Blogging NTI: The Last Round-Up, Part I
ZERO TO THREE’s 26th National Training Institute (NTI) came to a close Sunday as conference attendees regretfully headed out from the Gaylord Conference Center to return home.
Once again, NTI proved to be a special gathering of a multi-disciplinary group of infant-toddler professionals whose appetite for research to support their practices and information about “how to’s” from others conducting similar programs seems to know no bounds. Where else would you pack a cavernous ballroom with conference-goers at 8:00 in the morning for a research plenary so that latecomers (including this blogger) were left to sit on the floor to listen? But that’s what happened when Dr. Charles Zeanah spoke about his research on Romanian orphans’ development when placed in supported foster care. Or hear folks frequently lamenting that the 90-minute sessions should have been longer? Or have the attendees energized by the sight of ZERO TO THREE founding board member, Dr. T. Berry Brazelton waving a greeting, still working on behalf of and caring for babies in his nineties?
The Policy Booth has folded its banner and headed back up the Potomac, but our dedicated correspondents are still sending their write-ups about engaging and informative sessions that make us sorry we couldn’t be everywhere at once. Here are some of their reports:
Infants and toddlers in military—and veterans—families were the focus of sessions and a Pre-Institute
With just two big numbers, Patty Shinseki, wife of Secretary of Veterans Affairs General Eric Shinseki, laid out the challenge of meeting the needs of young families of Service members: There are about 500,000 military family children under age five. And seventy percent of military families live away from military installations. She underscored that when a mother or father is in uniform, everyone in the family serves–even infants and toddlers.
Mrs. Shinseki spoke at the NTI Pre-Institute on Military and Civilian Partnerships, describing the Joining Forces, Strengthening Our Military Families initiative spearheaded by First Lady Michelle Obama and Dr. Jill Biden. The initiative seeks to ensure a coordinated approach among Federal agencies to recognizing and supporting military families. Through its website, collaborations and outreach, Joining Forces helps communities, businesses and individuals identify ways to support military families.
Other speakers at the Pre-Institute focused on a growing population: veterans’ families, a particular concern as the war in Iraq officially ends and troops come home. Many of these soon-to-be veterans are young and have or will have young families. The Veterans Administration has made a key shift to focusing on the wellbeing of families and caregivers, as well as the veteran. They recognize the stresses families experience and are working not only to educate and involve family members in the veteran’s care, but also to develop activities to address the family’s needs and keep them functioning as a family. They recognize the difficult balance of the spouse-turned-caregiver, who has a young child but is now also a caregiver to a returned Service member with an injury or mental health condition. Barbara Thompson, Director, Office of Family Policy/Children and Youth, Office of the Secretary of Defense, noted that more veterans with young children qualify for Veterans Administration benefits. The Department of Defense recognizes the opportunity to partner with the Veterans Administration in responding to the needs of military and veteran families with very young children.
In a conference session on Research and Resilience: Promoting Studies on Behalf of Military Families and their Very Young Children, Dorinda Williams, Director of ZERO TO THREE’s Military Family Projects, and Dr. Stephen Cozza, MD, Uniformed Services University of the Health Sciences, underscored the need for more research on the effects of military family life on infants and toddlers. Ms. Williams juxtaposed evidence from infant mental health and brain research on the importance of early experiences and quality of secure relationships in infant and early childhood development, with elements of military family life that could pose challenges for such development. These ranged from mild stresses to more problematic and traumatic challenges including frequent relocations, deployment and reintegration challenges, injury of a parent, parental mental health issues and parental death. Ms. Williams discussed the Coming Together Around Military Families Project at ZERO TO THREE, supported by the Department of Defense, as well as the Research and Resilience initiative launched in 2010, through support of the Iraq Afghanistan Deployment Impact Fund of the California Community Foundation. The latter initiative promotes a research agenda that specifically addresses the needs and interests of military families and their infants and toddlers.
