A Look at Fond du Lac County SPROUT Partnership

1. A Look at Fond du Lac CountySPROUT Partnership Presented by: Dr. Matt Doll, Diane Fett, Matricia Patterson & Andrea Welsch

2. Overview of Presentation The Early Years Matter (Matt) A Community Plan (Diane) Collaborative Team (Matricia) Collective Impact (Andrea)

3. The Early Years Matter

4. The Earliest Years Leave a Permanent Imprint During a child’s first three to five years: Up to 90% of a child’s brain development takes place Patterns of behavior are formed A child’s learning capacity is firmly and broadly established “The later in life we attempt to repair early deficits, the costlier the remediation becomes.” - James J. Heckman, 2000 Nobel Laureate in Economics

5. Five Things To Know Neurodevelopment Processes Genetic predisposition exasperated by environmental influences (Nature And Nurture) Long term negative outcomes for physical health, emotional health and society for bad things happening to children. Long term positive outcomes when good things happen, potentially protective as well. These issues impact us all; no social, economic or cultural group is immune.

6. Across the Lifespan Intrauterine Experience - Heart Disease, Obesity, Diabetes, Pollution, Mental Illness. Adverse Childhood Experiences (ACE) - long-term changes in brain structure and function. 67% of all of us (87% < 1 ACE). Mortality - Individuals with an ACE score of 6 and higher had a lifespan almost 2 decades shorter than seen in those with an ACE Score of 0 but who otherwise have similar characteristics.

7. Social and Emotion Health is Directly Impacted by Experiences

8. Adverse Childhood Experiences (ACEs) Neuroscientists have linked childhood maltreatment to long-term changes in brain structure and function. Stress hormones interfere with mylenation: impacting the connective tissue between hemispheres - logical/emotional state lacks integration. Parts of brain responsible for affect regulation, learning and memory. Type of abuse: Verbal Abuse- Auditory Cortex; Witnessing Domestic Abuse-Visual Cortex

9. Stunning difference between a brain with proper stimulation and one that has been deprived. - Bruce Perry, Baylor College of Medicine

10. Serve and Return (1:42 min) http://www.youtube.com/watch?v=m_5u8-QSh6A Process by which attachment forms Can be taught. High jacked by Media? How would you know what to do when you have never experienced it? How would you know what not to do if it was all you knew?

11. Attachment (still face 2:49) http://www.youtube.com/watch?v=apzXGEbZht0 Maternal Depression/Mental Illness Impact on Attachment is across the lifespan. Sensitive periods. Estimates of secure attachment in general population between 55-65% About 40% of children insecurely attached. As high as 90% in some impacted populations. Inability to form quality relationships or have empathy for others.

12. Socially deprived cohort of mothers With High Mentalization: 10/10 secure children With Low Mentalization: 1/17 secure children Mentalization confers resilience: ability to recognize your own and others’ mental states, and to see these mental states as separate from behavior

13. Trauma and early attachment patterns determine brain development. Clare Pain, M.D.Bessel A. Van der Kolk, M.D.Martin H. Teicher, M.D., Ph.D.MaryleneCloitre, Ph.D.Judith Herman, M.D. National Child Traumatic Stress Network

14. Trauma & Attachment Theory of Change (5:18 min) http://www.youtube.com/watch?v=urU-a_FsS5Y Personal Responsibility? (1:01 min) http://www.youtube.com/embed/RBqjZ0KZCa0?showinfo=0&rel=0&hd=0FsS5Y

15. Why It Matters Until now, these persistent effects were “hidden” from the view of both neuroscientists and public health researchers This is no longer the case. In fact, with this information comes the responsibility to use it. If we can think long term instead of short term, our community’s social, emotional, health and economic welfare will benefit.

16. In Other Words… Communities need to build their capacity to deliver trauma-informed care services to achieve safety, permanency and well being for their children and families and develop community building activities to reduce ACES over the long term (Trauma Exposure Among Select Wisconsin Families in the Child Welfare System 2008-2010) Root Cause Return on Investment Measurable Goals and Outcomes Cradle to Career Manufacturing Graph Lean 6 Sigma Processes “Unemployable Populations” Skilled Worker Shortages

18. A Community Plan

19. We finally know… What Nurses have known all along What Home Visitors have long suspected What the Health Profession has been trying to tell us… This is bigger than any one of us There are no quick fixes

20. Taking What We Know and Changing What We Do A healthy community rethinks business as usual Rolls up its sleeves, Works smarter, not harder, Works together, not alone, Uses research and science as a guide

21. The Beginning: A Look at our History The Wisconsin Alliance for Infant Mental Health connection Department of Health, Division of Public Health 1 of 3 Communities Chosen Small Planning Group Formed

22. 1st Summit: October 17, 2008 Broad Sponsorship Introduction of Infant Mental Health Concepts 85 people attended Committees were formed

