Creating systems in which all children can be happy, healthy, and successful

Last week, both CT Voices for Children and the Connecticut Health and Development Institute (CHDI) issued publications focusing on the young child. CT Voices addressed access to high-quality early care and education; CHDI promoted a system through which early childhood professionals become more skilled in detecting mental health problems early.

Both publications hit the nail on the head; early childhood professionals are in the ideal position to detect developmental delays and early childhood mental health concerns. The importance of revealing developmental delays at an early stage has been addressed since the 1960s; more recently the early identification of mental health concerns gained traction too. Addressing mental health concerns at a young age can increase the likelihood that children will grow up happy, healthy, and successful.

Early detection is, however, not that simple. Imagine children being surrounded by adults (see illustration 1). Children’s immediate circle includes caregivers (e.g.  parents or foster parents, grandparents). The second circle encompasses children’s close community, adult with whom they interact on a regular basis, such as childcare providers, family members, and friends. The third circle includes grownups who children only see or visit for relatively short amounts of time but who have the most expertise in detecting if something is amiss (e.g. pediatrician, childcare director, social worker). Here is the paradox: the people with whom the child interacts most are often the people who are least likely to have the skills needed to detect concerns that require early intervention. This is especially true for many of Connecticut’s disadvantaged families.

As the article of CT Voices for Children mentions, 16 percent of Connecticut’s children under five grow up in poverty. In four of the five largest cities these percentages are at least double (see table). Children who grow up in poverty are more likely to experience a traumatic event. However, children who grow up in poverty are less likely to know adults (parents and professionals alike) with the knowledge to address mental health concerns adequately. Some of the children who grow up in poverty and/or experience trauma may not even haven access to a trustworthy and loving adult — which is the number one buffer against the impact of childhood trauma and toxic stress.

Things are changing. In 2013, the Connecticut Office of Early Childhood was established with the objective to create a cohesive high-quality early childhood system. Moreover, multiple cities in Connecticut are coming up with their own initiatives: New Haven, for example, is making schools more trauma-informed; New Britain is making the whole city trauma-informed; Norwalk is bringing partners together to synchronize early childhood efforts; and Bridgeport and Waterbury are educating early childhood providers on the impact of trauma and Post Traumatic Stress Disorder among (young) children and CHDI is implementing evidence-based practices in outpatient clinics throughout the state.

Most of these efforts, however, increase the knowledge of people on the outer rings. This is a problem because disadvantaged parents are less likely to seek formal mental health support for their child than their more well-off peers. Hispanic and non-Hispanic black parents are less likely to seek support for their children’s concerns too, as are non-English speaking parents. Consequently, poor, non-white, and non-English speaking parents have less access to many of the resources recently added to the state.

Compared to middle class parents, parents with little financial capital rely more heavy on their social capital. In other words, poor parents are more likely to seek support for their preschoolers from within their informal network. This too, is the case for Hispanic and non-English speaking parents.

Informal networks –family, friends, neighbors –are, however, often less likely to have had the training to adequately support a child’s mental health needs. Most caregivers, regardless of socioeconomic standing, want what is best for their children, they want their children to be happy, healthy, and successful. Parents do not want to be judged by the way they raise their children or the decisions they make; they do not want to be judged that their apples are not organic, about the way they disciple their child, about their child’s bedtime routine, or that their 4-year old doesn’t play the piano yet.

They do not want to be judged, not by professionals, and not by their family, their neighbors, or their peers. Most parents love their children. Indeed, most parents want their children to be happy, healthy, and successful. Most of us parents could probably use a little extra support. So how can we ‘educate’ parents on the importance of early childhood mental health without passing judgement?

One way is through Circle of Security (COS). COS was developed 20 years ago and began to spread in Connecticut about five years ago. This Tuesday, Waterbury Bridge to Success brought together Connecticut’s leader (Charlie Slaughter) in COS and several Waterbury-based organizations interested in implementing the model. To date, “approximately 1,500 people in Connecticut are trained to provide parents workshops in COS” Slaughter announced, and, he added, “we are probably the leading state in the country.” COS provides parents with new relationship tools to interact with their children in a constructive and secure manner, even in stressful situations.

COS is not a parent training, he stressed, it is an opportunity for parents to understand their experiences growing up and how these experiences impact their own childrearing practices today. As someone who has done extensive research on the inter-generational impact of child rearing, I can only imagine how powerful their “aha” moments are when parents realize that the interaction with their children often mirrors (or completely opposes) the interactions they had with their parents. COS, as one of the participants explained, is more of an awareness program; “going through the program gave me an opportunity to reflect on how I was raised, even how my parents were raised”.

In Waterbury, the plan is to create a system where everyone will be connected and aligned towards the same vision in supporting young people. Parents and other caregivers in the child’s immediate circle will receive supported through the COS; the community, the second circle –including family, friends, early childcare providers, neighbors, teachers, and others –will learn about trauma, toxic stress, and COS; professionals, the precious few who have most of the professional knowledge, are given the opportunity and responsibly to identify children early who may otherwise fall through the tracks. Pediatricians and childcare directors are in the ideal setting to screen children 0-5 to detect early delays in physical, cognitive, and socio-emotional development.

When connections are created, a web, a network, will form around the child (see figure 2). The more people in the network, the tighter the web will be, the more supported the child –and caregivers –will feel. We all need to come together to create these webs. The more webs the state will have, the more secure children grow up, the more secure they grow up, the more happy, healthy, and successful they will be, and the more they — and Connecticut—will prosper.

Kris Noam, Ph.D., is Director of Research and Development at Bridge to Success.