Dr. Cozza discussed his research on addressing military family issues around combat injury and parental death. The audience did not hold back when he asked about their own experiences and concerns, speaking of the limited services available around young children of military families and providers’ need for evidence and resources to help them be more confident and capable in providing relevant supports and services.
Infant/Early Childhood Mental Health Consultations was another area where attendees could learn a great deal about what was going on in the field. Our correspondents wrote:
What’s Beneath the Behavior: Consultation Strategies to Reduce the Incidence of Child Expulsion
Session participants got a glimpse of Alaska’s approach to supporting positive behavior in early care and learning settings through Early Childhood Mental Health (ECMH) consultation and training approaches. Participants were hungry for answers regarding how to support the social competence of children in theory care. A lively Q&A occurred throughout the session, and the Alaska faculty were more than helpful in sharing how their ECMH consultation project had transformed the behaviors and attitudes of Early Childhood Education (ECE) professionals towards young children’s concerning behaviors in Alaska.
Faculty filled us in on ways to emphasize relationships as the entry point of building social emotional competence in young children and how to focus on the function and meaning of behavior before jumping to an “intervention”. Faculty gave great examples of children and teachers working towards positive early childhood mental health through their consultation and implementation of “What’s beneath the behavior” training. Alaska developed this training to promote ECE professional awareness of the importance of building positive relationships with, and creating quality environments for, young children so their mental health can flourish in our care.
Linking Research Practice and Policy: Lessons Learned in Early Childhood Mental Health Consultation Evaluations in Three States
Dr. Deborah Perry of Georgetown University, Ms. Barbara Parks of District of Columbia Department of Mental Health and Ms. Mary Mackrain of Michigan Department of Community Health, presented a robust workshop to nearly 100 participants about the application of mental health consultation models and practices in Maryland, Washington, DC, and Michigan. They reported on the research evidence supporting the importance of early childhood mental health consultation in early care and education and discussed two primary consultation formats, Child/Family Centered consultation and Programmatic. While each of the state models initially started with a child initiated, and child/family centered approach, all became involved in programmatic consultation, especially in the Washington, DC, sites. The sites differed in whether staff providing the consultations had to be licensed mental health clinicians. Only Michigan emphasized the birth to three age group, with positive outcomes in decreasing attention-related problems, reducing parental stress reports and increasing parent empowerment.
Discussing the 2009 Georgetown University study What Works, Dr. Perry shared that consultation was viewed as the catalyst or “the yeast” for achieving positive child and family outcomes and that adoption of a Systems Framework for Early Childhood Mental Health Consultation was a key element for success. Their studies indicated a significant proportion of mental health or developmental problems and serious gaps in statewide services. ECMHC had positive effects, but often consultants were brought into the process too late, and there needed to be a more streamlined and proactive process for mental health consultation. Final recommendations included continued tracking/monitoring, and increased and more effective parent/family involvement. Participants felt that policy efforts could focus on using current ECMHC research to inform the integration of mental health consultation into home visiting and other applicable programs supporting primary care relationships.
Building a Community of Caring
This session described the Baltimore Infants & Toddlers Program (BITP), an interagency program for families with young children who may be experiencing a delay in development or who have been diagnosed with a condition that is likely to affect development. Presenters Margo Candelaria and Jessica Lertora from the University of Maryland School of Medicine, and Tody Hariston-Fuller from BITP, spurred thoughtful conversation on the importance of collaboration in promoting the wellbeing of families with young children. Through collaboration in clinical practice, consultation, training, and research, the program has successfully established a trans-agency coordination of services for families with children age 0 to 5. Audience members echoed the important role collaboration plays in early childhood mental health services, with one listener noting that these type of programs are greatly needed in communities where funds are drying up, as cooperating with other agencies can maximize dollars to help these families. Building relationships across agencies, encouraging mentoring amongst professionals, and initiating formal and informal cross-trainings across agencies can bolster program support and success.
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