental trajectories. High quality programs can mitigate the impact of poverty and family adversity on young children’s development. Research demonstrates a strong link between what parents know about parenting and child development and how they behave with their children. Parents with more knowledge are more likely to engage in positive parenting practices, whereas those with limited knowledge are at greater risk of negative parenting behaviors.
HMG is the system for collaboration and communication of ongoing developmental monitoring for young children. HMG is a system strategy to increase monitoring and screening of children across various settings and link children and families to existing services and resources. Partnerships between ECEP’s and health care providers can improve health and developmental outcomes for young children. Partnerships lead to: improved early identification of developmental concerns, better informed and empowered families, and timely coordination of needed services.
To Realize the Promise of Vermont’s Children

5. Aligned goals strengthen partnerships
VT AAP roll out of new guidelines
Focus on Social Determinants of Health
Greater focus on lifelong physical/mental health
Strength based approaches
Updated developmental milestones, surveillance questions and screening guidelines
New 4th edition revised recommendation: observation by child care and early childhood professionals be incorporated by the pediatrician into surveillance
Developmental Screening is a Healthy Vermonter’s 2020 performance measure and a shared priority in VT. The American Academy of Pediatrics (AAP) Bright Futures guidelines support this priority.
AAP Bright Futures Guidelines: a national health promotion/ disease prevention initiative that addresses children's health needs in the context of family and community. In Vermont: principles, guidelines and tools used to strengthen connections among state and local programs, pediatric primary care, families, and local communities
Ideal platform to address the social components of child health. The environment in which children develop – family, extended family, neighborhood, community and culture – impact brain development, health and even genetics.
AAP Developmental Screening Guidelines:
Developmental surveillance at every well-child preventive care visit
Promptly address concerns with standardized developmental screening tests administered at the 9-, 18-, and 30-month visits
New 4th edition revised AAP Bright Futures recommendation: observation by child care and early childhood professionals be incorporated by the pediatrician into surveillance

6. Help Me Grow System Centralized Telephone Access Point
Community and Family Outreach
Child Health Provider Outreach
Data Collection and Analysis
Organizing Entity
Statewide Expansion
Continuous Quality Improvement
Core Components
HMG system is comprised of 4 interdependent components which are required for cross-sector system building:
centralized access point or contact center - for effective and efficient statewide linkage
community and family outreach
child health provider outreach
data collection and analysis – for continuous system improvement
Early identification and timely linkage to services requires a collaborative, coordinated approach across child health, education, and community providers.
Structural Requirements

7. Help Me Grow System Components
To connect children and their families to services and care coordination
Centralized Telephone Access Point

8. Help Me Grow Contact Center
Centralized Phone Access Point/Contact Center serves as the hub to connect children and their families to community-based services and answer caregivers' questions about their child's development and behavior. Dial ext. 6, text HMGVT to , or at Interpretation services and translated materials, including tools to track developmental milestones, are provided.
Activities for students:
Place a call for the contact center on behalf of one of your families or, better yet, call with a family (speaker phone) on developmental or basic needs resources. Write a paragraph reflection on the experience reflecting on how it might be helpful in your work.

9. Help Me Grow Care Coordination1 2 6
Child care provider gets feedback from HMG
Parent Teacher Conference
Solicit
parent
concerns or needs
Help Me Grow Care Coordination 3 5 4
Refer to
Help Me Grow
HMG connects family to resources
Research shows it takes an average of 7 calls to connect a family to one service – you can see in this visual a feedback loop that is a key feature of the HMG Contact center (walk students through feedback loop). The HMG Contact center is a resource for you to refer families to connect to developmental services.
With parent permission we always follow up with the referring provider to let them know the family got connected to the service. And we also request family permission to f/u with the child’s health care provider – so that everyone is on the same page.
All callers are offered a follow up call. This enables us to see if they connected to referrals, to explore any barriers to services and to address other needs that may have arisen since initial call. It also helps us build a trusting relationship with the family over time.
HMG contacts
family

10. Help Me Grow System Components
To bolster healthy child development through families
Community and Family Outreach
HMG engages families and community partners in developmental promotion and prevention 10

11. QI Training to Child Care Providers
Selected as a HMG National Innovation and by CDC’s Act Early Program as a Promising Practice.
Key Outcomes include:
Trained 516 ECE providers in ASQ-3 & 192 providers cross-trained in ASQ:SE-2
5,270 children reached
Strengthened partnerships and improved communication between ECE providers and medical homes - supports health care screening efforts
Increased frequency and quality of developmental support and guidance families are receiving from their child’s child care provider
Higher quality child care programs for VT’s children
Since we started this training in 2014, there has been a 21% increase in referrals to EI in Chittenden County from our baseline year in 2013
Statewide, the average age at referral to EI has decreased: 26 months average age in 2014 to 14 months in 2017
Families are receiving EI services for longer period of time (5 months increase in average length of time in EI program)
Early identification has improved!