23. Defining Infant Mental Health Infant Mental Health is synonymous with healthy social-emotional development including the developing capacity of a child to: Experience, regulate, and express emotions; Form close interpersonal relationships; and Explore the environment and learn – all in the context of family, community, and cultural expectations for young children (Zeenah, Stafford, Nagle, & Rice, 2005)

24. Strengthening Each Child’s Capacity Trust Regulate and Express Emotions Form Close and Secure Relationships Identify Feelings Empathy Self confidence Curiosity Motivation Persistence Self Control

25. Focus of Work Centers on the Social and Emotional Foundations for Early Learning The Pyramid Model

26. OUR VISION Every Fond du Lac County child will have his/her social and emotional developmental needs met within the context of family, culture, education, and community. It Started With a Vision The Infant and Early Childhood communities of Fond du Lac County will strengthen its ability to support the social and emotional health of young children with Nurturing and Responsive Relationships, High Quality Supportive Environments, Targeted Social and Emotional Supports and Intensive Interventions. OUR MISSION

27. 2nd Summit: October 26, 2010 The Plan is Shared Presentations by law enforcement, elected officials, business and others, about the importance of the early childhood and received Plan endorsement from many agencies Committee support expanded

28. 2011: The Partnership is Formed Brown County United Way – Community Partnership presented their model to community members at the UW-Fond du Lac Campus The Fond du Lac County Community Partnership for Young Children held its first meeting The Fond du Lac School District Comprehensive Service Integration – Element 5 Committee merged with SPROUT Committee work began implementation of the SPROUT Plan

29. The Name: SPROUT Partnership Supporting Positive Relationships so Our Children Under 6 can Thrive

30. A Collaborative Team

31. KEEP FOCUSED OUR GOAL: All Fond du Lac County children are healthy, nurtured, safe and successful from birth to school entry. In turn, we build a strong community, a strong work force, and reduce crime and poverty. Science finally catches up with what we have known all along: Relationships matter Early experiences matter Adverse Childhood Experiences impact health and potential

32. Council Representatives Structure, Support, Guidance Children & Caregivers

33. Council Representatives Supporters Structure, Support, Guidance Children & Caregivers

34. Children’s Museum • Library • Faith Based • WIC • Public Health • Early Childhood Education • Higher Education • Media • Business • United Way • Government • Legislators Parents Physicians / Health Child Care Head Start / Birth to 3 Social Services Housing / Shelter Domestic Violence Services Law Enforcement Child Welfare Mental Health Council Reps

35. Council Representatives Structure, Support, Guidance Administrators Children & Caregivers

36. Council Representatives Executors of Plan & Embracers Structure, Support, Guidance Children & Caregivers

37. Funding • Coordination • Engagement • Structure / Commitment • Champions / Decision Makers • 100’s Impacted / Evaluation • Evidence Based • Recognition Funding Coordination & Coordinator Role Engagement Collective ImpactChallenges Successes

38. Collective Impact Effecting Change

39. Base of Pyramid Nurturing and Responsive Relationships: People who touch the lives of infants, young children and their families know how to foster healthy social and emotional development. Supportive responsive relationships among adults and children is an essential component to promote healthy social and emotional development

40. Nurturing and Responsive Relationships

41. Coordinated delivery of training Targeting parents and caregivers Focusing on healthy interactions for social emotional development. Embedded skills such as literacy, resiliency, language, and learning through sensory-motor activities. Breaking the Cycle: July 2014 Zero to Three Developed and distributed a County Resource Guide Parents, Caregivers, and Providers Comprehensive list of resources available within our community. Key Projects of N&RR Committee

42. Resource Guide Excerpt

43. The Second Layer High Quality Supportive Environments: All children will have high quality supportive environments, including their own homes. High quality early childhood environments promote positive outcomes for all children.

44. Supportive Environments

45. Coordinated delivery of training to childcare centers Breast Feeding Friendly Centers  Targeting training for 14 centers in 2014 Quality Focus: Activities to support Young Star Ratings PBIS - Behavioral System (originated in school district) Promoting effective use and access to ASQ screens Goal  Periodic Screens (18 mos) Education across Council Creation of WIC screening sites Critical access points (pediatricians, homeless shelters, domestic abuse) Key Projects of SE Committee

46. Third Layer Targeted Social Emotional Supports: There will be a coordinated community approach for teaching social and emotional skills to ensure children’s school readiness. Systematic approaches to teaching social skills can have a preventive and remedial effect

47. Targeted Social and Emotional Supports

48. Coordinated delivery of Conscious Discipline Curriculum Targeting child care centers and parents 80 participants, 6 child care centers, 1 in home provider Evidenced Based Targeted Parental Supports Parents going through Paternity Cases Access to ASQ screens to homeless & families experiencing domestic abuse Key Projects of TSES Committee

49. The Top of the Pyramid Intensive Interventions: Children with emerging mental health symptoms will receive evidence based treatment by trained and knowledgeable providers in partnership with parents and other caregivers resulting in optimal development. Families and children will feel supported by competent, knowledgeable and sensitive professionals and caregivers. Assessment based intervention that results in individual behavioral support plans

50. Intensive Interventions