Continuity of Care in Infant and Toddler Programs:

1. 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.

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

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

4. 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

5. 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

6. 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)

7. 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

8. 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

9. 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

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

11. 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

12. 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?

13. What’s Next? Lessons Learned From Teachers

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

15. 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

16. 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

17. 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

18. 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

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

20. Lessons Learned for Training: • Trainings on routines and limits …

21. 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!

22. 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

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

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

25. 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