12. “Learn the Signs. Act Early.”
Follow each child’s developmental journey, and show parents the path, too!
CDC’s Learn the Signs. Act Early. Program resources and tools are available for your students.
Separate PPT slides are included for use in your courses/training. 12

13. Help Me Grow System Components
For continuous system improvement
Data Collection and Analysis
Data is collected on all aspects of the HMG VT system promote continuous quality improvement across all components of the HMG VT system 13

14. Communication System
Did you know that Vermont has a statewide registry where developmental screening results can be safely shared across settings?
Did you know that you can use the registry to ensure the best outcomes for the children in your program?
Our registry is the tool to improve communication and coordination around child development
With help from key stakeholders, the Registry was built in an effort to advance developmental promotion, early identification and timely linkage to services. Use of this registry will support improved screening rates and help to identify young children with developmental concerns as early as possible.
Utilizing this tool can improve Early ID of concerns which means increased likelihood of supports being offered at the time when they are the MOST effective!

15. How Do I Access the Registry?
Vermont has a Developmental Screening Registry webpage hosted by the department of health. This page is a one stop shop where registry-related permission forms, contact information, related resources, and the portal to access the registry can be found in one place.
Student Activity:
View a recorded webinar to learn all they need to know about the registry. Write a paragraph reflection about how they might use the registry in their work and/or to share screening results with various providers (e.g. to provide communication with the child’s pediatrician about a developmental concern and any follow up/referral for services or further evaluation).

16. Let’s Play: Learn about the UDS Registry

17. Let’s Play: Milestone Tracker App
CDC’s new Milestone Tracker app offers:
Interactive milestone checklists for children ages 2 months through 5 years
Tips and activities to help children learn and grow
Information on when to act early and talk with a doctor about developmental delays
A personalized milestone summary that can be easily shared with the doctor and other care providers
Reminders for appointments and developmental screening
 Although it is packed with parent-friendly features, this app isn’t just for parents! Students can use it to better understand the skills and abilities of the infants and toddlers in their classroom and to engage families in monitoring developmental progress. Learn more and get information on downloading the app at CDC’s Milestone Tracker website. The app is available in the  App Store and on Google Play.
Activities for students: 1) Download the Milestone Tracker App and enter information for one of the children you are working with or a young child you know. Try some of the developmental promotion tips and activities suggested to support the child you are working with and/or share them with the family. Write a paragraph reflection of how the Milestone Tracker App will be helpful to you in your work and/or how you plan to use it. 17

18. Let’s Play: Watch Me! Online Training
“Watch Me! Celebrating Milestones and Sharing Concerns” is a free, 1-hour online CEU course (approved for credit by Vermont Northern Lights) that helps early care and education providers better identify and monitor developmental milestones; recognize signs of potential delays; and share observations with parents. This training offers tools and best practices to support professionals and help children reach their full potential.
Student activity:
Have students take the 1 hour online training to observe how to use CDC’s Milestones materials to support observations and conversations with parents on age-appropriate milestones, to teach parents about social and emotional skill development, and to share concerns Write up a paragraph reflection about the experience and/or how you plan to use these photos and videos in your work.
Available for CEU course credit (approved by VT Northern Lights at CCV)

19. Let’s Play: Milestones in Action
HelpMeGrowVT.org
Facebook.com/helpmegrowvt
HMG website has CDC’s Milestones in Action videos to help students (and parents) learn about child development:
watch videos of development by age
get parenting tips from birth to age 8
Nurture social and emotional growth
Learn effective ways to manage behavior
Student activities:
Use Milestones in Action to support observations and conversations with parents on age-appropriate milestones and to teach parents about social and emotional skill development. Write up a paragraph reflection about the experience and/or how you plan to use these photos and videos in your work.

20. Questions?

21. Please be in touch! Janet Kilburn Janet.Kilburn@vermont.gov
Lauren Smith
helpmegrowvt.org
facebook.com/helpmegrowvt 21