Rules of Engagement: Strategies for Engaging Teen Parents

1. Rules of Engagement: Strategies for Engaging Teen Parents National Partnership for Community Leadership 11th Annual International Fatherhood Conference June 17, 2009 Mark Boss Young Fathers Program Coordinator The Generations Program Children’s National Medical Center

2. Healthy Generations • Comprehensive Teen-tot program • Primary care and family planning for teen parents (up to age 21) and their children • Case management (including routine and specialty appointments) • Psychological evaluation and treatment • Home visitation

3. Generations • 526 families • 182 fathers • Ages 13-25 • Children’s Health Center, CNMC • Good Hope Road • THE ARC

4. Generations Statistics • Repeat pregnancy rate = 9% • Rapid repeat pregnancy rate = 3% • 2 yo immunization rate = 91% • EPSDT screening = 94% • 82% teens in school or graduated

5. Teen Birth Rate Statistics • From 1991-2005, birth rates for teens aged 15-19 declined 34% to a record low • Between 2005 and 2006, the teen birth rate increased 3%, the first increase in 15 years • In 2007, the teen birth rate in the US increased 1% • The U.S. teen birth rate remains notably higher than the rates in other industrialized countries

6. The Increase in 2006 and 2007 • The birth rate increased 1% for those aged 15-19 • The birth rate for those aged 10-14 remained unchanged • The teen birth rate declined 2% for Hispanic teens • The teen birth rate increased: • 2% for non-Hispanic whites, • 1% for non-Hispanic blacks, • 2% for Asian/Pacific Islander teens and • 7% among Native American teens. • In 2006 only three states and the District of Columbia reported declines in teen birth rate

7. Teen Birth Rates per 1,000 Girls Aged 15-19, 2006 United States 41.9 StateRateRank • Maryland 33.6 16 • Virginia 35.2 19 • District of Columbia 48.4 37 • Prepared by the National Campaign to Prevent Teen and Unplanned Pregnancy, January 2009 Source for rates: Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Menacker, F., Kirmeyer, S. & Matthews, T.J. (2009). Births: Final data for 2006. National Vital Statistics Reports,57 (7). Ranks calculated by the National Campaign to Prevent Teen and Unplanned Pregnancy.

8. Why do we care about teen parents? Risks • Parents • Children

9. Risks for Teen Parents • Less likely to receive early prenatal care (mothers) • More likely to be victim of violence • Less likely to complete school • Less likely to attain economic self-sufficiency • Increased dependence on government support

10. Risks for Children born to Teen Parents • Increased incidence of • Low birth weight • Premature birth • Developmental disabilities • Twice as likely to be abused • Twice as likely to be placed in foster care • More likely to repeat a grade and less likely to graduate from high school • More likely to live in poverty • More likely to be teen parents

11. The Adolescent Brain • The Adolescent Brain: MRI studies show that the adolescent brain exits adolescence different than when it entered • Pre-frontal Cortex is the last part of the brain to develop, still maturing during adolescence • Prefrontal cortex: Impulse control, planning, imagining consequences and decision making

12. The Adolescent Brain • On MRI study: identifying emotions expressed on faces • teen brains activated the amygdala (danger, threat) • adults activated the prefrontal cortex (reason, judgment) • Adult responses more intellectual • Teens responses from the gut

13. First… • Teens want to be good parents • With support, teens can be good parents • Though they are parents, developmentally, they are still adolescents • Fathers are important

14. What About Young Fathers? • Perceptions of Young Fathers • Stereotypes • Social Service Policy Tends to Ignore Fathers Generally (Until Recently) • Young Fathers Do Not Use Services Even When Available • Influence on Father Involvement

15. Young Fathers: Challenges • Age • Education • Income Projections • Correlations to Criminal Activity • Involvement in Decisions • Access to Baby • Relationship Issues • Mother • Extended Family • Peers

16. Young Fathers: Opportunities for Growth • Engaging young fathers can improve outcomes • Many young fathers want to be involved • A recent study of Generations families found 46% of fathers were highly involved during baby’s first year, 40% were involved when child was age 2 • Involvement • Accepting Responsibility • ‘Being There’

17. Young Parents • Face many obstacles • Need knowledge and resources about child development and effective parenting • May have a trauma history and/or stressful family histories: An estimated 60% of teen first pregnancies are preceded by experiences of molestation, rape, or attempted rape • Have high levels of depression • Many from the DC area have at least one parent with a drug addiction and/or incarceration

18. Working with Young Parents • Connect before you Correct • Providers as Models • Providers as Partners with Young Parents • Family/Social Support System • Living Situation

19. Working with Young Parents • Address needs of adolescent as well as child • Emphasize Family Planning • Explore teen’s feelings and goals regarding what is important to them • Focus on education/goals • Include Fathers • Address relationship/co-parenting dynamics

20. Strengthening Teen Parenting Skills • Addressing Risk Behaviors • Be open and direct without being judgmental • Address collaboratively • Neither condone nor condemn • Reframe child’s behaviors based on age/stage of development

21. and Last… • Teens want to be good parents • With support, teens can be good parents • Though they are parents, developmentally, they are still adolescents • Fathers are important

22. Generations • Mark Boss, Father’s Program Coordinator • 202-476-3097 • mboss@cnmc.org

23. Other Resources • Washington Hospital Center: Teen Alliance for Prepared Parenting (TAPP)-Obstetric care • Phone: 202-877-0747 • DC Campaign to Prevent Teen Pregnancy • www.teenpregnancydc.org • National Campaign to Prevent Teen Pregnancy • www.teenpregnancy.org